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Having had normal periods over the past 10 years, I suddenly stopped menstruating and haven't had a period in the last six months…

Having had normal periods over the past 10 years, I suddenly stopped menstruating and haven't had a period in the last six months. I'm not pregnant so why else would this happen?

Amenorrhea is the term used to describe the absence of the menstrual period. If a woman has never gone through puberty and menstruation has never occurred, it is called primary amenorrhea.

If, however, periods start and then stop, the condition is known as secondary amenorrhoea. Cessation of menstruation can occur for a wide range of reasons, including pregnancy, just before and during the menopause, and at times of stress. It can also occur as a result of changes in hormonal levels due to excessive exercise and weight loss, eating disorders and problems with the thyroid or pituitary glands. It may occur as a result of a condition know as polycystic ovary syndrome where multiple small cysts develop on the ovaries.

The use of some types of contraceptive pill - particularly those containing progestogen - can also result in the absence of menstruation.

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You mention that stress can cause amenorrhea. I have been under a lot of stress due to an increased work load, but thought I was being sensible using the gym daily as an antidote. How does exercise affect menstruation?

Exercise is a great way of releasing endorphins and other chemicals which make us feel good and is an excellent way of counteracting the effects of stress. However, daily gym sessions could be overdoing it and could be contributing to your amenorrhoea.

Stress, over-exercising and eating too little can cause amenorrhoea by interfering with the brain's hormonal control of the ovaries. You really need to see your doctor to rule out another cause for the cessation of your periods. If stress is established as the cause of the problem, seek a referral for stress management to help learn new ways of coping.

It is important to moderate your exercise levels, giving yourself rest periods between activity days to allow your body to recover. You should also examine your diet to ensure that it is balanced and catering for your body's needs.