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Guide to Absence of Menstrual Cycle (Amenorrhea)

MENSTRUAL PERIODS is crucial to teenage girls and adult women health. Learn why! Continue your reading about what everyone must know about Absence of MENSTRUATION (also known as Amenorrhea).

Introduction to Amenorrhea

Amenorrhea is the absence of menstruation that is one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row are referred to have amenorrhea, as do girls who haven’t begun menstruation by age 15.

The most common cause of amenorrhea is pregnancy whereas other causes of amenorrhea include problems with the reproductive organs or with the glands that help regulate hormone levels. In simple words, it is the absence of menstrual bleeding in a woman of reproductive age.

What is Amenorrhea?

The absence of menstruation or a monthly period is called Amenorrhea. In other words, the absence of menstruation in an women for three months in a row are treated to have amenorrhea, as do girls who haven’t begun menstruation by age 15. It can be both primary Amenorrhea and secondary Amenorrhea.

How Amenorrhea Occurs?

It can happen during puberty or later in life at the time of menopause. Lifestyle factors like excessive exercise and stress may also include. Having less than average weight or too much body fat may also be the reasons for the delay or stop of menstruation.

Some researchers found that the girls who diet are at risk for low bone density and that this condition increases their risk for osteoporosis later in life.

To understand what constitutes abnormal menstruation, first it’s important to define what is normal. This depends somewhat on your age.

• For adolescents, the onset of menstruation called menarche varies, though it typically occurs at 12 to 13 years of age. Within two years, menstruation for 95 percent of teens falls into a regular pattern. Girls who reach menarche early also tend to become regular more quickly. For those who begin their period shortly, the pattern may set in later.
• For women of reproductive age (18 to 50 years) menstrual cycles usually last 28 to 35 days, measured from the first day of bleeding in one cycle until the first day of the next. The menstrual period typically lasts four to six days.
• In postmenopausal women, those who have ceased menstruating any bleeding is considered abnormal and should be discussed with a physician.

Menstrual irregularities fall into four major categories across the age spectrum. They are

1. Amenorrhea, absence of menstruation
2. Frequent Bleeding
3. Bleeding Between Cycles
4. Excessively Heavy Periods

Types of Amenorrhea

• Primary
• Secondary

Primary Amenorrhea: It describes a condition in which you haven’t begun menstruation by age 16.

Secondary Amenorrhea: It occurs when you were previously menstruating, but then stopped having periods for six months or longer in the absence of pregnancy, lactation (production of breast milk), cycle control with systemic hormonal contraceptive birth control pills or menopause.

Causes of Amenorrhea

Primary and secondary amenorrhea can happen for numerous reasons and a very long list of causes exists for amenorrhea. The following are some of the causes for primary and secondary amenorrhea.

Causes of Primary amenorrhea

• Pituitary disease
• Chromosomal abnormalities
• Structural abnormalities of reproductive organs during foetal development

Causes of Secondary amenorrhea

• Pregnancy
• Contraceptives
• Chronic sickness
• Hormonal imbalance(polycystic ovary disease)
• Stress
• Thyroid disorders(hyperthyroidism)
• Premature menopause
• Hyperprolactenemia

Signs & Symptoms of Absent Menstrual Periods:

Depending on the cause of amenorrhea, there are some other signs or symptoms one might experience along with the absence of periods, such as

• Sudden pain in lower segment of abdomen
• Milky nipple discharge
• Heavy Hair loss
• Headache
• Vision changes
• Excess facial hair and torso (hirsutism)
• Pelvic pain
• Acne

How does amenorrhea affect the Body?

Amenorrhea mostly affects the reproductive system, causes problems such as anorexia or bulimia, excessive exercise, or tumors. These may cause lasting damage to the body. These Tumors may spread in the body and prevent the functioning of organs, and anorexia and bulimia can cause extreme muscle or bone loss if they are not treated.

The absent menstrual periods can cause effects similar to those of menopause if it is not noticed. Another serious condition associated with amenorrhea is osteoporosis or bone loss that usually occurs in menopausal women who do not have enough calcium and vitamin D to maintain the bone density. Prolonged amenorrhea can also increase the threat of infertility.

When to see a doctor?

Menstrual irregularities are common and often harmless but may cause irritation. If we ignore, this can range from being a nuisance to signaling a more serious underlying problem. You need to see the doctor when you have any of the following problems.

• When you have not started menstruating by the age of 16.
• When you have not started menstruating within 3 years after you developed breasts, or if you have not started developing breasts by age 13.
• When you have not had a period for more than 3 months.
• When your periods become very irregular after you previously had regular, monthly cycles.

If you have observed any of the symptoms, first thing you need to do is to avoid junk food and immediately consult the doctor. Because it is important to rule out the condition that requires treatment. Once that has occurred, you and your doctor together can address ways to reduce the impact that irregular menstruation have on your life.

