What is Amenorrhea?
Menses is the regular shedding of the uterine lining, which may result in amenorrhea.
A primary amenorrhea is the absence of menstruation in a person who is 15 or older. The most common causes are related to hormone levels, but anatomical problems can also cause amenorrhea.
Secondary amenorrhea means the absence of three or more periods in a row. This can be caused by problems with hormones, such as during pregnancy.
Treatment of amenorrhea depends on the underlying cause. If the amenorrhea is due to an illness, then treatment will depend on the illness. If the amenorrhea is not due to an illness, then treatment will depend on the woman's age and reproductive history.
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Internal reproductive organs
External reproductive organs
Medical terms
Amenorrhea is a condition where a woman has had no menstrual cycle for three months or more. It can happen to women of any age, but it is most common in women who are either pregnant or going through menopause. Amenorrhea can happen for a number of reasons, including hormonal imbalances, excessive exercise, eating disorders, and certain medications. In some cases, amenorrhea is caused by a medical condition that requires treatment.
Amenorrhea is the medical term for the absence of menstrual periods. It is not uncommon for many women to have irregular cycles, but when missed periods become a pattern then amenorrhea could be the cause. There are two types of amenorrhea: primary and secondary. Primary amenorrhea is when a woman has never had a period, while secondary amenorrhea is when someone has had periods that have stopped for at least three months.
How does the menstrual cycle work?
The menstrual cycle is the regular natural change that occurs in the female reproductive system (specifically the uterus and ovaries) that makes pregnancy possible. It is a monthly cycle that can be divided into four phases: the menstrual phase, followed by the follicular phase, ovulation, and the luteal phase. During the menstrual phase, the uterus sheds its lining and a new cycle begins. During the follicular phase, the ovary releases a mature egg, which then travels down the fallopian tube.
Understanding the menstrual cycle is essential to understanding female health and reproduction. The process typically occurs every 28 days and involves several different hormones, which cause changes in the uterus and ovaries. During the first part of the cycle, estrogen levels increase, causing the uterine lining to thicken in preparation for a potential pregnancy. This is also when an egg is released from one of the ovaries and travels down the fallopian tube.
The menstrual cycle can be complex, but it is a normal and natural phenomenon for women of reproductive age. The cycle of hormonal changes begins with the first day of the period, when the body sheds the uterine lining from the previous cycle. This is followed by days of increasing levels of estrogen, which stimulates the growth and thickening of the uterine lining. At its peak, ovulation occurs, releasing an egg from the ovary and initiating a decrease in estrogen levels.
A disorder in any of these parts can save you a person from getting a duration:
Hypothalamus, which controls the pituitary gland.
Pituitary gland, referred to as “the master gland,” which produces the hormones that instruct the ovaries to ovulate.
Ovaries, which produce the egg for ovulation and the hormones estrogen and progesterone.
Uterus, which responds to the hormones and prepares the lining. This lining sheds as the menstrual period if there’s no being pregnant.
Symptoms Amenorrhea
If you are experiencing amenorrhea, you might also experience other signs or symptoms along with the lack of periods, such as:
Milky nipple discharge
Hair loss
Headache
Vision changes
Excess facial hair
Pelvic pain
Acne
When to see a doctor
If you have not had a menstrual period in the past three months or if you are over the age of 15, consult a doctor.
Causes Amenorrhea
Amenorrhea can occur for many reasons. Some are normal, while others may be a sign of an illness or a side effect of medication.
Natural amenorrhea
It may happen during the course of your life that you will not menstruate for natural reasons. This could be due to things like age, health conditions, or stress.
Pregnancy
Breastfeeding
Menopause
Contraceptives
Some people who take birth control pills (oral contraceptives) may not have periods. Even after stopping birth control pills, it may take some time before regular ovulation and menstruation return. Birth control pills that are taken by mouth or injected or implanted can also cause amenorrhea. IUDs are birth control devices.
Medications
Some medications can stop a woman's menstrual cycle, including some types of medications.
Antipsychotics
Cancer chemotherapy
Antidepressants
Blood pressure drugs
Allergy medications
Lifestyle factors
Amenorrhea can be caused by various factors, such as lifestyle choices.
Low body weight.If someone's body weight is too low, it can interrupt many hormonal functions. This can lead to a lack of ovulation in women who have an eating disorder, such as anorexia or bulimia.
Excessive exercise.Athletes who participate in rigorous training may find their menstrual cycles interrupted. Factors such as low body fat stress and high energy expenditure can combine to cause the loss of periods.
