Amenorrhoea refers to the absence of menstrual periods in someone of reproductive age. It can be divided into two main types:
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Primary amenorrhoea: Menstruation never begins, often due to congenital (from birth) conditions.
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Secondary amenorrhoea: Periods previously occurred, but have stopped for an extended time.
Among these, secondary amenorrhoea is far more common and is especially relevant for people living with Polycystic Ovary Syndrome or PCOS.
What Causes Secondary Amenorrhoea?
Secondary amenorrhea is the absence of menstrual periods for at least 3 cycles in individuals with previously regular cycles or for 6 months in those with irregular cycles.
It’s essential to first rule out pregnancy. When pregnancy isn’t the cause, other reasons include:
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Polycystic Ovary Syndrome (PCOS): PCOS is one of the leading causes of irregular periods and amenorrhoea. In PCOS, higher levels of androgen (male hormone) and insulin resistance disrupt the usual menstrual cycle, often leading to skipped or absent periods.
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Hyperprolactinemia: When there is too much prolactin in the blood. This may be functional if you are breastfeeding, or it may not be.
- Primary ovarian insufficiency: The dysfunction or depletion of ovarian follicles before the age of 40 can cause menstruation to stop.
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Eating disorders: Low body weight and poor nutrition, as in anorexia nervosa or bulimia, can stop the menstrual cycle.
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Excessive exercise: High levels of physical activity or training can put stress on the body, temporarily disrupting the menstrual cycle.
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Emotional or physical stress: Stress affects the hypothalamus in the brain, disrupting signals that regulate hormone and menstrual cycles.
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Drug interactions and medical conditions: Some medications, thyroid or pituitary disorders, and other health issues can block the signals that trigger menstruation.
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Other causes: Weight gain, sudden travel, and rare conditions like Asherman’s syndrome (uterine scarring) can also cause missed cycles.
What Can Amenorrhoea Lead To?
When periods are absent for months, it’s more than just a change in routine. Prolonged amenorrhoea can have health consequences:
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Infertility: Without regular ovulation and cycles, conceiving a child can be much more difficult for people with PCOS or other hormonal causes.
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Bone health: Low bone density is highly prevalent in amenorrhoea. The lack of a period may weaken bones, increasing the risk for osteoporosis.
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Cardiovascular health: Amenorrhoea, including exercise-induced, may affect the heart and blood vessels, increasing the risk of cardiovascular disease (CVD). While still controversial, it’s essential to understand this risk as PCOS cysters already face an increased risk of CVD.
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Pelvic pain: If amenorrhoea is due to anatomical issues or adhesions, pain or discomfort in the pelvic area can sometimes occur.
PCOS and Your Periods
PCOS is a common endocrine cause of amenorrhoea in people of reproductive age. Its underlying hormonal imbalances—high androgens and insulin resistance—interfere with the follicle maturation and ovulation, so periods may be missed, infrequent, or irregular. If left untreated, PCOS-related amenorrhoea can contribute to challenges with fertility and long-term health.
What To Do If Your Periods Stop
If your cycles have stopped for several months or have become unusually irregular, it’s time to see your healthcare provider. With a few simple tests, the cause can often be identified, and a treatment plan can be created to help restore hormonal balance and support overall health.
Understanding amenorrhoea is key to managing PCOS and improving your wellbeing. Periods are more than a monthly event: they’re a window into your hormonal health. If your cycle stops, don’t hesitate to seek gentle, supportive care—answers are available, and you’re never alone.
From PCOS to perfect health, with love,
Dr. Rebecca Harwin
The PCOS Expert
Chiropractor & Bestselling Author of
Conquer Your PCOS Naturally
www.ConquerYourPCOSNaturally.com
P.S. For more success strategies and scientific secrets, head to our Facebook page and hit ‘like’. There is so much more I have to share with you to balance your PCOS hormones!
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