It is not uncommon that women present to me with infrequent or absent periods. A fairly universal concern in these women is that they may be menopausal and that they will have no chance for a pregnancy. In fact, premature menopause is exceptionally rare, and the causes of absent periods can usually be addressed quite easily.
Many of these cases are divided into 2 fairly distinct groups. One in which the signals from the brain are working to try to stimulate the ovary, but the ovary itself is a little ‘resistant’ to these signals ( eg polycystic ovarian syndrome), the other in which the brain signals are not being released in the first place ( this is sometimes the explanation in athletes and underweight women).
A routine clinical history and examination often reveals hints as to the diagnosis I will find with investigations. Each individual woman requires targeted investigations to determine why it is that she is not getting her period.
Often simple measures can lead to ovulation either spontaneously or with the help of fertility medications. The treatment options are discussed once a cause has been identified.