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What is Amenorrhea?Amenorrhea represents absence of the menstrual bleeding. Amenorrhea can be primary and secondary. Primary amenorrhea is failure to menstruate by the age of 16 and it may be seen in underweight girls. Secondary amenorrhea occurs when a woman who was previously regularly menstruating stops menstruating for 3 or more months due to unexplained reasons. Absence of menstrual bleeding normally stops after a conception in healthy women. However, amenorrhea can be caused by other factors too. Amenorrhea is not an illness but a symptom of some underlying condition which is rarely serious. Amenorrhea can be reversed when the condition that has led to absence of period is identified and treated.

Amenorrhea and PregnancyAmenorrhea and pregnancy are two conditions that are not related to each other. This especially refers to primary amenorrhea since absence of menstrual bleeding occurs when a girl is in her teens when she didn’t start to menstruate yet. Similarly, secondary amenorrhea and pregnancy are not related because a conception does not cause secondary amenorrhea although it may occur during a woman’s childbearing years. Secondary amenorrhea is usually caused by hormonal imbalance such as polycystic ovarian syndrome, infertility, problems with reproductive organs, premature menopause, uterine scarring due to dilation and curettage, stress or drastic weight reduction. There is also a condition known as hypothalamic amenorrhea and pregnancy. Hypothalamic amenorrhea occurs due to a problem involving the hypothalamus that produces hormones and controls reproduction, which leads to absence of menstruation for several months. Hypothalamic amenorrhea can result from low body fat, excessive exercise, eating disorders, stress or obesity.

Causes

Amenorrhea can be due to anatomical abnormalities of genital tract, abnormalities of hypothalamus or pituitary gland, stress, endocrine disorders, nutritional deficiency, low body weight, anovulation, intrauterine adhesions, absence of opening in hymen and use of oral contraceptive pills or intrauterine devices.

Symptoms

Apart from absent menstruation, symptoms of amenorrhea include: excessive hair growth on the face and torso, reduced breast size, lower libido, deepening of the voice and milky nipple discharge.

Complications

Amenorrhea can cause several complications related to reproductive tract. That includes polycystic ovarian syndrome, hirsutism, and uterine fibroids. Amenorrhea may also impair fertility and cause inability to ovulate.

Treatment

Treatment for amenorrhea depends on the condition that has caused failure to menstruate. The treatment may involve dietary and lifestyle changes if amenorrhea results from malnutrition, stress, unhealthy body weight or substance abuse. Oral contraceptives are given for treatment of hypothalamic amenorrhea and polycystic ovarian syndrome while endocrine disorders are treated with medications.

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