Amenorrhea: Lack of periods and how to tackle it

Amenorrhea mainly refers to either missed menstrual period on one or more occasions or the entire absence of menstruation. Women missing a minimum of three menstrual periods consecutively, or young girls who have not started to menstruate by the age of 15 years are diagnosed as having amenorrhea.

Pregnancy is one of the most prevalent causes of amenorrhea. The other reasons behind the missing of periods include complications with endocrine glands or reproductive organs. Treating the condition can help resolve amenorrhea.

About Amenorrhea

Amenorrhea can occur if you are pregnant, or have either attained menopause or have not started menstruating. Amenorrhea, meaning the absence of periods, is of two types:

Primary Amenorrhea

It happens when a girl has not started her menstrual cycle by 16 years of age.

Secondary Amenorrhea

It happens when a woman who has been having regular menstrual cycles has been experiencing the missed periods for the past 3 months or more.

Causes of Amenorrhea

Many things may cause amenorrhea. Potential causes of primary amenorrhea (when a woman does not get her first period) include:

● Complications in the Central Nervous System (brain & spinal cord) or the pituitary gland, a gland in our brain which produces the hormones involved in menstruation

● Failure of ovaries

● Problems with reproductive organs

In most cases, doctors do not know why a girl never gets her first period.

Some common causes of secondary amenorrhea (when woman who had normal periods stops getting them) include: ● Breastfeeding

● Pregnancy ● Menopause ● Stopping the use of birth control ● Certail birth control methods like Depo-Provera or some types of IUDs (intrauterine devices)

Other secondary amenorrhea causes include: ● Poor nutrition ● Stress ● Depression ● Over-exercising ● Some prescription drugs ● Extreme weight loss, or sudden weight gain, or being extremely overweight (obesity)

● Ongoing sickness ● Thyroid gland disorders ● Hormonal imbalance owing to PCOS (polycystic ovarian syndrome) ● Tumors on the ovaries, or the brain (rare)

A woman who has had her ovaries or uterus removed will stop menstruating as well. Amenorrhea can also be caused by problems with the sexual organs themselves. For example:

● Uterine scarring: A condition called Asherman’s syndrome in which scar tissue builds up in the uterus lining, can often occur after a C-section (caesarean section), dilation and curettage (D&C), or in the treatment for uterine fibroids. Uterine scarring prevents the normal shedding and build-up of uterine lining.

● Lack of reproductive organs: Sometimes problems occur during fetal development that leads to a girl born without certian major part of her reproductive system like the cervix, uterus or vagina. As such girl’s reproductive system did not develop normally, she cannot have menstrual cycles.

● Structural abnormality of the vagina: An obstruction of the vagina can prevent visible menstrual bleeding. A wall or membrane may be present in the vagina which blocks the outflow of blood from the cervix and uterus.

Please consult a doctor, as he/she will be able to find the cause and guide you, as amenorrhea can result from a medical condition that can potentially be treated.

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Symptoms of Amenorrhea

The absence of menstruation is amenorrhea. The other symptoms will depend upon the underlying reason for a missed period; however, here are the symptoms and signs that you might experience besides the absence of periods:

● Loss of hair

● Milky discharge from nipples

● Change in vision

● Headache

● Pain in the pelvic region

● Acne outbreak

● Excessive facial hair

Risk factors of Amenorrhea

Risk factors for amenorrhea might include:

● Arduous physical training

● Eating disorder- such as anorexia

● Family history of amenorrhea

Complications of Amenorrhea

Complications due to amenorrhea might include:

● Osteoporosis– low estrogen levels may weaken your bones

● Infertility- the absence of menstruation makes it impossible to conceive

Treatment of Amenorrhea

The treatment for amenorrhea is based upon the underlying reason. Hormonal therapy or contraceptive pills may be given to revive the periods.

If you have a pituitary or thyroid gland disorder that causes the missing of periods, then you might be prescribed medications for these conditions. On the other hand, if the issue is an internal blockage or a tumor, then surgery may be advised for treating amenorrhea.

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Precautions of Amenorrhea

If there are no underlying medical or hormonal causes , some lifestyle changes may help prevent amenorrhea. These include:

● Less stress

● Eating nutritious food

● Avoiding extreme dieting and consuming very little food

● Avoiding excessive workouts

● Ensuring adequate sleep

● Taking recreational breaks, whenever possible.

● Striking a work-life balance

Try and maintain a record of your menstrual cycle and symptoms, in case you find anything abnormal. Ensure to maintain a healthy weight and have your Gynecological check-up regularly.

Frequently Asked Questions (FAQs)

1. What can you do for amenorrhea?

The approach to treating amenorrhea depends upon the underlying cause . At times a simple lifestyle change could help . Your Gynecologist could help you to tackle the issue .

2. What happens if amenorrhea is not treated?

Amenorrhea, meaning the absence of menstruation in women, could lead to complications such as infertility if not treated on time. If a woman is unable to ovulate and have a regular menstrual cycle, conception becomes an issue . Another difficulty as a result of amenorrhea is osteoporosis, as it makes the bones weak.

3. How long does it take to get your period back after amenorrhea?

This depends on the cause and the treatment given to amenorrhea and varies due to this .

4. How long can amenorrhea last?

Secondary amenorrhea occurs in women who have gone through at least a one-period cycle and stopped menstruating for three months or even longer. Primary amenorrhea is not the same as secondary amenorrhea, as the latter happens when young women have not had her first period by the age of 16.

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