Risk factors of Absent Menstrual Periods

• Chronic absence of periods: Chronic absence of periods causes infertility
• Natural causes: These are most likely to cause amenorrhea including pregnancy, breast-feeding, and menopause.
• Lifestyle: Lifestyle like excessive exercise and stress may include in irregular periods. Also, having less body or too much body fat may also delay or stop menstruation.
• Hormonal imbalances: Hormonal imbalances may also be the reason for cause of amenorrhea. They are typically caused by tumors on the pituitary gland or the thyroid gland.
• Low or high testosterone levels: Low estrogen levels or high testosterone levels can also cause them.
• Disorders: Disorders like Genetic disorders or chromosomal disorders, such as Turner syndrome and Sawyer syndrome, can sometimes cause late menstruation.
• Medications: Medications can cause amenorrhea in some women.
• Antipsychotics and antidepressants: Antipsychotics and antidepressants are often involved in causing irregular periods.
• Chemotherapy drugs and medications: Chemotherapy drugs and medications that treat high blood pressure can cause problems with menstruation as well.
• Birth control pills: Suddenly stopping birth control pills may also lead to several months of absent periods before the cycle returns to normal.
• Physical defects: Physical defects such as structural problems in the female reproductive organs might be a cause for absent or delayed menstruation.
• These issues may come from birth defects, tumors, or infections that occurred in the womb or soon after birth.
• Asherman’s syndrome: In some rare cases, missed periods can be a symptom of Asherman’s syndrome. This occurs due to scarring in the uterus after surgery, which can prevent menstruation.

Medical Advice for Absent Menstrual Periods

Menstrual cycle disorders can cause a woman’s periods to be absent or irregular. Some women do not mind event if they miss their menstrual period, but these changes should always be discussed with a health care provider because they can signal underlying medical conditions and may lead to long-term health problems.

A woman who misses more than three menstrual periods either consecutively or over the course of a year should consult a health care provider.

Treatment for Absent Menstrual Periods

The Treatment for Amenorrhea varies depending on the underlying cause. In some cases, your menstrual cycles can restart by contraceptive pills or other hormone therapies. Before starting the treatment, your health provider will figure out the best treatment for you based on:

• Your age
• Your present health and past health
• How unwell you are
• How adequately you can handle specific medicines or therapies
• How long the condition take to last
• Your preference

Your doctor may also recommend making simple lifestyle changes if your weight or exercise routine is a reason to your condition. If needed, you can ask advice from a nutritionist or dietitian. In this way you can manage your weight and physical activity in a healthy way.

If doctors find it serious, they may also want to remove ovarian cysts, scar tissue, or uterine lesions that are causing you to miss your menstrual periods. So, before it’s too late, it’s better for you to consult your doctor when you have observed the amenorrhea symptoms.

Fix an appointment with your doctor so they can determine the cause of your amenorrhea. Stick with your treatment plan and attend all follow-up appointments are very important. Contact your doctor immediately if your condition doesn’t improve with medical treatments or lifestyle modifications.

Investigations for Absent Menstrual Periods

When you consult your doctor about amenorrhea, your doctor will perform a physical exam and ask you a series of questions. Be prepared to tell about your normal menstrual cycle, your lifestyle, and any other symptoms you’re experiencing.

If you haven’t had a period in three months the doctors will also order a pregnancy test. If that condition is serious, you may need more tests to determine the underlying cause of your missed periods. These diagnostic tests may include:

• Lab tests
• CT and MRI scans
• Ultrasound

Lab tests like Blood tests will allow your doctor to check hormone levels in your body. Prolactin, luteinizing hormone, and follicle stimulating hormone are all related to menstruation. Determining these levels can help your doctor determine or rule out the cause of your absence of periods.

Ultrasound is an imaging test that uses high frequency sound waves to create detailed pictures of the inside of the body. It helps to view various organs, such as the ovaries and uterus, and check for abnormal growths.

CT scan is another type of imaging test that uses computerized and rotating X-ray machines to create cross-sectional images of the body. If there are any masses and tumors present in your glands and organs, these can be identified through these images.

Can Amenorrhea be Cured?

Depending on the cause of amenorrhea like primary and secondary, a cure may be possible. If it is caused by primary Amenorrhea the treatment would be different and for secondary Amenorrhea the treatment would be different. To reduce the effect of Amenorrhea, you need to take some care.

Self-care for Absent Menstrual Periods

• Balanced diet
• Peaceful sleeping.
• Regular exercise
• Stress reduction
• Make less use of Birth control pills
• Make less use of Depoprovera injection

What to eat for Amenorrhea?

Always try to maintain a balanced diet and avoid junk food. Eat foods which are rich in iron, Vitamin C, B Vitamins, Essential fatty acids, Cholesterol, Fiber, Zinc, etc. If necessary, ask your doctor to refer you to a nutritionist or dietitian. These specialists can guide you how to manage your weight and physical activity in a healthy way.

