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True oligomenorrhea can not occur until menstrual periods have been established. In the United States, 97.5% of women have begun normal menstrual cycles by age 16. The complete absence of menstruation, whether menstrual periods never start or whether they stop after having been established, is called amenorrhea. Oligomenorrhea can become amenorrhea if menstruation stops for six months or more.

It is quite common for women at the beginning and end of their reproductive lives to miss or have irregular periods. This is normal and is usually the result of imperfect coordination between the hypothalamus, the pituitary gland, and the ovaries. For no apparent reason, a few women menstruate (with ovulation occurring) on a regular schedule as infrequently as once every two months. For them that schedule is normal and not a cause for concern.

Women with polycystic ovary syndrome (PCOS) are also likely to suffer from oligomenorrhea. PCOS is a condition in which the ovaries become filled with small cysts. Women with PCOS show menstrual irregularities that range from oligomenorrhea and amenorrhea on the one hand to very heavy, irregular periods on the other. The condition affects about 6% of premenopausal women and is related to excess androgen production.

Other physical and emotional factors also cause a woman to miss periods. These include:

  • emotional stress
  • chronic illness
  • poor nutrition
  • eating disorders such as anorexia nervosa
  • excessive exercise
  • estrogen-secreting tumors
  • illicit use of anabolic steriod drugs to enhance athletic performance

Professional ballet dancers, gymnasts, and ice skaters are especially at risk for oligomenorrhea because they combine strenuous physical activity with a diet intended to keep their weight down. Menstrual irregularities are now known to be one of the three disorders comprising the so-called "female athlete triad," the other disorders being disordered eating and osteoporosis. The triad was first formally named at the annual meeting of the American College of Sports Medicine in 1993, but doctors were aware of the combination of bone mineral loss, stress fractures, eating disorders, and participation in women's sports for several decades before the triad was named. Women's coaches have become increasingly aware of the problem since the early 1990s, and are encouraging female athletes to seek medical advice.

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