Amenorrhoea

Amenorrhea is the absence of menstruation that lasts for at least three months. The causes are many and the treatments depend on them.

What is it

Amenorrhea is an absence of menstruation that lasts for at least three months. It is divided into primary amenorrhea, when the first menstruation (menarche) has never occurred by the age of sixteen, and secondary in all other cases.

Unless the absence of menstruation is not linked to pregnancy, the beginning of breastfeeding or menopause, amenorrhea is an indication of some disorder that, in general, is of a physical nature, but which can sometimes also have a psychological origin.

What to do if the cycle disappears in a young girl? Read the opinion of the gynecologist of Empoweressence  .

Causes

Menstruation is the result of a complex process that involves numerous organs: hypothalamus and pituitary gland in the brain, ovaries, uterus and lower genital tract.

Amenorrhea can therefore originate from abnormalities affecting each of these districts and therefore recognizes endocrine, anatomical, genetic and other causes. Here are some examples:

Endocrine causes Chronic anovulation
Anatomical causes Abnormalities in the vaginal septum, unperforated hymen
Pharmacological causes Taking psychiatric drugs or chemotherapy drugs

Suspension of the contraceptive pill

Malnutrition Anorexia

The most frequent cause of amenorrhea in women of reproductive age is chronic anovulation, in which, even in the presence of a functioning ovary, this is not reached by the hormonal signals necessary to induce ovulation and, consequently, menstruation. Usually this happens due to a dysfunction of the hypothalamus or pituitary.

Polycystic ovary, which usually causes only irregular menstrual rhythms, can sometimes induce amenorrhea.

Among the anatomical causes are abnormalities in the vaginal septum and an unperforated hymen. Curettages or other interventions on the uterus can cause scarring (adhesions or synechiae) that block menstruation.

Several drugs (including phenothiazine-based psychiatric drugs and cyclophosphamide or busulfan-based chemotherapeutics) can cause amenorrhea. This may also occur, temporarily, after stopping taking the birth control pill.

The interruption of menstruation can also be caused by a state of severe malnutrition, such as anorexia, or in women who practice constant and intense physical activity without adequate food.

Particularly high psychic stress can lead to the interruption of the menstrual cycle.

Finally, there are a number of genetic diseases that cause amenorrhea, but they are rare.

Most common symptoms

Amenorrhea itself is a symptom, not a disease. Depending on the cause that originates it, it can be accompanied by a variety of other symptoms including headache, galactorrhea (abnormal secretion of milk), weight gain or loss, decrease or increase in body hairiness, changes in breast size, vaginal dryness.

Complications

Any complications are related to the cause that is at the origin of the absence of menstruation.

Treatment

Therapy also depends on the cause, which must therefore be investigated. Once pregnancy is ruled out, a gynecological examination and a series of tests are required to measure hormone levels.

If the presence of genetic diseases is suspected, the karyotype, i.e. the number and shape of chromosomes, can be examined.

When to consult your doctor

In the presence of amenorrhea it is always advisable to contact the doctor for the appropriate investigations.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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