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2 Amenorrhoea Types & 10 Reasons You Should Not Ignore Missed Periods

January 16, 2023

Amenorrhoea (missed periods) is one of the commonest reasons women attend the clinic. For simple classification, we organise amenorrhea into two main types, which you will learn about below.

A dry sanitary towel during missed periods

Difference between Primary and Secondary Amenorrhoea

Primary amenorrhoea describes a woman who has never had periods (from birth).

Secondary amenorrhoea is absent (missed) periods when you previously had periods.

When a woman goes without her period for 3-6 months, having previously had normal periods, that is known as secondary amenorrhoea.

If she initially had irregular or infrequent bleeding and the period stops for 6-12 months, that is secondary amenorrhoea.

Having missed periods is a medical condition that needs investigating. It has a wide variety of causes.

Missed periods may happen with other symptoms like pelvic pain

Causes of Missed Periods from Secondary Amenorrhoea

Hormonal Contraception

Using Contraceptives (extended-cycle combined oral contraceptives, injectable progesterone, implantable etonogestrel [Nexplanon®], and levonorgestrel intrauterine system [Mirena®] may cause amenorrhea).


Natural menopause or Early menopause (symptoms include: Hot flashes and vaginal dryness) lead to the end of your periods. Before it sets in, there are missed periods as the cycle becomes irregular until the periods eventually stop.  

Brain Tumour

Some types of brain tumour – specifically a pituitary tumour can lead to amenorrhea. Some symptoms include: headaches, visual disturbances, or galactorrhoea – producing breast milk in the absence of pregnancy and breastfeeding. 

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (symptoms include irregular periods, acne, excess hair growth and weight gain). Please check out my video here to learn more about PCOS and natural treatments

Keeping a menstrual diary is a good way to help manage missed periods from secondary amenorrhoea

Conditions affecting Brain/Hormone function

Problems that affect the brain’s and reproductive hormones’ normal functioning, e.g. high prolactin and abnormal FSH/LH levels: Stress, depression, weight loss, disturbance of perception of weight or shape, level of exercise, and chronic (long-term illness) like kidney or heart failure).

Endocrine Conditions

Other hormone conditions like Thyroid and other endocrine diseases.

Previous Surgery

Previous surgery or obstetric procedures may lead to womb adhesions and scarring – for example, surgical termination of pregnancy.

Cancer Treatment

Your periods may stop after having chemotherapy or radiotherapy to the pelvic area – for conditions like cervical cancer. Any of these can lead to early menopause from premature ovarian failure. 

Brain Injury

Other conditions that can lead to early menopause relate to the brain and damage the organs in the brain which produce reproductive hormones. Examples are head injury, radiotherapy for brain tumours, and a condition known as Sheehan’s Syndrome. In Sheehan’s syndrome, a woman who just delivered a baby and experienced heavy blood loss suffers damage to her pituitary gland in the brain from lack of oxygen. It is a potentially life-threatening condition, but other symptoms are problem breastfeeding and the absence of menstruation.

Image with 3 sanitary towels with dark red objects on the surface. Missed periods are caused by several different conditions

Non-hormone drugs

Apart from contraception, some other drugs can affect and stop menstruation. Examples are antipsychotics, which can cause increased prolactin levels) and illicit drug use (primarily cocaine and opiates, which can cause your sex glands to produce little or no sex hormones, i.e. hypogonadism).

Primary Ovarian Insufficiency

Finally, a condition known as Primary Ovarian Insufficiency can happen. In POI, the ovaries do not work as they should. It is different to premature menopause, and it causes women to stop having their periods before the age of 40 years. 

It can also run in families, so if a woman has a close relative with POI, she is at a higher risk of developing this condition.

Managing Missed Periods

These are some conditions that could affect you and lead to delayed periods. It’s important to keep track of your menstrual cycle. You can do so with an app or a simple diary. Including other events or symptoms that happen around the time of your menstrual cycle can provide a clue for the cause and a quicker diagnosis.

More Reading

Editing by AskAwayHealth Team


All AskAwayHealth articles are written by practising  Medical Practitioners on various healthcare conditions to promote quality healthcare. The advice in our material is not meant to replace a qualified healthcare practitioner’s management of your specific condition.
Please contact a health practitioner
 to discuss your condition, or reach us directly here.

Image Credits: Canva

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