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Amenorrhea is a reflection of some failure in the integrally interconnected neuroendocrine feedback loop between the hypothalamus, the pituitary gland, the ovaries, and the uterus which control the menstrual cycle. However, amenorrhea is not itself a disease.
There are two categories of amenorrhea, primary and secondary amenorrhea. Primary amenorrhea is the delay or failure of a young woman to start menstruating upon reaching the age of 16. The course of puberty and the age of menarche vary so widely that there should be no worry until the girl reaches the age of 16, provided that there are other signs of early pubertal changes (growth spurt, underarm or pubic hair, breast development). Treatment for primary amenorrhea usually is not undertaken until the age of 18.
Secondary amenorrhea refers to the lack of menstruation that occurs in women who had previously been menstruating but then ceases menstruation for at least three cycles. It is much more common than primary amenorrhea. However, unless symptoms are extreme or there is another underlying problem, such as inability to conceive, there is no pressing need for treatment.
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