Amenorrhea- Overview, Types, Causes, Symptoms and Treatment

Amenorrhea occurs when you do not have your monthly menstrual period. The absence of menstrual bleeding is referred to as amenorrhea.

It is usual to not have a period when pregnant or after menopause. However, if you skip periods at other times, it might be a sign of an underlying medical problem.

Amenorrhea is classified into two categories. Those who haven't started menstruating by the age of 16 may have primary amenorrhea. The phrase also refers to reproductive system disorders that inhibit menstrual menstruation.

Secondary amenorrhea occurs when you miss your monthly period for three months in a row after having regular cycles for the preceding nine months. This is the most frequent kind of amenorrhea.

Amenorrhea Types

Amenorrhea is classified into two types:

Primary Amenorrhea This problem happens when a woman's periods do not begin during adolescence, i.e., if the periods do not begin by the age of 16 years, medical attention should be needed.

SecondaryAmenorrhea This syndrome happens when a woman gets periods for a while, but then they stop. The condition is normal during pregnancy and nursing, but when it happens without these two circumstances, it is known as secondary amenorrhea. A woman with secondary amenorrhea used to have regular periods but then does not have any for 3 months or more, or used to have irregular periods but then does not have any for 6 months or more.

Amenorrhea causes

The cause of amenorrhea varies depending on the kind of amenorrhea. Primary amenorrhea occurs in females under the age of 16 who have not had their first period. Secondary amenorrhea occurs in women who have completed puberty and had a regular cycle but have not had a period in more than three months.

Primary amenorrhea is caused by two basic factors

Genetic abnormalities abnormalities such as Turner syndrome, a condition where a girl is born without an X chromosome, and androgen insensitivity syndrome, a condition where a girl has high levels of testosterone

Anomalies of the hypothalamus or pituitary gland these conditions may cause hormonal imbalances, which might cause girls' menstruation to be delayed.

Secondary amenorrhea may be caused by a variety of factors, including:

  • Birth control pills, IUDs (intrauterine devices for birth control), antidepressants, blood pressure drugs, chemotherapy, and radiation may all cause a woman to miss her period on a regular basis.
  • Amenorrhea may occur in women who have low body weight, an eating problem, mental or physical stress, or who engage in severe exercise if the hypothalamus ceases generating gonadotropin-releasing hormone (GnRH), the hormone that initiates the menstrual cycle.
  • Polycystic ovarian syndrome and fragile X, both of which are linked with primary ovarian insufficiency, are gynecologic diseases that may lead to hormone abnormalities.
  • Thyroid issues, such as hypothyroidism or hyperthyroidism
  • A pituitary tumor may disrupt your body's regulation of the hormones that affect menstruation.

Amenorrhea Risk Factors

There are many risk factors that might raise your chances of experiencing amenorrhea, including:

  • Excessive physical activity
  • Obesity
  • Anorexia Nervosa
  • family history of early menopause or amenorrhea.
  • Genetic composition – having the FMR1 gene

Amenorrhea Symptoms

The major symptom of amenorrhea is missing a period for three or more consecutive months.

Amenorrhea may also cause the following symptoms:

  • Hair thinning
  • Headache
  • Vision changes
  • Pelvic ache
  • Facial hair growth
  • Acne

Amenorrhea diagnosis

Before doing any more tests, your doctor will prescribe a pregnancy test to rule out the possibility that you are pregnant. If the pregnancy test comes back negative, your doctor will order a battery of blood tests to assess your levels of testosterone, estrogen, and hormones.

Your doctor may also prescribe the following tests:

Hormone challenge examination

Your doctor will prescribe hormone therapy until menstruation occurs. This test can determine the level of estrogen in your body. If your estrogen levels are really low, this might explain your inability to have regular periods.

Imaging diagnostics

In certain situations, your doctor may utilize diagnostic imaging procedures to get comprehensive pictures of your inside organs, such as an MRI, CT scan, or ultrasound. Any cysts or other growths on or in your reproductive organs that may be impending menstruation will be readily seen in the imaging procedures.

A hysteroscopy may be ordered by your doctor to get a close-up image of the interior of the uterus in order to examine for cysts and other abnormalities. A lit camera is placed into the uterus through the vagina during a hysteroscopy.


Primary amenorrhea

Depending on the person's age and the results of the ovarian function test, treatment for primary amenorrhea may begin with cautious waiting. Periods may begin later if there is a family history of late menstruation.

Surgery may be required if there are genetic or physical issues with the reproductive organs. This, however, does not ensure that regular menstrual periods will occur.

Secondary amenorrhea

This will be determined by the underlying reason.

  • Factors of living: If the individual has been exercising excessively, a change in exercise routine or nutrition may aid in the stabilization of the monthly cycle.
  • Counseling may be beneficial if emotional or mental stress is an issue.
  • Excessive weight loss may occur for a variety of causes. The individual may need a professionally supervised weight-gain program. If an eating problem is suspected, therapy may involve a weight-gain program as well as counseling sessions with a psychiatrist and a nutritionist or dietician.
  • Weight loss may be caused by certain medical problems. A doctor may screen for them and, if necessary, treat them.
  • Underactive thyroid: If your menstruation stops due to an underactive thyroid, your doctor may give thyroxine, a thyroid hormone.
  • Polycystic ovarian syndrome (PCOS): The doctor will advise you on the best course of action. If PCOS has resulted in excess weight, they may advise you to follow a weight-loss plan.
  • Premature ovarian failure: Hormone replacement treatment (HRT) may restore menstruation.
  • Menopause: Menopause usually begins at the age of 50, however, it may begin as early as 40. This might be influenced by family history.
  • There is an increased risk of osteoporosis if menopause begins early. To avoid this problem, the individual may need therapy.