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Warning-sign checks

Absent menstrual periods - primary: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek urgent or emergency care for:

    • Severe or rapidly worsening abdominal or pelvic pain
    • Pelvic pain with repeated vomiting, fainting, or marked weakness
    • Inability to urinate with lower abdominal swelling or pain
    • A sudden severe headache, major vision loss, confusion, or loss of consciousness
    • Severe symptoms during a possible pregnancy, especially pain, bleeding, dizziness, or fainting

    These symptoms do not indicate one specific diagnosis but require timely assessment.

    And for anyone, someone who:

    • is bleeding heavily and it will not stop with firm pressure
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact a clinician promptly for new headaches, vision changes, milky nipple discharge, hot flashes, rapidly increasing facial hair, a deepening voice, or worsening pelvic symptoms.

  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up may include monitoring growth, puberty, menstrual bleeding, nutrition, hormone levels, treatment effects, and bone health.

    Record pelvic pain, spotting, headaches, nipple discharge, and other changing symptoms.

    Bring an updated list of medicines and supplements to appointments.

    Arrange a routine appointment if periods have not started by age 15, more than three years have passed since breast development began, breast development has not started by age 13, or puberty appears to have stopped.

Every sign above is quoted from the sofidex article on Absent menstrual periods - primary. If you are not sure, err upward — it is always reasonable to be checked.