Amenorrhea is the lack of menstruation, which is commonly described as missing one or more menstrual cycles.
Primary amenorrhea is the lack of menstruation in a woman who has not had a period by the age of 15. The most prevalent causes of primary amenorrhea are hormonal imbalances, though anatomical issues can also induce amenorrhea.
Secondary amenorrhea is the absence of three or more periods in a row by someone who has previously had periods. Secondary amenorrhea is most commonly caused by pregnancy, however hormone issues can also cause it.
The treatment of amenorrhea is determined on the underlying cause.
WHAT ARE THE SYMPTOMS OF AMENORRHEA?
Depending on the reason of amenorrhea, you may also suffer the following indications or symptoms in addition to the absence of periods:
- Nipple discharge that is milky
- Loss of hair
- Headache
- Vision changes
- Excessive facial hair
- Pelvic pain
- Acne
WHAT ARE THE CAUSES OF AMENORRHEA?
Amenorrhea can happen for a number of causes. Some are normal, while others may be a pharmaceutical side effect or a sign of a medical concern.
Natural amenorrhea
Amenorrhea can occur naturally during the course of your life for a variety of causes, including:
- Pregnancy
- Breastfeeding
- Menopause
Contraceptives
Some persons who use birth control pills (oral contraceptives) may not experience menstruation. Even after discontinuing birth control medications, regular ovulation and menstruation may take some time to return. Injection or implanted contraception, as well as some intrauterine devices, can cause amenorrhea.
Medications
Menstrual periods can be stopped by some drugs, including several forms of:
- Antipsychotics
- Chemotherapy for cancer
- Antidepressants
- Blood pressure medications
- Medication for allergies
Lifestyle factors
Amenorrhea can be caused by a variety of lifestyle variables, including:
- Low body weight: Excessively low body weight — roughly 10% of normal weight — disrupts several hormonal activities in the body, perhaps preventing ovulation. Women suffering from an eating disorder, such as anorexia or bulimia, frequently stop having periods as a result of these aberrant hormonal changes.
- Excessive physical activity: Women who engage in strenuous training activities, such as ballet, may have their menstrual cycles disrupted. Athletes lose periods due to a combination of circumstances, including low body fat, stress, and high energy consumption.
- Stress: Mental stress can temporarily disrupt the functioning of your hypothalamus, a region of your brain that regulates the hormones that govern your menstrual cycle. As a result, ovulation and menstruation may cease. Regular menstrual periods usually resume once your stress levels have decreased.
Hormonal imbalance
Hormonal imbalance can be caused by a variety of medical issues, including:
Polycystic ovary syndrome (PCOS): PCOS results in relatively high and prolonged hormone levels, as opposed to the variable levels seen in the typical menstrual cycle.
Thyroid malfunction: Menstrual abnormalities, including amenorrhea, can be caused by an overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism).
Pituitary tumor: A noncancerous (benign) pituitary tumor can disrupt the hormonal regulation of menstruation.
Premature menopause: Menopause often begins around the age of 50. However, for some women, the ovarian supply of eggs declines before the age of 40, and menstruation ceases.
Structural issues
Amenorrhea can also be caused by problems with the sexual organs. Here are several examples:
- Uterine scarring: Asherman's syndrome, a disorder in which scar tissue forms in the uterine lining, can arise following a dilation and curettage (D&C), cesarean section, or therapy for uterine fibroids. Uterine scarring inhibits the uterine lining from forming and shedding normally.
- The lack of reproductive organs: During fetal development, abnormalities can arise that result in missing elements of the reproductive system, such as the uterus, cervix, or vagina. Menstrual periods are not possible later in life because the reproductive system did not fully develop.
- Vaginal structural abnormalities: A vaginal blockage may impede noticeable menstrual bleeding. There may be a membrane or wall in the vagina that prevents blood from leaving the uterus and cervix.
WHAT ARE THE RISK FACTORS FOR AMENORRHEA?
The following factors may raise your risk of amenorrhea:
- Family history: If other women in your family have had amenorrhea, you may have inherited a susceptibility to the condition.