Stress.When you are stressed, your hypothalamus may temporarily stop controlling your hormones. This can cause ovulation and menstruation to stop. Usually, after your stress decreases, your periods will resume as usual.
Hormonal imbalance
Many medical problems can cause hormonal imbalance, including:
Polycystic ovary syndrome (PCOS).PCOS is characterized by relatively high and sustained levels of hormones, rather than the cyclical fluctuations seen in normal menstruation.
Thyroid malfunction.If someone has an overactive or underactive thyroid gland, their menstrual cycles may be disrupted. This can include amenorrhea (absence of menstrual periods).
Pituitary tumor.If you have a noncancerous tumor in your pituitary gland, it can interfere with the hormonal regulation of your menstrual cycle.
Premature menopause.Menopause usually begins around 50 years old for most women. But for some women, the ovarian supply of eggs ends before 40 years old, and periods stop.
Structural problems
Amenorrhea can be caused by problems with the sexual organs themselves. Some examples include:
Uterine scarring.Asherman's syndrome is a condition in which scar tissue can sometimes form in the lining of the uterus after a dilation and curettage (D&C) cesarean section or treatment for uterine fibroids. Uterine scarring prevents the normal shedding of the uterine lining, which can lead to complications.
Lack of reproductive organs.Some problems during fetal development can prevent the reproductive system from developing fully. This means that a woman's menstrual cycles cannot happen later in life.
Structural abnormality of the vagina.If there is an obstruction in the vagina, it may prevent menstrual bleeding to the exterior. This could be due to a membrane or wall that is present in the vagina.
Video: Ovulation
Ovulation is the release of an egg from one of the ovaries. It can happen at any point during the menstrual cycle, though it may vary in timing.
Before ovulation, the lining of the uterus or endometrium thickens. The pituitary gland in the brain signals one of the ovaries to release an egg. The wall of the ovarian follicle bursts open at the surface of the ovary, releasing the egg.
Fingers called fimbriae sweep the egg into the neighboring fallopian tube. The egg is propelled along by contractions in the fallopian tube walls. Here in the fallopian tube, it may be fertilized by a sperm.
If an egg is fertilized, the egg and sperm unite to form a one-celled entity called a zygote. The zygote then travels down the fallopian tube toward the uterus. As it increases in size, the zygote begins dividing rapidly to form a cluster of cells called a blastocyst. The blastocyst looks like a tiny raspberry when it reaches the uterus. Pregnancy starts when the uterus implants in the lining of the uterus.
If an egg isn't fertilized, it's simply recycled by the body - perhaps before it even reaches the uterus. About two weeks later, the lining of the uterus sheds through the vagina. This is known as menstruation.
Risk factors Amenorrhea
Some factors that may increase your risk of amenorrhea include: -Having a history of amenorrhea -Being overweight or obese -Having a family history of amenorrhea
Family history.If other members of your family have had amenorrhea, it may be because of a genetic predisposition.
Eating disorders.If you have an eating disorder such as anorexia or bulimia, you are at a higher risk of not becoming pregnant.
Athletic training.Athletic training can increase your risk of amenorrhea.
The history of certain gynecological procedures.If you've had a D&C or a procedure known as loop electrodiathermy excision procedure (LEEP), your risk of developing amenorrhea is higher.
Complications Amenorrhea
Amenorrhea can have other consequences as well. These can include:
Infertility and problems with pregnancy.If you don't ovulate and don't have menstrual periods, you cannot become pregnant. When hormone imbalance is the cause of amenorrhea this can also lead to miscarriage or other problems with pregnancy.
Psychological stress.Not having your period can be stressful, especially if you are a young person transitioning into adulthood.
Osteoporosis and cardiovascular disease.These problems can be caused by a lack of estrogen.Osteoporosis is a weakening of the bones. Cardiovascular disease includes heart attack and vascular problems as well as problems with the heart muscle.
Pelvic pain.An anatomical problem that is causing amenorrhea may also cause pain in the pelvic area.
Diagnosis Amenorrhea
During your appointment, your doctor will check for any problems with your reproductive organs. If you've never had a period, your doctor may also check your breasts and genitals to see if you are experiencing the normal changes of puberty.
Amenorrhea (absence of menstruation) can be a sign of a complex set of hormonal problems. Finding the root cause may take a while and may require more than one type of testing.
Tests
Various blood tests may be necessary, including:
Pregnancy test.This is probably the first test your doctor will suggest to rule out or confirm a possible pregnancy.
Thyroid function test.A blood test can determine if your thyroid is functioning properly.
