Amenorrhea

Overview of Amenorrhea

Amenorrhea (حیض کی نکاسی نہ ہو نا) pronounced as (uh-men-o-REE-uh) is basically missing one or more periods. It is also simply known as the absence of the periods. In amenorrhea, even though a female has undergone puberty, isn’t pregnant, and even hasn’t undergone menopause, she doesn’t get her periods.

It can be permanent or temporary. It can result due to a problem or change in any of the functions of the female reproductive system. Amenorrhea is not just about having irregular periods, in fact, in amenorrhea, an affected female doesn’t go get periods at all. It is not a disease, but rather a condition. It can also be a symptom of any underlying health condition. So, you need to consult a medical practitioner.

Signs and Symptoms of Amenorrhea

The other symptoms and signs of amenorrhea vary depending upon the cause. Apart from the absence or irregularity of the periods, other amenorrhea symptoms include:

  • Hair fall or hair loss
  • Milky discharge from the nipple
  • Excessive hair on the face
  • Acne
  • Headache
  • Pelvic pain
  • Changes in vision

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Types of Amenorrhea

What is the classification of amenorrhea

There are 2 types of amenorrhea based on the health condition namely primary amenorrhea and secondary amenorrhea.

Primary Amenorrhea

In this type, a female doesn’t get her first period by the age of 15. It is due to the changes in the glands, organs, or hormones linked with the periods or menstruation.

Secondary Amenorrhea

In this, affected females have normal periods but the cycle stops for either 3 or more months. It can be due to the underlying health condition, stress, or pregnancy.

Causes of Amenorrhea

 There are multiple reasons for amenorrhea. Some of them are normal while others can be due to the underlying medical health condition or due to the side effects of medication.

Primary Amenorrhea Causes

Possible reasons for primary amenorrhea are:

  • Failure of the ovaries due to chromosomal or genetic factors
  • Problem with the central nervous system
  • Problem with reproductive organs

Secondary Amenorrhea Causes

Possible reasons for secondary amenorrhea are:

  • Pregnancy
  • Menopause
  • Breastfeeding
  • Contraceptive pills
  • Radiation or chemotherapy for cancer
  • Previous medical history of uterine surgery

Other major causes of secondary amenorrhea are:

  • Poor nutrition
  • Stress
  • Changes in weight i.e. obesity or extreme weight loss
  • Chronic illness

Secondary amenorrhea can also be due to various other health conditions, which include:

  • Primary ovarian insufficiency when a woman suffers menopause before the age of 40.
  • Pituitary disorders (such as prolactin excessive production of benign pituitary tumor)
  • Disorders of the Hypothalamus e.g. FHA or functional hypothalamic amenorrhea. It is also known as hypothalamic amenorrhea (HA). It is a condition where amenorrhea is caused by weight loss or stress.
  • Tumours of the ovaries.
  • Surgery for the removal of ovaries or uterus.
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Risk Factors of Amenorrhea

The amenorrhea risk factors include:

  • Early menopause or family history of amenorrhea
  • Eating disorder
  • Stress
  • Poor dietary habits
  • Chronic illness
  • Excessive exercise
  • Being underweight or obesity
  • Affected menstrual cycle due to the chromosomal condition

Health Complications

Apart from the aforementioned amenorrhea causes, it can be due to other health complications as well. These include:

  • Problems with Infertility or Pregnancy
  • Psychological stress issues
  • Cardiovascular disease (e.g. heart attack, problems with the heart muscle and blood vessels)
  • Osteoporosis
  • Pain in the pelvic region

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Prevention

Amenorrhea prevention is not really difficult if it is not due to any genetic issue. You can prevent some of the major causes of secondary amenorrhea by following ways:

  • Eating a healthy diet and maintaining a healthy lifestyle
  • Keep a track of your periods
  • Getting sufficient and enough sleep
  • Getting yourself checked regularly by your gynecologist
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Diagnosis

If you miss a period, you need to consult your doctor. Your doctor will ask about your medical history and symptoms if you have any. You would be asked to start prenatal care if you suffer from amenorrhea during the pregnancy. If amenorrhea is due to menopause, your doctor will help you in managing your uncomfortable symptoms.

To further confirm that a female is suffering from amenorrhea, medical healthcare would recommend the following diagnostic tests:

  • Genetic testing (if you are under 40 years of age and suffer from primary ovarian insufficiency)
  • Pregnancy test (such as USG test etc)
  • Blood test (such as CBC, hormone test- basic thyroid test, FSH, TSH, etc) to check and detect the adrenal gland disorder or thyroid issue
  • MRI (In case the symptoms suspects a problem with hypothalamus or pituitary glands)

Do I Need to Keep a Track of My Periods?

It can be quite challenging to diagnose amenorrhea properly. Your doctor may ask you to keep a track of your periods if it is not due to pregnancy. This can help your doctor with the proper diagnosis.

You need to keep track of:

  • How many days do your periods last
  • The last period that you had
  • Medication (if you are taking any)
  • Exercise and diet changes
  • Stress

Treatment of Amenorrhea | When to Consult a Doctor

The amenorrhea treatment depends upon a patient’s health condition. If it is due to pregnancy or menopause, the medical healthcare provider will treat it. Amenorrhea treatment mainly depends upon the cause and it may include:

  • In case of being underweight, the treatment would include weight gain through a customized diet plan.
  • Losing weight by exercising or dieting, in case of obesity.
  • Techniques for stress management.
  • Improving levels of exercise.
  • Medication (Hormonal treatment)
  • Surgery (In rare cases such as during uterine scar tissue, pituitary tumor and chromosomal or genetic problem)

Amenorrhea can also be the symptom of an eating disorder, anorexia nervosa. So, you need to give a proper health profile to your doctor for complete treatment.

In case of the side effects of amenorrhea, the doctor may also recommend the following treatment plans:

  • Strength Training
  • Vitamin D and Calcium Supplements for bone strength
  • Estrogen therapy to get relief from vaginal dryness and hot flashes.

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Last updated on Friday 21/10/2022

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