Why menses stops

Women may wish to do a home pregnancy test before they see the doctor. Doctors first ask about the medical history, including the menstrual history.

Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of amenorrhea and the tests that may need to be done see table Some Causes and Features of Amenorrhea Some Causes and Features of Amenorrhea Having no menstrual periods is called amenorrhea.

Amenorrhea is normal in the following circumstances: Before puberty During pregnancy While breastfeeding read more. For the menstrual history, doctors determine whether amenorrhea is primary or secondary by asking the girl or woman whether she has ever had a menstrual period. If she has, she is asked how old she was when the periods started and when the last period occurred.

She is also asked to describe the periods:. This information enables doctors to rule out some causes. Information about delayed puberty and genetic disorders in family members can help doctors determine whether the cause is a genetic disorder. Doctors ask about other symptoms that may suggest a cause and about use of drugs, exercise, eating habits, and other conditions that can cause amenorrhea.

During the physical examination, doctors determine whether secondary sexual characteristics have developed. A breast examination is done. A pelvic examination is done to determine whether genital organs are developing normally and to check for abnormalities in reproductive organs.

A milky discharge from both nipples: Possible causes include pituitary disorders and drugs that increase levels of prolactin a hormone that stimulates milk production. Headaches, hearing loss, and partial loss of vision or double vision: Possible causes include tumors of the pituitary gland or hypothalamus. Development of masculine characteristics, such as excess body hair, a deepened voice, and increased muscle size: Possible causes include polycystic ovary syndrome, tumors that produce male hormones, and use of drugs such as synthetic male hormones androgens , antidepressants, or high doses of synthetic female hormones called progestins.

Hot flashes, vaginal dryness, and night sweats: Possible causes include premature menopause, a disorder that causes the ovaries to malfunction, radiation therapy, and use of a chemotherapy drug. Shakiness tremors with weight loss or sluggishness with weight gain: These symptoms suggest a thyroid disorder. If pregnancy is ruled out, other tests are done based on results of the examination and the suspected cause. If girls have never had a period primary amenorrhea and have normal secondary sexual characteristics, testing begins with ultrasonography to check for birth defects that could block menstrual blood from leaving the uterus.

If birth defects are unusual or difficult to identify, magnetic resonance imaging MRI may be done. Tests are usually done in a certain order, and causes are identified or eliminated in the process. Whether additional tests are needed and which tests are done depend on results of the previous tests. Typical tests include. Blood tests to measure levels of prolactin to check for conditions that cause high levels , thyroid hormones to check for thyroid disorders , follicle-stimulating hormone to check for pituitary or hypothalamus malfunction , and male hormones to check for disorders that cause masculine characteristics to develop.

Imaging tests of the abdomen and pelvis using computed tomography CT , MRI, or ultrasonography to look for a tumor in the ovaries or adrenal glands.

Viewing of the uterus and usually fallopian tubes hysteroscopy Hysteroscopy Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system gynecologic Use of hormones estrogen and a progestin or progesterone to try and trigger menstrual bleeding. For hysteroscopy, doctors insert a thin viewing tube through the vagina and cervix to view the interior of the uterus.

This procedure can be done in a doctor's office or in a hospital as an outpatient procedure. For hysterosalpingography, x-rays are taken after a substance that can be seen on x-rays a radiopaque contrast agent is injected through the cervix into the uterus and fallopian tubes.

Hysterosalpingography is usually done as an outpatient procedure in a hospital radiology suite. If hormones trigger menstrual bleeding, the cause may be malfunction of the hormonal system that controls menstrual periods or premature menopause. If hormones do not trigger bleeding, the cause may be a disorder of the uterus or a structural abnormality preventing menstrual blood from flowing out. If symptoms suggest a specific disorder, tests for that disorder may be done first.

For example, if women have headaches and vision problems, MRI of the brain is done to check for a pituitary tumor. When amenorrhea results from another disorder, that disorder is treated if possible. With such treatment, menstrual periods sometimes resume. For example, if an abnormality is blocking the flow of menstrual blood, it is usually surgically repaired, and periods resume.