- Eating problems: You are more likely to develop amenorrhea if you have an eating disorder, such as anorexia or bulimia.
- Athletic training: Athletic training can raise your chance of amenorrhea.
- History of some gynecologic procedures: If you've had a D&C, particularly one connected to pregnancy, or a technique known as loop electrodiathermy excision procedure (LEEP), you're more likely to develop amenorrhea.
WHAT ARE THE COMPLICATIONS OF AMENORRHEA?
Other difficulties can arise as a result of the causes of amenorrhea. These are some examples:
- Infertility and pregnancy complications: You cannot become pregnant if you do not ovulate and do not have monthly cycles. When hormone imbalance is the cause of amenorrhea, it can potentially lead to miscarriage or other pregnancy complications.
- Psychological stress: It can be distressing to not have periods when your contemporaries do, especially for young individuals transitioning into adulthood.
- Cardiovascular disease and osteoporosis: These two issues can be caused by a lack of estrogen. Osteoporosis is a bone weakening condition. Cardiovascular illness encompasses heart attacks as well as blood vessel and heart muscle issues.
- Pelvic discomfort: If the amenorrhea is caused by an anatomical condition, it may also produce pelvic pain.
HOW IS AMENORRHEA DIAGNOSED?
Your doctor will perform a pelvic exam during your appointment to check for any abnormalities with your reproductive organs. If you have never had a period, your doctor may examine your breasts and genitals to see if you are going through the regular puberty changes.
Amenorrhea can be a symptom of a more complex collection of hormonal issues. Finding the root problem can take time and may necessitate more than one type of testing.
Tests
A number of blood tests may be required, including:
- Pregnancy test: This is most likely the first test your doctor will recommend to rule out or confirm a probable pregnancy.
- Thyroid function test: Thyroid-stimulating hormone (TSH) levels in the blood can indicate whether or not your thyroid is functioning normally.
- Ovary function test: The level of follicle-stimulating hormone (FSH) in your blood can indicate whether or not your ovaries are functioning properly.
- Prolactin test: Prolactin levels that are low may indicate a pituitary gland malignancy.
- Male hormone test: If you have growing facial hair and a lower voice, your doctor may want to evaluate your blood levels of male hormones.
Hormone challenge test
For this test, you must take a hormonal medicine for seven to ten days in order to induce menstruation. This test can tell your doctor if your periods have stopped because of a shortage of estrogen.
Imaging tests
Depending on your indications and symptoms, as well as the results of any blood tests, your doctor may order one or more imaging tests, such as:
- Ultrasound: This test generates images of internal organs using sound waves. If you have never had a period, your doctor may advise you to get an ultrasound to look for any abnormalities in your reproductive organs.
- Magnetic resonance imaging (MRI): MRI produces extremely detailed images of soft tissues within the body by combining radio waves with a strong magnetic field. An MRI may be ordered by your doctor to look for a pituitary tumor.
Scope tests
If other tests find no clear cause, your doctor may consider a hysteroscopy, which involves passing a narrow, illuminated camera into your vagina and cervix to examine the inside of your uterus.
WHAT ARE THE TREATMENTS FOR AMENORRHEA?
The treatment for your amenorrhea is determined by the underlying cause. Birth control tablets or other hormone therapy may be able to restart your menstrual cycle in some situations. Medication can be used to treat amenorrhea caused by thyroid or pituitary abnormalities. Surgery may be required if the condition is caused by a tumor or structural impediment.
HOME REMEDIES FOR AMENORRHEA
Some lifestyle factors, like as excessive activity or insufficient nutrition, might cause amenorrhea, so seek for balance in your job, recreation, and rest. Examine the sources of stress and conflict in your life. If you are unable to reduce stress on your own, seek assistance from family, friends, or your doctor.
Keep an eye out for changes in your menstrual cycle and consult your doctor if you have any concerns. Keep track of when your periods come. Take note of when your period begins, how long it lasts, and any bothersome symptoms you have.