During adolescence, it may take a while for ovulation to occur regularly and sometimes periods even stop for several months. A woman should always check for pregnancy if her period is unduly late, although any stressful situation, including anxiety over the possibility of pregnancy, can delay a period. Ovulation abnormalities are usually the cause of very irregular or frequently skipped menstrual cycles. In women over 40 who are approaching menopause ovulation becomes irregular and may even stop for several months.

Symptom

Amenorrhea is the absence of menstruation. It is usually divided into two categories: primary amenorrhea, in which a girl does not even start to menstruate; and secondary amenorrhea, in which periods that were previously regular become significantly delayed or absent.There is such a thing as having no menstrual cycle. However, if you don't begin menstruating by the age of sixteen, there are some birth defects and potentially serious conditions that can prevent menstruation. It's important to diagnose these as soon as possible. There's usually a hormonal imbalance that is easily remedied with oral contraceptives or hormonal supplements. If you're menstruating regularly, and are between the ages of twenty and forty, it's unusual to simply stop menstruating. If this does occur, pregnancy, obesity (fat cells make more estrogen than your body needs, which interferes with ovulation), food refusal (anorexia nervosa), or vomiting/purging (bulimia) are common causes. When the problem is starvation-related, a protective mechanism is triggered in the body. When the female body is malnourished, it stops ovulating because it can't sustain a pregnancy. an aboriginal tribe in Australia demonstrates this unique protective mechanism. Women of that particular tribe menstruate only at certain times of the year, when the food cycle is abundant. Athletes, again, may experience amenorrhea, and either an overactive or underactive thyroid gland can cause it. Progesterone supplements will remedy it. If you skip periods, medication may be prescribed in either progesterone or oral contraceptive form.

Treatment

Treatment depends on the cause of the amenorrhea. If it is caused by another systemic disorder, normal menstrual function usually returns after the primary disorder is treated. For example, if the primary disorder is hypothyroidism, then amenorrhea will be cured when the thyroid disorder is treated with thyroid supplements. 

Pituitary tumors are usually treated with bromocriptine, a drug that inhibits prolactin secretion. Surgery removal may also be suggested. Radiation therapy is usually reserved for situations where other medical or surgical treatment regimens are not successful. 

Hormonal supplements are commonly utilized for those women who do not bleed in response to the progestin challenge test. Daily estrogen supplements are given in conjunction with intermittent progestin for 10 to 14 days per month every 1 to 3 months. 

Women who bleed in response to the progestin challenge test are anovulatory--they do not menstruate because they do not ovulate. This common cause of amenorrhea is treated by inducing ovulation with medication such as clomiphene citrate (Clomid)--but only if the patient desires pregnancy. 

Young women with primary amenorrhea, found to be caused by developmental abnormalities, may require hormonal supplementation, surgery, or both. In any case, psychosocial support and counseling for the patient and family is necessary to address specific concerns and provide guidance regarding anticipated sexual development.