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Absent menstrual periods - primary Absence of a woman's monthly menstrual period is called amenorrhea. Primary amenorrhea is when a girl has not yet started her monthly periods, and she: Has gone through other normal changes that occur during puberty Is older than 15. Causes: Most girls begin their periods between ages 9 and 18. The average is around 12 years old. If no periods have occurred when a girl is older than 15, further testing may be needed. The need is more urgent if she has gone through other normal changes that occur during puberty. Being born with incompletely formed genital or pelvic organs can lead to a lack of menstrual periods. Some of these defects include: Blockages or narrowing of the cervix. Hymen that has no opening. Missing uterus or vagina. Vaginal septum (a wall that divides the vagina into 2 sections). Hormones play a big role in a woman's menstrual cycle. Hormone problems can occur when: Changes occur to the parts of the brain where hormones that help manage the menstrual cycle are produced. The ovaries are not working correctly. Either of these problems may be due to: Anorexia (loss of appetite) with low body mass index (BMI). Chronic or long-term illnesses, such as cystic fibrosis or heart disease. Genetic defects or disorders. Infections that occurred before or after the woman's birth. Other birth defects. Poor nutrition. Tumors. In many cases, the cause of primary amenorrhea is not known.