Amenorrhea

Written by Jane Carrasco

amenorrhea

Lack of Periods Is Amenorrhea

Amenorrhea is the term used to describe the absence of ovulation and a menstrual period in a woman of reproductive age, with many potential causes. It is not a diagnosis in itself but rather a sign of a disorder.

Treating the underlying problem can resolve amenorrhea.

Amenorrhea may result from an abnormality at any level of the reproductive tract.

It has been shown that pubertal development, menstruation, continues to begin earlier in American girls. Consider a physician evaluation be initiated for a girl who has not begun menstruation by the age 14. In addition, women who menstruate fewer than 9 times in any 12-month period should be evaluated. See a physician if you have any irregularities in your menstrual cycle.

Your physician will determine which of the two types of amenorrhea you suffer from, primary or secondary amenorrhea.

Primary amenorrhea is when you haven't ever had a period and you are 16 years old or older. It is the less commonly reported type, affecting less than 1 percent of adolescent girls in the United States.

What Causes Primary Amenorrhea?

Chromosomal abnormalities- This type of amenorrhea is a depletion of the eggs and follicles involved in ovulation and menstruation prematurely, caused by chromosomal abnormalities.

Problems with the hypothalamus- Functional hypothalamic amenorrhea is a failure of the hypothalamic-pituitary-gonadal axis to induce cyclic changes in the endometrium that normally result in menses. The normal function of the hypothalamus can be disrupted by excessive exercise, eating disorders, such as anorexia, and physical or psychological and stress. Less commonly, a tumor could prevent the hypothalamus from functioning normally.

Pituitary disease- The pituitary gland is found in the brain. It's ability to perform the function of regulating the menstrual cycle may be disrupted if a tumor or other invasive growth is present.

Lack of reproductive organs- Amenorrhea may indicate the absence of end organs or from obstruction of the outflow tract. A baby girl can be born without some major part of her reproductive system, such as her uterus, cervix or vagina.

Structural abnormality of the vagina- A membrane, wall or obstruction may be present in the vagina that blocks the outflow may prevent visible menstrual bleeding.

The diagram below shows a development problem which is an example of a cause of primary amenorrhea symptoms.

You may have secondary amenorrhea if you have had normal periods but then you don't have one for 3 or more months in a row. It is much more common than primary amenorrhea. With this condition, a woman with a history of regular cyclic bleeding has ceased menstruating for three months, or six months in a woman with a history of irregular periods.

What Causes Secondary Amenorrhea?

Pregnancy- Pregnancy is the #1 most common cause of amenorrhea. The lining of the uterus isn't shed as menstruation.

Contraceptives- Oral contraceptives can keep a woman from menstruating. Regular ovulation and menstruation should resume within three to six months after you quit taking the pill.

Breast-feeding- Breast-feeding can cause a woman to experience amenorrhea, although ovulation still may occur.

Stress- The functioning of the hypothalamus can be altered by mental stress. This can cause irregular menstrual periods. They usually resume after your stress decreases.

Medication- Certain medications can cause menstrual periods to stop. For example, antidepressants, antipsychotics, some chemotherapy drugs and oral corticosteroids can cause amenorrhea.

Illness- Having and illness may make menstrual periods irregular. Menstruation typically resumes after recovery.

Hormonal imbalance- Secondary amenorrhea can also be an indication of polycystic ovary syndrome (PCOS), the leading cause of infertility in women, affecting about 1 in 10 in the United States . The name polycystic ovary syndrome comes from the appearance of the ovaries in some women with the disorder large and studded with numerous cysts (polycystic).? This condition causes relatively high and sustained levels of estrogen and androgen, a male hormone, rather than the fluctuating levels seen in the normal menstrual cycle. This results in a decrease in the pituitary hormones that lead to ovulation and menstruation.

Low body weight- Abnormal hormonal changes caused by eating disorders, such as anorexia or bulimia or excessively low body weight interrupt ovulation. Women stop having periods because of this.

Excessive exercise. Athletes that require rigorous training, may find their menstrual cycle interrupted. Low body fat, stress and high energy expenditure contribute to the loss of periods in athletes.

Thyroid malfunction. Thyroid disorders can also cause an increase or decrease in a reproductive hormone generated by your pituitary gland, prolactin. An altered prolactin level can affect your hypothalamus and disrupt your menstrual cycle.

Pituitary tumor. An overproduction of prolactin, which can interfere with the regulation of menstruation can be caused by a noncancerous (benign) tumor in your pituitary gland. This type of tumor is treatable with medication, but it sometimes requires surgery.

Uterine scarring- A condition in which scar tissue builds up in the lining of the uterus, Asherman's syndrome, can sometimes occur after uterine procedures, such as a dilation and curettage (D and C), Cesarean section or treatment for uterine fibroids. The normal buildup and shedding of the uterine lining is prevented by uterine scarring.

Premature menopause- If you prematurely menopause, before age 40, the lack of ovarian function associated with menopause decreases the amount of circulating estrogen in your body. The endometrial, or uterine lining thins, bringing an end to your menstrual periods.

The great majority of women with Secondary Amenorrhea were unable to become pregnant until recent advances in reproductive techniques, which have enabled many to have children. Weight gain or maintenance of normal weight, lowering stress hormone levels, and restoring normal estrogen levels are important factors associated with recovery from Amenorrhea.

Talk to your physician and schedule a gynecological exam to find the cause of your amenorrhea and discuss possible treatments available.

Disclaimer
The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions. The content provided is intended strictly for informational purposes to help patient understanding of medical terms and conditions.

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