Amenorrhea is the absence of menstruation, often defined as missing one or more menstrual periods. Primary amenorrhea is the absence of menstruation in someone who has not had a period by age 15. This article will explain in depth the causes and treatments of amenorrhea.
Medically Reviewed by Dr. K on 2nd Dec 2021.
Amenorrhea: Why You May Not Be Getting Your Period
Amenorrhea is when you do not have your periods despite having completed puberty, not being pregnant, and not going through menopause.
It is not about menstrual irregularities. You do not receive your period if you have amenorrhea. Even though it is not an illness, you should inform your doctor about it since it may be a sign of a medical problem that can be addressed.
There are two kinds of amenorrhea:
Primary amenorrhea. When a young woman reaches the age of 15, she has not had her first period.
Secondary amenorrhea. This is when you’ve had regular menstrual periods, but they’ve stopped for three months or longer.
Aside from not having your period, you may have the following symptoms, depending on the reason for your amenorrhea:
- Pelvic pain is a common problem.
- Changes in your eyesight
- Hair loss
- Hair growth on your face
- Milky discharge from your nipples
- There is no evidence of breast growth (in primary amenorrhea)
Causes of Amenorrhea
A variety of factors may cause amenorrhea.
Primary amenorrhea (when you don’t receive your first period) may be caused by a variety of factors, including:
- Ovarian failure – a condition in which the ovaries fail to function correctly.
- Problems with the pituitary gland or the central nervous system (brain and spinal cord) (a gland in the brain that makes the hormones involved in menstruation)
- Having issues with your reproductive organs
In many instances, the underlying cause is not understood.
Secondary amenorrhea (when a woman who previously had regular periods ceases having them) may be caused by a variety of factors, including:
- Putting an end to the use of birth control
- Some birth control techniques, such as Depo-Provera or some intrauterine devices (IUDs), are contraindicated.
Secondary amenorrhea may also be caused by:
- Nutritional deficiencies
- Antidepressants, antipsychotics, blood pressure meds, and allergy treatments are examples of prescription pharmaceuticals.
- Extreme calorie restriction
- Illness that persists
- Sudden weight increase or becoming very obese (obesity)
- Polycystic ovarian syndrome (PCOS)
- Thyroid gland failure
- Tumours on the ovaries or brain (rare)
- Cancer treatments such as chemo and radiation
- Scarring of the uterus
- Removal of sexual reproductive organs – ovaries and uterus
Because there are so many causes of amenorrhea, determining the precise reason may take some time.
Your doctor will begin by reviewing your medical history and doing a physical and pelvic examination. They may request a pregnancy test if you’re sexually active to rule out pregnancy as a reason.
Finding out what’s causing your amenorrhea may need a variety of tests. One or more of the following may be used by your doctor:
Blood tests. These tests look at the amounts of hormones like follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), prolactin, and male hormones in your blood. The menstrual cycle may be disrupted by too much or too little of these hormones.
Imaging tests. These tests may reveal abnormalities in your reproductive organs or where malignancies are located. Ultrasound, computed tomography (CT), and magnetic resonance imaging are available diagnostics (MRI).
Hormone challenge test. Your doctor will prescribe a hormonal prescription that, when stopped, should result in menstrual bleeding. If you don’t, your amenorrhea may be caused by a lack of oestrogen.
Hysteroscopy. To examine the interior of your uterus, your doctor will insert a tiny illuminated camera into your vaginal and cervix.
Genetic screening. Look for congenital abnormalities that may cause your ovaries to cease functioning, as well as missing or partially missing X chromosomes (Turner’s syndrome).
Chromosome tests (karyotype). Identifies missing, extra, or altered cells in your chromosomes to aid in the diagnosis of amenorrhea-causing disorders.
Amenorrhea Treatment and Home Care
The condition that causes amenorrhea will be the focus of treatment. Hormone treatment or birth control tablets may help you re-establish your menstrual cycle. Medication may be used to treat a thyroid or pituitary problem. Surgery may be required for physical defects.
If anything influences your menstrual cycles, such as stress, weight gain or loss, or sadness, you may take an active part in your therapy by taking measures to control it. Your doctor, family, or friends may be able to assist you.
By keeping note of changes in your cycle and symptoms and sharing this information with your doctor, you may assist them in determining the reason for your amenorrhea. Tell them about any medicines you’re taking, as well as any dietary, exercise, or stress adjustments you’ve made.
- Hormone Health Network: “Amenorrhea."
- National Institute of Child Health & Human Development: “Amenorrhea."
- Mayo Clinic: “Amenorrhea.”
- Eunice Kennedy Shriver National Institute of Child Health and Human Development: “Amenorrhea.”
- Cleveland Clinic: “Amenorrhea.”
- Fertility and Sterility: “Menses resumption after cancer treatment-induced amenorrhea occurs early or not at all.”
- Children’s Hospital of Philadelphia: “Amenorrhea.”
- Yale Medicine: “Amenorrhea.”