menstrual cycle

Primary and Secondary Amenorrhea - What are the causes of missed periods?

  • 4.8   (8 Votes)
Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 28 May 2019 - Written by Dr. Weena Krutsawad - MD, Diploma, Diploma - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

Amenorrhea is of two types i.e. Primary Amenorrhea and Secondary Amenorrhea. Missed periods can be seen in pregnancy, breastfeeding, and menopause. Other reasons for delayed periods in women are obesity, excessive stress, and performance of exercise, presence of PCOD in women.

Amenorrhea is a condition means an abnormal absence of menstruation cycles that comes monthly or simply long time missed periods. There are various reasons that could lead to amenorrhea be it genetic, physiological, hormonal or deteriorating health or malnutrition. There are certain ways in which you can try to regularize delayed menstruation cycle on a monthly basis. (3) This condition of amenorrhea or irregular periods is broadly classified into two main categories:  primary amenorrhea and secondary amenorrhea. (1)

What is Primary Amenorrhea:

Primary amenorrhea is a medical condition in young adolescent girls or teenage girls those who have not yet experienced their first menstrual period cycle up till the age of 16 years, that is, even after hitting puberty age. (2)

Underdeveloped Sexual Organs:

In some conditions or cases, genetic damage or defect during fetal development could lead to the medical condition of amenorrhea in young girls and teenage girls. Malfunctioning of ovaries or poorly dysfunction of reproductive organs can come in the way of menstruation. (4)

A reproductive defect in the reproductive system could mean that some part of the system like the cervix, uterus or the vagina didn’t form properly to function at their respective time, and that's the reason why a physiological process of menstruation cycle didn’t take place at the right time.

Problems in the central nervous system:

Malfunctioning of the pituitary gland, which controls most of the hormonal functions of your body can delay the period cycle or mess up one’s menstrual period cycle. In addition to this, an injury to the brain or the spinal cord could also be a big reason for primary amenorrhea condition in young girls. (5)

Secondary Amenorrhea:

This medical condition of Amenorrhea is linked up with women who suffer from long time missing periods due to some gynecological problems, complications of medications, (6) malfunctioning of the glands or hormonal disturbance in the body. Secondary, amenorrhea is also been seen in women who had been menstruating normally and now suffers from missing periods for a long time due to the other medical condition mentioned here.


The time when the missing period seems normal that is during: (7)

1. Pregnancy:

During the pregnancy phase, the fetus develops and grows inside the womb of the woman, which simply means that the uterus lining doesn’t shed out and this prohibits menstruation in women. (8)

2. Breastfeeding:

Breastfeeding helps the new mother to delay menstruation. It works as a natural method of family planning by delaying menstruation or period cycle.

3. Menopause:

Menopause is the phase between 45-50 years of age that is seen with a total absence of menstruation cycle.


Sometimes some health conditions can also disrupt normal menstrual periods and become a cause of secondary amenorrhea in women. Polycystic ovarian syndrome or PCOS is a lifestyle condition that affects ovulation and chances of conceiving. In this condition of PCOS, the woman’s body produces more androgens than usual, which gives rise to fluid-filled cysts inside the ovaries might be painful sometimes and interferes with the release of the eggs that is needed to fertilization. Women who are suffering from PCOS either suffer from amenorrhea or have irregular periods with unusual bleeding. This medical condition also affects a woman’s fertility vastly. (9)

Medications and treatments:

Missing period or long delayed menses could also be a side-effect of certain medications or an outcome of some medical procedure or treatments, like Contraceptives. Many women show concern about delayed or missing periods after discontinuing oral birth control pills. Exceptionally, intra-uterine devices can also lead to amenorrhea- primary or secondary. Some medications may also be a concern like antidepressants, blood pressure drugs allergy pills can cause more severe effects. (10)

Written by

Dr. Weena Krutsawad

MD, Diploma, Diploma
Gynecologist, Reproductive Endocrinologist
Dr. Weena Krutsawad successfully is an infertility specialist who has completed MD from Faculty of Medicine, Chulalongkorn University, Thailand, Bangkok in 2007. She has also completed Diploma of Obstetrics and Gynecology and Diploma of Reproductive Medicine from The Medical Council of Thailand in 2011 and 2013 respectively. Dr. Weena Krutsawad specializes in IVF, IUI, Reproductive Endocrinology and Menopausal Care. Find more information about Dr. Weena Krutsawad at


  1. ^ Amenorrhea - Cleveland Clinic, 28 May 2019
  2. ^ Amenorrhea Treatments, 28 May 2019
  3. ^ Primary Amenorrhea - Pituitary Network Association, 28 May 2019
  4. ^ Primary amenorrhea - Medline Plus, 28 May 2019
  5. ^ Nervous System Problems - Uofm Health, 28 May 2019
  6. ^ Amenorrhea Diagnosis and Management, 28 May 2019
  7. ^ Amenorrhea - Mayo Clinic, 28 May 2019
  8. ^ Absent Menstrual Periods - Secondary, 28 May 2019
  9. ^ Signs and Symptoms for Gynecologic Problems - ariahealth, 28 May 2019
  10. ^ Medication and Counseling Treatment - Samhsa, 28 May 2019
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Arpita Raja

My daughter had her cycles at the age of 11 for the first time. and after that, she faced pause for one year and it started again in the normal way. I was so tensed about it, But thank god it's normal.

Oct. 13, 2018, 10:07 a.m. 4.5

Yasmeen Ansari

Having some sort of medication can also influence or pause the periods. its completely normal and the chances of Amenorrhea is very less.

Oct. 6, 2018, 8:10 a.m. 5.0


My cycles are irregular, does that mean I have amenorrhea?

Sept. 18, 2018, 7:22 a.m. 4.5


Please suggest me with some medicine for amenorrhea?

Aug. 28, 2018, 11:15 a.m. 5.0

Palak Rana

My mother is 51 years old and she still has her cycles. Is it completely normal??

Aug. 16, 2018, 11:55 a.m. 5.0

Sakshi Agarwal

I am missing my periods for 6 months and I am just 20. I am afraid that I might not conceive in future.

June 13, 2018, 4:16 p.m. 5.0

Surbhi Jaiswal

We all women must take iron and vitamins in good amount. I guess it's only your fault that we do not take care of our body and take it so lightly. Fresh fruit juices, green vegetables and whole grains should be our priority diet every day.

Oct. 31, 2017, 5:09 p.m. 5.0

Ericka Grigsby

Stress can also cause missed periods. Stress acts on hypothalamus and it prevents the signal transferring from brain to the reproductive parts and vice-versa. Over thinking or taking too much stress can cause delay in periods.

Oct. 31, 2017, 5:07 p.m. 4.5


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