Amenorrhea Causes, Symptoms, Risk Factors, and Treatment

Amenorrhea is defined as the absence of menstrual periods in women who are over 15 years old. This condition can occur in individuals who have not yet had their first menstrual period or in those who have missed their period for up to four consecutive cycles. Amenorrhea is considered a treatable medical condition, and with appropriate intervention, it is often possible to restore regular menstrual cycles.

What is Amenorrhea?

Types of Amenorrhea

Primary Amenorrhea

Secondary Amenorrhea

Causes of Amenorrhea

Causes of Primary Amenorrhea

• Genetic or chromosomal issues affecting your reproductive system include Turner syndrome, which refers to the lack of one of the two X chromosomes typically present in females. Turner syndrome causes amenorrhea because little estrogen is produced, and scar tissue replaces the ovaries.
• Hormonal disorders result from brain or pituitary gland dysfunction.
• Organ structural issues, such as having an immature reproductive system or missing sections of your uterus or vagina.

Causes of Secondary Amenorrhea

• Medicines: Some users of oral contraceptive pills may not have their periods. It could take some time before regular ovulation and menstruation return, even after stopping the drugs. Amenorrhea can also result from injectable or implanted contraceptives, such as some intrauterine devices.
• Polycystic ovarian syndrome : Hormone levels are relatively high and persistent in PCO as opposed to fluctuating as in a regular menstrual cycle.
• Thyroid issues : Menstrual abnormalities can happen due to an underactive thyroid gland (hypothyroidism) or an overactive thyroid gland (hyperthyroidism) disorder.
• Cancer treatment : Radiation therapy and chemotherapy for cancer can aggravate this problem.
• Previous surgery : Any earlier uterine surgery that left scars or damage can cause these complications.

Symptoms of Amenorrhea

• Hot flashes
• Breasts that leak milk
• Dryness in the vagina
• Headaches
• Vision disturbances
• Acne
• Pelvic pain
• Overgrowth of facial and body hair

Risk Factors for Amenorrhea

• Instances of amenorrhea or early menopause in the family history
• Chromosomal or genetic disorders affecting the uterus or ovaries
• Obesity or underweight
• Eating disorder
• Too much exercise
• Inadequate diet
• Stress,
• Persistent sickness

Complications of Amenorrhea

• Issues with pregnancy and infertility : You cannot become pregnant if you are not ovulating and are not having menstrual cycles. Miscarriage or other pregnancy-related problems may arise when a hormone imbalance causes amenorrhea.
• Stress and anxiety : It can be stressful, particularly for young individuals entering adulthood, to not have their period.
• Cardiovascular illness and osteoporosis : Inadequate estrogen production may cause weakening of the bones (osteoporosis). Heart attacks, blood vessel and cardiac muscle issues, and other conditions that may arise.
• Anatomical reasons for amenorrhea can also cause pelvic pain.

Diagnosis of Amenorrhea

Blood Tests

• Pregnancy examination : To rule out or confirm a suspected pregnancy, your doctor would most likely recommend this test initially.
• Thyroid function test : Thyroid functioning can be assessed by taking a blood sample for thyroid-stimulating hormone (TSH).
• Test of ovarian function : Analyzing the blood sample for follicle-stimulating hormone (FSH) can indicate whether the ovaries usually function.
• Prolactin measurement : Prolactin levels below normal could indicate a malignancy in the pituitary gland.
• Test of male hormones : Based on specific indications, your doctor might wish to check your blood for the presence of male hormones.

Hormone Challenge Tests

Imaging Test

• Ultrasound: This test creates images of interior organs using sound waves to look for reproductive organ problems if you have never had a period.
• Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves provide detailed images of the body's soft tissues. To look for a pituitary tumour, your doctor might prescribe an MRI.

Scope Tests

Treatments for Amenorrhea

• Maintaining a weight that is healthy for you requires adhering to a diet and exercise regimen.
• Strategies for managing stress.
• We are altering the intensity of activity.

• Vaginal dryness and hot flashes can be relieved with estrogen therapy.
• Doses of calcium and vitamin D can help to maintain strong bones.
• Strength training or performing exercises as required.