The regular presence of menses can be considered a sign of health, because amenorrhea is cause for concern because it is frequently associated with loss of femininity or fertility. Amenorrhea is a symptom quickly perceived by women and usually raises the need to go to a doctor.

The diagnostic evaluation should be carried out in a girl with absence of menstruation at age 15 and delayed pubertal growth or development of secondary sexual characteristics, or when, regardless of growth and development of secondary sexual characteristics, there has not been menstruation at age 16. In this case we would speak of primary amenorrhea .

For its part, the concept of secondary amenorrhea will refer to cases in which, once menstrual cycles have been established, they disappear for at least six consecutive months. It is a much more common disorder than primary amenorrhea.

Amenorrhea is a symptom, not a disease, and we must remember that for menstruation to occur it is necessary:

• The anatomical and functional integrity of the hypothalamus and pituitary gland with their multiple connections to the central nervous system.
• Adequate endocrine-metabolic environment.
• Correctly developed genital apparatus.

The classification:

• Central amenorrhea (CA): hypothalamic or pituitary.

• Gonadal amenorrhea: of ovarian origin.

• Genital amenorrhea: of uterine or vaginal origin.

Classification of amenorrhea.