Amenorrhea or lack of menstruation can occur both during puberty and at a later stage in the life of a woman. Primary amenorrhea is a condition characterized by a complete absence of a monthly cycle from birth to 16 years. Secondary amenorrhea occurs after the initial presence of menstruation and is characterized by a sudden cessation of the cycle. In case your monthly cycle is interrupted, chances are, your first thought will be that you are pregnant. In fact, there are many other possible explanations for the usual delay. So, the absence of menstruation: the causes, treatment - the topic of conversation for today.
Amenorrhea rarely becomes the result of a serious illness. However, uncertainty about the causes of abrupt cessation of menstruation can be a stress for any woman. Do not panic. After a thorough acquaintance with your medical history and a detailed description of the symptoms on your part, a specialist can determine the cause of the problem. Adequate treatment will necessarily lead to the elimination of menstruation.
Symptoms of amenorrhea
The main indicator of the presence of amenorrhea is the absence of monthly cycles. This disease is of two types:
- Primary amenorrhea - absence of menstruation at the age of 16 years.
- Secondary amenorrhea - no menstrual cycle for 3-6 months or more.
Depending on the cause of amenorrhea, you may experience other signs or symptoms, such as discharge of milky white liquid from the nipples, headaches, vision problems or excessive growth of facial and body hair.
Causes of amenorrhea
Primary amenorrhea
Primary amenorrhea affects less than 1% of girls in early adolescence. Among the most common reasons are:
- Chromosomal abnormalities. They can lead to premature exhaustion of eggs and follicles involved in the process of ovulation and menstruation.
- The problem with the hypothalamus. Observed with functional disorders of the hypothalamus - the area of the brain, which controls the body functions and the menstrual cycle. Excessive physical activity, eating disorders, such as anorexia, as well as physical and psychological stress can contribute to the disturbance of the normal function of the hypothalamus. In very rare cases, the appearance of a tumor in the hypothalamus is the basis for the suspension of its normal functioning.
- Pituitary diseases. The pituitary gland is the gland in the brain that regulates the menstrual cycle. The presence of a tumor or other forms of aggressive development can affect the ability of the pituitary gland to perform its functions.
- Absence of genital organs. Sometimes during embryonic development, anomalies occur, resulting in girls being born without most organs of the female reproductive system, such as the uterus, cervix or vagina. In these cases, the absence of menstruation or amenorrhea is due precisely to the underdevelopment of the reproductive system.
- Structural vaginal pathologies. Pathologies of the structure of the vagina can prevent obvious menstrual bleeding. Sometimes the vagina is blocked by a membrane or barrier, which prevents the flow of blood to the uterus and cervix.
Secondary amenorrhea
Secondary amenorrhea is more common than primary. The reason for it may be:
- Pregnancy. In women of reproductive age, pregnancy is the most common reason for the absence of menstruation. When a fertilized egg is introduced into the wall of the uterus, it is the uterine wall that begins to feed the embryo.
- Contraceptive means. Some of the women who take birth control pills do not have a clear menstrual cycle. After stopping taking oral contraceptives, the normalization may take three to six months before regular ovulation and menstruation are restored. Contraceptives and intrauterine devices containing progesterone may also cause amenorrhea.
- Breast-feeding . Nursing mothers also often suffer from amenorrhea. Although they have ovulation, but menstruation does not occur. It is important to know that even in this condition a woman can become pregnant again! And even in the absence of menstruation.
- Stress. Emotional stress can temporarily worsen the function of the hypothalamus - the part of the brain that controls the hormones that regulate the cycle. As a result, ovulation and menstruation can be suspended. The regular monthly cycle resumes after a decrease in the intensity of stress.
- Medicines. The use of certain types of drugs can lead to the termination of the menstrual cycle. For example, antidepressants, neuroleptics, some chemotherapy drugs and corticosteroids can lead to the onset of amenorrhea.
- Diseases. Chronic diseases can delay or stop menstruation. After restoring menstruation usually resume.
- Hormonal imbalance. A common cause of amenorrhea or an irregular cycle is a disease known as polycystic ovary syndrome. This condition leads to a relative increase in the level of estrogen hormones and androgens in the body. As a result, the level of hormones produced by the pituitary gland decreases, which leads to the absence of menstruation. Polycystic ovary syndrome leads to obesity, often unusually abundant uterine bleeding, acne, and sometimes excess facial hair.
