Secondary Amenorrhoea
Secondary amenorrhoea is the absence of expected menstrual periods after they have previously occurred. It is a symptom with several possible causes, not a diagnosis by itself.
Key points
- Pregnancy should be excluded first, even when another explanation such as stress, weight change or contraception seems likely.
- Cycle history, medicines, nutrition, exercise, thyroid and prolactin tests and signs of androgen excess guide further assessment.
- A withdrawal bleed after a progestogen does not treat every cause or establish normal ovulation, fertility or oestrogen status.
Catalogue matches do not identify why periods stopped or indicate that hormone treatment is safe.
Which causes are commonly considered?
Pregnancy, polycystic ovary syndrome, hypothalamic suppression from inadequate energy intake, thyroid disease, raised prolactin, ovarian insufficiency and uterine scarring can interrupt periods. Headache, vision change, hot flushes or excess hair growth offer additional clues.
When are hormones used?
Medroxyprogesterone or dydrogesterone may have diagnostic or treatment roles in selected cases. Pregnancy possibility, clot risk, migraine, liver disease and the underlying hormone pattern affect suitability. See women’s health.
When to seek urgent care
Seek urgent care for a positive or possible pregnancy with one-sided pelvic pain, shoulder pain, heavy bleeding, fainting or marked dizziness. Sudden severe headache or new vision loss also needs urgent assessment.