Amenorrhea (No Menstruation): Overview
No menstruation also known as amenorrhea, is the absence of menstrual periods. There are two types of absent menstruation. The type depends on whether menstruation has not occurred at a certain age, or if menstruation has occurred and then is absent.
No menstruation also known as amenorrhea. Amenorrhea is when you miss your monthly period. It can be temporary or permanent. Amenorrhea may result from a shift in the role of some part of the female reproductive system or from a problem.
Sometimes you are not supposed to have your period, such as before puberty, during pregnancy, and after menopause. If the amenorrhea lasts for over three months, it should be investigated.
Types of No Menstruation?
Two types of amenorrhea are: primary and secondary.
Primary Amenorrhea:
Primary amenorrhea is when cycles do not begin during puberty. According to the National Institutes of Health, if periods do not start by the age of 16, the person should seek medical help. Primary amenorrhea is rare.
Secondary Amenorrhea:
This is when periods start, but then stop occurring. This is normal during pregnancy or breastfeeding, but it can also mean there is a problem. Missing a period is not usually a sign of a health problem, although many people will request a pregnancy test if this happens.
A doctor will consider secondary amenorrhea if a person:
- you used to have regular periods and then don't have them for 3 months
- you used to have irregular periods and then don't have them for 6 months
Causes
Primary and secondary amenorrhea can occur for several reasons. Some causes are natural, while others are medical conditions that must be treated.
- Natural causes are more likely to cause amenorrhea, such as pregnancy, breastfeeding, and menopause.
- Lifestyle factors can include excessive exercise and stress. Also, having too little body fat or too much body fat can delay or stop menstruation.
- Hormonal imbalances can cause amenorrhea. They are usually triggered by tumors in the pituitary gland or the thyroid gland. They may also be caused by low estrogen levels or elevated testosterone levels.
- Genetic or chromosomal disorders, such as Turner syndrome and Sawyer syndrome, can sometimes cause a late period.
- Medications can cause amenorrhea in some women.
- Antipsychotics and antidepressants are often involved.
- Chemotherapy drugs and drugs that treat high blood pressure can also cause problems with menstruation.
- Stopping birth control pills suddenly can also lead to several months of missed periods before the cycle returns to normal.
- Physical defects, such as structural problems in the female reproductive organs, may be responsible for the absence or delay of menstruation.
- These problems can result from birth defects, tumors, or infections that occurred in the uterus or shortly after birth.
- In rare cases, missed periods can be a symptom of Asherman's syndrome. This occurs due to scars on the uterus after surgery, which can prevent menstruation.
Risk factors:
Factors that can increase your risk of amenorrhea may include:
Family history:
If other women in your family have experienced amenorrhea, you may have inherited a predisposition to the problem.
Eating disorders:
If you have an eating disorder, such as anorexia or bulimia, you have a higher risk of developing amenorrhea.
Athletic training:
Rigorous athletic training can increase the risk of amenorrhea.
Complications:
Complications of amenorrhea can include:
Infertility:
If you do not ovulate and have menstrual periods, you cannot get pregnant.
Osteoporosis:
Osteoporosis If your amenorrhea is caused by low estrogen levels, you may also be at risk for osteoporosis, a weakening of your bones.
Diagnosis :
The doctor will perform a physical exam and ask you a series of questions. Be prepared to talk about your normal menstrual cycle, your lifestyle, and any other symptoms you are experiencing.
Your doctor will also order a pregnancy test if you haven't had a period in three months. You will require further testing to ascertain the root cause of the missed cycles if the condition is ruled out. These diagnostic tests can include:
- Blood tests, which will allow your doctor to monitor the hormone levels in your body. Prolactin, luteinizing hormone, and follicle-stimulating hormone are linked to menstruation. Determining these levels can help your doctor determine or rule out the cause of your missed period.
- Ultrasound is an imaging test that uses high-frequency sound waves to create detailed images of the inside of your body. It allows your doctor to view various organs, such as the ovaries and uterus, and check for abnormal growths.
- Another form of imaging procedure that uses computers and spinning x-ray equipment to generate cross-sectional body images is the CT scan. These photographs help your doctor to scan your glands and organs for masses and tumors.
Treatment :
Treatment of amenorrhea varies depending on the underlying cause. Supplemental or synthetic hormones can address hormonal imbalances and can help to normalize hormone levels.
Your doctor would also seek to remove ovarian cysts, scar tissue, or tumors of the uterus that trigger the menstrual cycles.
Your doctor may also recommend making simple lifestyle changes if your weight or exercise routine contributes to your condition.
When to visit a Doctor?
A teenager who has not started her period by at least 16 years should see a doctor. You also need to go to the doctor's office if you are 14 or older and have not yet experienced signs of puberty:
- thelarche (development of the mammary bud)
- pubarche (development of pubic hair)
- menarche (start of menstrual periods)
If they have missed three or more days in a row, menstruating women and teenagers should visit their physician.
Prevention
To prevent amenorrhea, try:
- maintain a healthy weight
- eat a well-balanced diet
- exercise regularly
- learn to manage stress
Discuss any concerns you have about your menstrual period with your doctor.