Some disorders, such as Turner syndrome and other genetic disorders, cannot be cured. If women have a Y chromosome, doctors recommend surgical removal of both ovaries because having a Y chromosome increases the risk of ovarian germ cell cancer Ovarian Cancer Ovarian cancer, which typically starts on the surface of the ovaries, is not usually diagnosed until it is advanced.

Based on these findings, your physician may also draw your blood to measure some hormone levels. The most common blood tests to check in a patient with amenorrhea are serum levels of prolactin, thyroid stimulating hormone TSH , and follicle stimulating hormone FSH. Prolactin is usually only present in pregnant or nursing women, but it can be a sign of a pituitary tumor, eating disorders, thyroid issues or diseases affecting the hypothalamus in the brain — all conditions that can impact your period.

If there are signs of PCOS, like acne or hair growth, testosterone levels may be drawn as well. Once a diagnosis is made, Dr. Hewitt says that the physician will work with you on a treatment plan. Hewitt explains. Therapy concentrates on treating the underlying cause may require increasing caloric intake, decreasing exercise and seeing a psychiatric specialist.

Return of the periods is a sign of improvement of the underlying condition and recovery. Can a missing period negatively affect my health? Missing your period in and of itself does not tend to be detrimental to your health.

Rather, the causes of amenorrhea are the most serious. If left untreated, more serious conditions like eating disorders can lead to low bone density, and diseases like PCOS can increase the risk of uterine cancer. At the beginning of a period, levels of the hormones estrogen and progesterone drop.

This provides a signal for the endometrium to begin shedding, and for the period to start. Towards the end of the period, estrogen levels begin to rise again. Increasing estrogen levels cause the menstrual tissue to thicken. This hormonal change can affect the menstrual flow. Certain medical conditions can cause hormone imbalances that may interrupt or interfere with menstruation.

The following conditions may result in irregular periods:. Polycystic ovary syndrome PCOS is an imbalance of hormones that affects the ovaries and ovulation.

The exact cause of PCOS is unknown. However, high levels of male hormones such as androgens and testosterone may play a role. Females who have PCOS may experience an irregular menstrual cycle.

They may also miss periods, or find that their periods stop altogether. Lifestyle factors can help a person manage PCOS and balance their hormone levels. Examples include:. Endometriosis happens when the endometrium grows outside of the uterus.

Endometriosis may affect menstrual flow and can cause painful symptoms during periods. A person may also experience spotting between periods. Endometriosis may occur as a result of menstrual tissue passing through the fallopian tube and into other parts of the body. Other causes may include:. Changing estrogen levels can also raise cholesterol levels and increase your risk for heart disease and stroke.

Talk to your doctor about possible treatment for your menopause symptoms if they bother you. Perimenopause, the transition to menopause, can last between two and eight years before your periods stop permanently. For most women, this transition to menopause lasts about four years.

You will know you have reached menopause only after it has been a full year since your last period. You can still get pregnant during perimenopause, the transition to menopause, even if you miss your period for a month or a few months.

During perimenopause you may still ovulate, or release an egg, on some months. But it is impossible to know for sure when you will ovulate. Talk to your doctor about your birth control needs. Learn more about different birth control methods. If you are not in a monogamous relationship in which you and your partner have sex with each other and no one else, protect yourself by using a male condom or dental dam correctly every time you have vaginal, oral, or anal sex. After menopause you may be more likely to get an STI from sex without a condom.

Vaginal dryness or irritation is more common after menopause and can cause small cuts or tears during sex, exposing you to STIs. Menopause happens when you have gone 12 months in a row without a period. The average age of menopause in the United States is The range for women is usually between 45 and Certain health problems can also cause you to start menopause earlier.

Menopause usually happens on its own. However, you may enter menopause earlier than you normally would if you have had chemotherapy or surgery to remove both ovaries. Learn more about early menopause on our Early or premature menopause page. After menopause you will no longer be able to get pregnant and you will no longer get a period.

If you have any type of vaginal bleeding after menopause, you should see a doctor as soon as possible. Vaginal bleeding after menopause is not normal and can mean that you have a serious health problem. For more information about menopause, call the OWH Helpline at or check out the following resources from other organizations:.

Department of Health and Human Services. ET closed on federal holidays. Breadcrumb Home Menopause Menopause basics. Menopause basics.