Ovary function test.Knowing the level of FSH in your blood can tell you if your ovaries are working properly.
Prolactin test.Low levels of the hormone prolactin may be a sign that you have a tumor on your pituitary gland.
Male hormone test.If you're having more facial hair and a lower voice, your doctor may want to check your levels of male hormones.
Hormone challenge test
For this test, you take hormonal medication for seven to 10 days in order to trigger your menstrual cycle. The results of this test will help your doctor determine whether you are no longer experiencing periods because you lack estrogen.
Imaging tests
Depending on your symptoms and test results, your doctor might recommend one or more imaging tests. These tests can include:
Ultrasound.This test uses sound waves to create pictures of internal organs. If you have never had a menstrual cycle, your doctor may suggest an ultrasound test to check for any abnormalities in your reproductive organs.
Magnetic resonance imaging (MRI).MRI uses radio waves with a strong magnetic field to create detailed images of soft tissues within the body. Your doctor may order an MRI to look for a tumor in the pituitary gland.
Scope tests
If other testing shows no specific cause, your doctor may recommend a hysteroscopy - a test in which a thin lighted camera is passed through your vagina and cervix to look at the inside of your uterus.
Treatment Amenorrhea
The treatment for amenorrhea will depend on the underlying cause. If the amenorrhea is caused by an issue with your thyroid or pituitary gland, you may be treated with medications. If the amenorrhea is due to a tumor or obstruction, treatment will likely require surgery. Surgery may be necessary in order to treat the injury.
Lifestyle and home remedies
Amenorrhea may be caused by lifestyle factors such as too much exercise or not enough food. Try to find balance in your work, recreation, and rest schedules. If you can't reduce stress on your own, talk to your family and friends about it, or see a doctor for help.
Pay attention to your menstrual cycle and check with your doctor if you have any questions. Keep track of the date your period starts, how long it lasts, and any symptoms you experience.
Preparing for your appointment
Your first appointment will most likely be with your primary care doctor or gynecologist.
Here are some tips to help you prepare for your appointment and know what to expect from your doctor.
What you can do
To get ready for your appointment:
Write down details about your symptoms.If you are TTC, you should include the date and duration of your last period when you fill out this form.
Make note of key medical information,Tell your doctor about all of the other conditions you are being treated for and the names and doses of any medications, vitamins, or supplements you regularly take.
Review your family history.To see if you are also suffering from menstrual problems, ask your mother or any of your sisters.
Write down questions to ask your doctor,Making a list of the most important things first will help to avoid running out of time.
If you are experiencing amenorrhea, some basic questions you should ask your doctor include:
What could be causing me not to have my periods?
Do I need any tests? What should I do to prepare for those tests?
What types of treatments are available? Which would you recommend for me?
Can you show me some brochures or websites about this topic?
What to expect from your doctor
Your doctor will likely ask you a few questions such as: What is your general health like? Are you experiencing any unusual symptoms? Do you have any allergies or sensitivities to medications or other substances? Have you been sick recently?
When was your last period?
Are you sexually active?
Could you be pregnant?
Do you use birth control?
Are you under any stress?
Do you have a hard time controlling your weight?
How often and how vigorously do you exercise?
Do you have any other medical conditions that I should be aware of?
General summary
Amenorrhea is a condition where a woman’s menstrual cycle stops and she no longer has her regular period. It is seen, however, that this condition affects anyone who has periods, including pre-teens, teens and women in their twenties and beyond. Amenorrhea can be either primary or secondary depending on the situation. Primary amenorrhea is when a female has never had her period, while secondary amenorrhea is when a female that previously had her period stops getting it for three months or more.
Amenorrhea is defined as the absence of menstrual cycles for more than three consecutive months. This medical condition can be categorized into two distinct types: primary amenorrhea, the congenital absence of menstrual periods, and secondary amenorrhea, the absence of menstrual periods in women with prior menstrual cycles. Primary amenorrhea is typically associated with reproductive abnormalities while secondary amenorrhea can be caused by certain diseases, lifestyle factors, and medications. It is important to note that amenorrhea is not always a sign of an underlying medical condition and can be perfectly normal in certain scenarios.
Amenorrhea is the absence of menstruation in a woman when it is expected to occur. This medical condition can be classified as primary or secondary depending on the cause. Primary amenorrhea is when the female has never had a period and is typically due to some sort of hormone imbalance or structural abnormality. Secondary amenorrhea is when the female has had a period before, but it has now stopped due to certain lifestyle factors such as stress, weight loss, or changes in birth control.