AMENORRHEA
Amenorrhea is the absence of menstrual period in a woman of reproductive age. Amenorrhea is not a disease, and it does not always mean that a person is infertile, but it can be a symptom of a health problem that requires medical attention. Menstruation begins around puberty and then it occurs about once a month until the age of 50.At this time, the monthly flow stops altogether, as menopause begins. Menstruation also stops during pregnancy, and it is also common to stop during breastfeeding. In amenorrhea, menstruation does not occur at times when it is expected to.
There are two types of amenorrhea: primary and secondary.
In primary amenorrhea, the menstrual period has not begun by age 16.
In secondary amenorrhea, there is an absence of menstrual period for three consecutive cycles in a woman with previously normal menstruation or nine months in a woman with a history of irregular periods.
Long-term amenorrhea leads to an estrogen deficiency which can result in rapid calcium loss and lead to osteoporosis.
CAUSES
Amenorrhea can be caused by a variety of reasons. Some are normal during the course of a woman’s life, others may be due to medical problems or a side effect of medications.
This may include:
- Pregnancy
- Breastfeeding
- Menopause
- Medications such as antipsychotics, blood pressure drugs, chemotherapy, antidepressants, or allergy medications.
- Obesity
- Having a low body weight
- Excessive exercise
- Stress
- Tumors on the ovaries or pituitary gland
- Uterine scarring
- Premature menopause
- Polycystic ovary syndrome
- Thyroid malfunction such as overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism)
- Structural abnormality of the vagina
- Contraceptives
- Severe illness
- Lack of reproductive organs
- Weight loss
SYMPTOMS
- Acne
- A headache
- Hair loss
- Vaginal dryness
- Changes in vision
- Nipple discharge
- Excess facial hair
- Pelvic pain
DIAGNOSIS AND TREATMENT
To make a diagnosis, the doctor will carry out a pelvic exam to detect any problems with your reproductive organs.
If you have primary amenorrhea, the doctor may examine your breasts and genitals to see if you are going through the normal changes of puberty.
The doctor may also carry out varieties of blood tests, including:
- Pregnancy test to rule out or confirm pregnancy
- Thyroid function test where the amount of thyroid-stimulating hormone in your blood is measured to determine if your thyroid is working well.
- Ovary function test where the amount of follicle-stimulating hormone in your blood is measured to determine if your ovaries are working well.
- Male hormone test if symptoms include increased facial hair. This is done to check the level of male hormones in your blood
- Prolactin test
Imaging tests such as MRI, CT scans, and ultrasound can also be used. This allows your doctor to view your internal organs including your uterus, ovaries, kidney, and other reproductive organs.
TREATMENT
Treatment option depends on the underlying cause of the condition.
Surgery may be necessary if a tumor or structural blockage is causing your problem
If a thyroid disorder is causing your problem, medications can be used.
If your weight or exercise routine is causing your problems, your doctor may recommend making certain lifestyle changes.