Amenorrhea is a health condition that arises due to complete absence or due to one or more missed periods or menstruation during the reproductive age between puberty and menopause. Amenorrhea can occur due to pregnancy or some hormonal or reproductive organ malfunctioning.
Customarily, menstruation occurs due to a cycle which starts from hormonal changes taking place within the ovaries. The ovaries usually retort back to hormonal signals from the pituitary gland, which is located at the base of the brain, which, in turn, is regulated by the hormones produced in the hypothalamus region. Any change or disturbance that affects any of the hormones or organs within the cycle can lead to amenorrhea.
Even though it is not a diseased condition, it can be a symptom of an underlying health problem that must be treated on time to ward off severe health conditions like infertility, osteoporosis, etc. Also Read: Struggling With Infertility? Don’t Lose Hope
Normally there are two types of amenorrhea,
This mostly happens when the child doesn’t get her periods even at the age of 16. It generally occurs due to a genetic problem or a family history of delayed menstruation. Genetic conditions mostly include Turner Syndrome, Mullerian defects (i.e. malfunctioning of the reproductive organs) and Androgen sensitivity syndrome (i.e. excessive secretion of the androgen hormone). It can also occur due to problems with sexual organs like uterine scarring, structural abnormality of the vagina and lack of proper reproductive organs.
This happens when a person doesn’t have her periods due to pregnancy, lactation, menopause or some other hormonal problem.
It is considered a secondary type:
- When the person used to have regular periods and then does not have them for 3 consecutive months.
- When the person used to have irregular periods and then does not have them for 6 consecutive months.
The menstruation in this case can stop suddenly due to physical stress, poor nutrition, depression, health issues like polycystic ovarian syndrome (i.e. PCOS), thalamic pituitary problems, premature ovarian failure, tumours in the ovaries, thyroid malfunctioning, pituitary tumour, excessive low or high BMI (i.e. Body-Mass Index) due to sudden weight loss or weight gain, rigorous exercise regimen, and medications like antipsychotics, antidepressants, blood pressure modulating medicines and those used for chemotherapy. Also Read: Polycystic ovary syndrome (PCOS)
The chief symptom of amenorrhea is the absence of periods. Other signs and symptoms include the particular cause due to which one is not having periods which include:
- Milky nipple discharge
- Pelvic pain
- Changes in the size of the breast
- Vision changes
- Deeping of the voice
- Hair loss
- Excess facial hair
Diagnosis and Treatment
Amenorrhea is usually diagnosed by a gynaecologist after a thorough physical check-up of the pelvis and proper review of the past medical history and health history of both the patient and family members. Additionally, the doctor may perform some tests to understand the exact cause of it which includes:
- Pregnancy Test to rule out if the patient has conceived
- Thyroid Function Test to determine the TSH levels
- Ovary Function Test to determine the FSH or LH levels
- Tests determining the level of estrogen and testosterone in the blood to detect PCOS.
- Prolactin test to determine any abnormality with the pituitary gland
- Karyotype test to understand the genetic defect
- Other Imaging techniques including Ultrasound, CT-Scan, MRI-Scan.
Treatment usually depends upon the type of amenorrhea a person is suffering from. Amenorrhea occurring due to thyroid or pituitary gland malfunctioning can be treated by medications. In some instances, contraceptive pills and hormonal therapies can also start the periods. In case, there is a tumour or structural deformity, it can be treated by performing surgery.
Doctors also suggest some lifestyle changes and home remedies to deal with weight gain or weight loss, have a well-balanced diet and go for proper exercises to balance the work, rest and recreation to avoid stress.