- Low body weight. Excessively low body weight distorts the function of many hormones in the body and can stop ovulation. Women who suffer from eating disorders, such as anorexia or bulimia, often do not have a one-month cycle because of these hormonal changes.
Excessive exercises. Women who engage in sports that require high physical exertion, such as ballet, long-distance running or gymnastics, often suffer from an irregular menstrual cycle. Factors contributing to the lack of a menstrual cycle in athletes - the minimum amount of subcutaneous fat, high tension and excess energy.
- Thyroid dysfunction. Low activity of the thyroid gland (hypothyroidism), often causes disturbances and even the absence of menstruation. Diseases of the thyroid gland can also lead to low or high levels of prolactin production - a hormone that is produced by the pituitary gland. The change in the level of prolactin can affect the work of the hypothalamus and disrupt the regularity of the menstrual cycle.
- Tumors of the pituitary gland. Benign tumors of the pituitary gland (adenoma or prolactinoma) can cause excessive production of prolactin. Excess of prolactin can disrupt the functions of the pituitary gland, as a regulator of the menstrual cycle. This type of tumor is treated with medication, but sometimes surgical removal is required.
- Intrauterine scars and adhesions. In this case, a state occurs in which fluid accumulates in the mucous membrane of the uterus. Sometimes this occurs as a result of medical procedures related to the uterus, such as enlargement and curettage, cesarean section or the treatment of uterine fibrosis. Intrauterine adhesions and scars interfere with the normal growth and scaling of the uterus, which in turn leads to a decrease or total absence of menstruation.
- Premature menopause. As a rule, menopause occurs in women aged 45 to 55 years. When this occurs at an earlier age, menopause is defined as premature. In the absence of an adequate function of the ovaries, the amount of circulating estrogen in the body decreases, which in turn leads to a thinning of the mucous membrane of the uterus and the absence of menstruation. Premature menopause can be the result of genetic factors or an autoimmune disease. Often, however, the reasons for it remain unknown.
Diagnosis of amenorrhea
Although amenorrhea rarely occurs as a result of life-threatening diseases, it can lead to a number of complex hormonal problems. Revealing the true cause of amenorrhea may take a long time and may require the use of several tests. First, your doctor will ask you to take a pregnancy test. In addition, a full gynecological examination will be performed to look for signs of pregnancy or other problems with reproductive organs. If you are not pregnant, the doctor will conduct a physical examination and will ask you questions about your health and medical history. For young women, this review includes testing for signs and symptoms that are characteristic of puberty. The next step is to perform a blood test to check the level of hormones, evaluate the thyroid function and the level of the prolactin hormone. Also, doctors can advise a so-called progestin test, in which the patient takes hormonal drugs (progestogen) for 7-10 days. The drug causes bleeding. The results of this test show whether amenorrhea is associated with the absence of estrogen.
Depending on the signs and symptoms, and the results of all blood tests and tests, the doctor may require additional tests. Computer tomography, magnetic resonance or ultrasound can detect tumors in the pituitary gland and other structural disorders in the reproductive organs. Finally, laparoscopy or hysteroscopy is sometimes recommended. These are sparing surgical methods, in which internal genital organs can be examined.
Treatment of amenorrhea
Treatment, if any, depends on the cause of amenorrhea. Sometimes the doctor recommends a change in lifestyle, depending on the weight of the patient, physical activity and intensity of stress. If you suffer from polycystic ovary syndrome or sports amenorrhea, your doctor can prescribe oral contraceptives to solve this problem. Amenorrhea due to a violation of the thyroid gland or pituitary gland suggests another treatment.
The best way to avoid the absence of menstruation is to lead a healthy lifestyle:
- Change your diet and engage in physical activity to achieve and maintain weight in a healthy range.
- Maintain a healthy balance in everyday life - work, rest and relaxation.
- Decide what are the tensions and conflict situations in your life, and try to avoid them. If you can not reduce the impact of stress on your own - ask your family, friends, or doctor for help.
Monitor the changes in the menstrual cycle, and if there is something that worries or bothers you - seek advice from a specialist. Keep a diary and every month mark the beginning of each menstrual cycle, its duration and any symptoms that you are experiencing. Talk to your mother, sister, or other close female relative, and find out if they had a similar problem. This kind of information can help the doctor determine the cause of amenorrhea in you. Sometimes amenorrhea causes severe anxiety and anxiety. Then only the doctor will assess the symptoms of your absence of menstruation, the causes, treatment of this ailment. With a doctor, you can find a way to regulate the monthly cycle.