Home Remedies for Amenorrhea

These following are some of the traditional remedies for not only amenorrhea but also for many other menstrual related problems.

Cinnamon

Cinnamon is actually a spice that has been traditionally used as a cure for amenorrhea. It is suggested by many studies that using cinnamon with honey can treat this condition.

Saffron

Saffron is an antioxidant that can help to treat amenorrhea. Saffron acts as toxin-flushing and stress-reducing agent helps to regularize menstruation by cleaning up and soothe the body from the inside out.

Angelica Sinensis

Angelica is a root that has been used in relief from amenorrhea. Several studies show that it has significant effects on other problems like painful periods, or menstrual cramps and pain during menstruation.

False Unicorn

False unicorn is an herb which has traditionally been used very often as a medicine for amenorrhea and other women’s gynecological health and to cure infertility. It is proved by scientific studies that false unicorn indeed has some infertility-curing properties.

Lemon Balm

Lemon balm is another herb that has been used in the treatment of amenorrhea and other menstrual problems. It regulates menstrual cycle and eases menstrual cramps. It is also used to treat migraines and headaches resulting from amenorrhea.

Blue Cohosh

Blue cohosh is a plant that has been used in traditional medicine as it is a very good menstruation stimulant and it also provides stimulation for blood flow to effectively treat amenorrhea.

Dill Weed

Dill Weed herb is another best remedy for amenorrhea. The Women who do not have regular periods can take dill to have periods on a regular basis. It has been used for enhancing the flow of breast milk. Dill weed can be taken as medicine and also in cooking.

Sweet Fennel

Sweet fennel is an herb which has a good effect on stimulating the menstrual cycle and it also helps in maintaining an optimum fluid balance in the body. It has been found to be effective in premenstrual syndrome (PMS).

Fenugreek

Fenugreek is considered to be one of the best solutions for many problems related to the menstrual cycle and reproduction. Fenugreek has been used with positive results not only in amenorrhea but also in milk production, relief from menstrual cramps and hot flashes for generations.

Chasteberry

Chasteberry is another herb that helps in treating menstrual cycle disorders. It balances estrogen and progesterone hormones, which are very important in keeping the menstrual cycle on course.

Tomato Juice

Drinking tomato juice or intake of tomatoes every day is recommended for excellent results in treating amenorrhea. Ayurveda, the ancient Indian system of traditional medicine, also recommends tomatoes as a remedy for amenorrhea.

FAQs of Amenorrhea

How does amenorrhea affect bone health?

The production of the hormone estrogen is an important part of the menstrual cycle. Estrogen also plays a crucial role in bone health. Low estrogen or problems with estrogen production may cause amenorrhea. In this case a woman may be at risk for loss of bone mass.

Excessive exercise and eating disorders are some common causes of estrogen deficiency that show effect on bone density.

When should I talk to doctor about a missed period or several missed periods?

If you have had irregular periods for more than three months or if there is any chance you may be pregnant, check with your health care provider about a missed period right away.

If you are just beginning to menstruate, it may take several months for your menstrual cycle to become regular.

Will amenorrhea cause infertility?

If you don’t have menstrual periods, you can’t become pregnant. You may also be at risk of osteoporosis, a weakening of your bones if your amenorrhea is caused by low estrogen levels.

Is there still any chance to get pregnant if I have amenorrhea?

Yes, you can still get pregnant even if you have irregular periods. Although some of the conditions that cause amenorrhea can also be a reason for infertility, but there is still a chance for pregnancy.

Which doctor should be consulted for the problem of Amenorrhea?

You may consult a gynecologist for this problem.

What is the difference between primary and secondary Amenorrhea?

Primary Amenorrhea occurs when women fails to menstruate even after attaining 16 years of age. Secondary Amenorrhea refers to an absence of menses in women for more than three months.

Is Primary Amenorrhea hereditary?

In some individuals, heredity plays a role in the onset of the disease.

What is the role of exercise in the beginning of the Primary Amenorrhea?

Excessive exercise may lead to an energy drain and increased fatigue,   which may lead to delayed menarche.

Do Birth control pills cause Amenorrhea?

Studies show that the Birth control pills can delay the return of menstruation in some women. Most of the time, this effect is temporary and your cycle should return within a couple of months. If your period is still missing for more than three months after you stopped the pill, then it’s better to talk to a doctor.

Is there a cure for Amenorrhea?

Depending on the cause of amenorrhea like primary and secondary, a cure may be possible.

Can our lifestyle be a cause for Amenorrhea?

Lifestyle like excessive exercise and stress may be one of the reasons for irregular periods. Also, having less body or too much body fat may also delay or stop menstruation.

What are the major consequences of Amenorrhea?

If doctors find it serious, they may also want to remove ovarian cysts, scar tissue, or uterine lesions that are causing you to miss your menstrual periods. So, before it’s too late, it’s better for you to consult your doctor when you have observed the amenorrhea symptoms.