Amenorrhea
Overview
What is Amenorrhea?
Amenorrhea (uh-men-o-REE-uh) affects 2% to 5% of women under the age of 40. Amenorrhea is defined as missing one or more menstrual cycles (periods). Sometimes this is perfectly normal, while at other times, it could be a symptom of something more serious. Women who have a family history of amenorrhea or a history of gynecologic procedures such as a D&C seem to have a higher risk of developing amenorrhea. Identifying the cause of your amenorrhea is important to your overall health because it can cause pelvic pain, psychological stress, infertility, problems during pregnancy, osteoporosis, and cardiovascular disease.
Primary amenorrhea is defined as the absence of menstruation in someone who has not had a period by age 15. Sometimes the cause of primary amenorrhea is related to anatomical problems. But the most common cause of primary amenorrhea is related to hormonal levels.
Secondary amenorrhea refers to missing three or more periods in a row by someone who has had at least one period in the past. The most common causes of secondary amenorrhea include:
- Pregnancy
- Menopause
- Breastfeeding
- Hysterectomy
- Chemotherapy
- Female athletics
- Hormonal imbalance
Other things to consider that could cause you to miss your period include:
- Lifestyle – This includes things like:
- Stress
- Low bodyweight
- Excessive exercise
- Structural problems – This includes things like:
- Uterine scarring
- A lack of reproductive organs
- Structural abnormality of the vagina
- Medications – Some medications that can disrupt your periods include:
- Antipsychotics
- Antidepressants
- Allergy medications
- Blood pressure medications
- Hormonal imbalance – There are many types of medical issues that can cause a hormonal imbalance, including but not limited to:
- Pituitary tumor
- Premature menopause
- Polycystic ovary syndrome (PCOS)
- Thyroid disorder (hyperthyroidism and hypothyroidism)
Symptoms
Amenorrhea Symptoms
Besides the absence of periods, there may be other signs or symptoms that accompany amenorrhea, depending on the cause. These include:
- Acne
- Hair loss
- Headache
- Pelvic pain
- Vision changes
- Excess facial hair
- Milky nipple discharge
Diagnosis
Amenorrhea Diagnosis
The type of amenorrhea you are experiencing (primary or secondary) will help determine which tests the doctor uses to diagnoses the problem. Your doctor will ask you questions such as when was your last period, could you be pregnant, are you under any stress, and more. A pelvic exam will check for inconsistencies with your reproductive organs. In primary amenorrhea, your doctor may examine your breasts and genitals to make sure you are experiencing the regular changes of puberty. Finding the underlying cause may take time and require patience. It may require more than one kind of test, including:
Treatments
Amenorrhea Treatments
Treatment of your amenorrhea will depend on the underlying cause. Some lifestyle factors such as too much exercise or too little food can cause amenorrhea, so a balanced lifestyle could solve the problem. However, in some cases, hormone therapy or birth control pills may be needed to restart your period. Your doctor may treat you with medications if your amenorrhea is the result of thyroid or pituitary disorders. Or the doctor may recommend surgery if a tumor or structural blockage is causing the problem.
Specialists
