Amenorrhea, Pediatric

Renee K. Kottenhahn and Deborah B. Ehrenthal Reviewed 06/2017



Amenorrhea is the absence of menstruation. It is divided into 2 categories: 
  • Primary amenorrhea is the failure to begin menstruation by 16 years of age in girls with otherwise appropr...


Approach to the Patient

A stepwise approach to the evaluation, guided by the history and physical exam, is recommended. 
  • Phase 1: Exclude pregnancy by urine or serum β-hCG testing.

  • Phase 2: Obt...


  • Identification and management depends on the underlying disorder.

  • Estrogen/progestin hormonal therapy may have a role but should not be initiated prior to completing a full evaluation.

  • Prematu...

Additional Reading

  • Domine  F, Dadoumont  C, Bourguignon  JP. Eating disorders throughout female adolescence. Endocr Dev.  2012;22:271–286. [View Abstract]

  • Gray  SH. Menstrual disorders. Pediatr Re...



  • 626 Absence of menstruation

  • 256.8 Other ovarian dysfunction


  • N91.2 Amenorrhea, unspecified

  • N91.0 Primary amenorrhea

  • N91.1 Secondary amenorrhea

  • E28.8 Other ovarian dysfunction


  • 14302001 A...


  • Q: What are the normal benchmarks for evaluating pubertal development in girls?

  • A: Normal benchmarks for evaluating pubertal development in girls: breast development by age 12–13 years, menarche ∼2...

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