Amenorrhea is the absence of menstruation and is common among women. It happens due to numerous possible causes, including hormonal imbalances, changes in the diet, and other lifestyle factors. Amenorrhea can have various consequences on the woman’s health, fertility, and well-being in general.
It is important to understand this condition so that women can seek medical help as soon as possible if they’re experiencing any symptoms. This blog will look at the various types of amenorrhea, the causes, the diagnosis, and the different treatment options that can be adopted for the condition.
A] What is Amenorrhea?
Amenorrhea is when a woman does not get her menstrual period in her reproductive years. It can occur naturally, like during pregnancy, breastfeeding, or menopause, or it can also be an abnormal disruption of the menstrual cycle. Amenorrhea is not a disease itself but rather a sign of other underlying diseases. This absence may be a sign for many women that something significant is happening in their bodies, particularly when the situation extends beyond a few months. It is important to know the difference between primary amenorrhea (no menstruation by age 15) and secondary amenorrhea (the absence of periods for more than three or more months after having regular cycles).
B] Types of Amenorrhea
- Primary Amenorrhea: This is when the girl reaches the age of fifteen years and has not had her first period despite other signs of puberty, like the development of breasts. Primary amenorrhea may suggest a problem with puberty, or it can also be a symptom of a more serious underlying condition.
- Secondary Amenorrhea: Secondary Amenorrhea is more prevalent and happens when a woman who has had regular menses misses her period for three months in a row or longer. Secondary amenorrhea can stem from several factors, such as lifestyle, hormonal, or other medical factors.
C] Causes of Amenorrhea
What are the causes of amenorrhea? The causes of amenorrhea are diverse and range from natural to lifestyle and medical factors:
- Hormonal Imbalances: Amenorrhea can be caused by conditions such as Polycystic Ovary Syndrome (PCOS), thyroid disorders, and adrenal gland problems. PCOS is the most common cause of secondary amenorrhea. It is associated with hormonal disorders and irregular menstrual cycles. Hypothyroidism can also interfere with the menstrual cycle since the thyroid gland influences ovulation.
- Lifestyle Factors: Weight loss, vigorous exercises, and stress are some of the factors that interfere with the hormonal balance required for monthly menstruation. Lack of body fat, excessive exercise, particularly in athletes, and stress can disrupt ovulation and cause amenorrhea.
- Medical Conditions: Some of the diseases that can cause amenorrhea include such as diabetes, celiac disease, and heart disease. Pregnancy is another natural cause since menstruation is suppressed during pregnancy. Other causes include uterine abnormalities such as scarring from surgery or structural issues in the reproductive system.
- Medications and Treatments: Some of the drugs that may cause amenorrhea are those used in chemotherapy, antidepressants, and antipsychotic drugs. Types of contraceptives, such as pills or injections, also have an impact on the menstrual cycle and are major amenorrhea causes.
Some of these causes may be similar to the causes of Menorrhagia, but it’s important to consult an expert if you experience any symptoms.
D] Symptoms of Amenorrhea
One of the primary amenorrhea symptoms is the absence of menstruation, but this condition may be accompanied by a variety of other symptoms, depending on the underlying cause:
1. Lack Of Menstruation
The most prominent sign of amenorrhea is the lack of menstruation, which means never having had a period at all (primary) or the loss of periods after having had them regularly (secondary).
2. Milky Nipple Discharge
Some women with symptoms of menstruation loss may have spontaneous breast milk production, which may be associated with high prolactin levels.
3. Hair Loss
Hormonal imbalances lead to hair thinning or hair loss, especially those including androgens.
4. A Headache
Some women with amenorrhea experience persistent headaches, which may indicate an issue with the pituitary gland, a critical regulator of reproductive hormones.
5. Vision Changes
When amenorrhea is related to hormonal changes, it can lead to vision disturbances.
6. Additional Facial Hair
Hair growth in unwanted areas can be one of the side effects of amenorrhea, particularly in women with conditions such as PCOS, which causes high androgen levels.
These symptoms differ from person to person and may be associated with hormonal imbalances that interfere with the regular menstrual cycle.
E] How to Diagnose Amenorrhea
Amenorrhea can be primary or secondary, and the diagnosis involves consultation with a doctor to determine the cause. The following steps are typically involved in amenorrhea diagnosis:
1. History Taking
In addition to the patient’s medical history, the doctor may also need to know the patient’s menstrual cycle, diet, exercise routine, stress, and any changes in weight or medication.
2. Lab tests
Blood tests, such as FSH, LH, prolactin, and thyroid function tests, are performed. These tests are essential for measuring hormone levels.
3. Imaging
An ultrasound or MRI may ascertain structural changes in the reproductive organs or diagnose abnormalities. Ultrasound can assess uterine scarring or structural issues, which may be causing amenorrhea
F] Treatment for Amenorrhea
The treatment for amenorrhea depends on its type and underlying cause. Treatments are personalised to address the root issue:
Primary Amenorrhea
If delayed puberty is the cause, the physician may advise the parents to wait and see and allow the body to grow at its own pace. In genetic cases or structural abnormalities, medical or surgical help from a private gynaecologist in London or your city may be necessary.
Secondary Amenorrhea
Treatment options vary based on the cause:
- Lifestyle Changes: Adjustments such as managing stress, modifying exercise routines, or maintaining a healthy weight can often restore normal menstrual cycles. For example, women with amenorrhea due to excessive weight loss may benefit from increasing caloric intake and reducing physical activity.
- Addressing Underlying Issues: Conditions like PCOS, thyroid dysfunction, or pituitary disorders require targeted treatments. Medications to regulate hormone levels, such as thyroid hormone therapy or birth control pills, can help restore regular cycles.
- Hormone Replacement Therapy (HRT): In cases of oestrogen deficiency, HRT may be prescribed to maintain bone density and trigger menstrual cycles. This therapy is particularly useful for women approaching menopause or those with ovarian insufficiency.
Conclusion
Amenorrhea, while not life-threatening, can have a significant impact on a woman’s health. Diagnosing and treating the underlying cause is crucial for preventing complications like infertility or bone density loss. Women experiencing menstrual irregularities should consult a healthcare provider to explore appropriate treatment options.
Neha Goel
Neha Goel, a Psychology alumna and MBA graduate from CASS Business School, London, brings together her expertise as a Reiki Practitioner and Practice Manager. She integrates psychology and business strategies to foster holistic well-being and personal development.