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Absent periods (amenorrhoea)

Amenorrhoea · Chybějící menstruace (amenorea)

female only

What it is

No period by 15, or none for three months — pregnancy first, then weight, stress, exercise, thyroid, prolactin or the ovaries.

Symptoms & signs

  • No periods
  • hot flushes or vaginal dryness (low oestrogen)
  • excess hair or acne (PCOS)
  • milky nipple discharge (high prolactin)
  • headache or changed vision (pituitary)

🚩 Get help if…

  • call 112 / 911 now Missed period with one-sided belly pain, bleeding or fainting
  • see a doctor soon No periods by age 15 or no breast growth by 13
  • see a doctor soon Milky nipple discharge, headaches or changes in vision
  • see a doctor soon Very low weight, heavy exercise or eating problems

Where it strikes

Medical treatment

  • Pregnancy test
  • FSH, LH, oestradiol, prolactin, TSH, testosterone
  • treat the cause — weight restoration, thyroid or prolactin treatment
  • hormone replacement to protect bone
  • imaging for an anatomical cause (absent womb, Asherman's)

Natural & lifestyle

  • Regain weight and eat enough for the training done
  • cut back extreme exercise
  • stress management
  • calcium and vitamin D

Emerging & experimental

  • Kisspeptin for hypothalamic amenorrhoea
  • leptin therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Vitex (chasteberry) — lowers prolactin a little; small trials mixed evidence
  • Acupuncture — small studies; untested for most causes anecdotal / traditional
  • Seed cycling — no evidence; hormones do not follow seeds anecdotal / traditional

ICD codes