How to distinguish between pregnancy and amenorrhea

Written by Zhao Li Li
Obstetrics
Updated on May 25, 2025
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If your menstrual cycles have been regular up to now and there is a delay in your current cycle, the first thing to do is to rule out the possibility of pregnancy. There is a significant difference between a normal pregnancy and amenorrhea, and pregnancy can generally be detected through early pregnancy test strips if the menstrual cycle is irregular.

If the test strip is positive, it is generally considered likely that you are pregnant, and it is not a case of amenorrhea. If the test shows a negative result, then it is necessary to check the thickness of the endometrium. If the endometrium is thin, the likelihood of amenorrhea significantly increases.

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Written by Li Shun Hua
Obstetrics and Gynecology
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What should a woman do if she experiences amenorrhea?

The number of follicles in a woman's ovaries is fixed from birth. From birth to adolescence, the follicles begin to develop, and ovulation occurs each month. Once all the follicles are depleted, ovarian function declines, leading to menopause. When a woman experiences menopause after the age of 40, it is considered a normal occurrence, and estrogen replacement therapy can be used at this time. However, a physical examination must be conducted before using these medications, as they are not suitable for everyone. If menopausal symptoms are particularly severe, sequential estrogen therapy can be applied, which may result in the return of menstrual periods, but this does not indicate a recovery of ovarian function; it is due to the medication. If the symptoms during menopause are not very severe, observational treatment may also be considered.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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Can amenorrhea be treated with Xiaoyao pills?

You should not take Xiaoyao pills if you have amenorrhea. Amenorrhea refers to a situation where a person who normally menstruates suddenly stops menstruating for more than six months, which is likely considered secondary amenorrhea. Once menstruation stops, it's important to promptly investigate the cause of the cessation. If it occurs around the time of menopause, then it is likely an indication of menopause. If it happens to women of reproductive age, it is crucial to go to the hospital for checks to determine if there are issues like ovarian dysfunction or polycystic ovary syndrome, or even conditions such as pituitary tumors causing the amenorrhea. Treatment should be based on the results of these examinations, and medication should not be taken blindly. It is also advised to avoid catching cold or becoming overtired, and to avoid spicy and irritant foods.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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What should I do if my period has been absent for three months?

If a woman does not menstruate for three months, medically this is called amenorrhea. If she is relatively young, it is essential to visit a hospital for relevant examinations. Generally, an ultrasound is conducted first to check the thickness of the endometrial lining and to assess if there are any organic diseases affecting the uterus or ovaries. If the endometrium appears thin and there are no organic diseases, further examinations should include tests for six sex hormones, which are indicators of ovarian function. If the results suggest premature ovarian failure or some endocrine disorders, treatment can be tailored according to these findings. Moreover, if the woman has reached menopausal age and indeed has not menstruated for three months, this condition is considered amenorrhea, which might be physiological. Hence, if an older woman experiences amenorrhea, it is likely true menopausal amenorrhea. Additionally, if a woman who normally has regular menstrual cycles does not menstruate for three months, pregnancy cannot be ruled out, and it is crucial to conduct relevant tests for early pregnancy.

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Written by Hou Jie
Obstetrics and Gynecology
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How can amenorrhea be treated to restore menstruation?

In the treatment of amenorrhea, systemic treatment plays an important role. It includes actively treating systemic diseases, improving the overall quality of the body, providing sufficient nutrition, and maintaining standard body weight. If the patient is overweight, it is recommended to exercise to lose weight; if it is exercise-induced amenorrhea, it is appropriate to reduce the amount of exercise; if the amenorrhea is due to stress or psychological factors, then patient and psychological treatment should be conducted to eliminate mental tension and anxiety; if the amenorrhea is caused by tumors, polycystic ovary syndrome, then treatment should be based on the specific cause.

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Written by Li Shun Hua
Obstetrics and Gynecology
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How should amenorrhea be managed?

Menopause occurring after the age of 40 is a normal physiological phenomenon. If menopause occurs before the age of 40, it indicates premature ovarian failure. Women with premature ovarian failure will exhibit symptoms of menopause and also experience accelerated aging. At this stage, if there are no contraindications to medication, hormone replacement therapy can be used. Hormone replacement therapy is also applicable if menopause occurs after the age of 40. For those over 40 who still wish to menstruate, sequential estrogen-progestogen therapy can be applied. If menstruation is not desired, estrogen supplementation therapy can be used.