Amenorrhea is the absence of menstruation. Women typically do not menstruate before puberty, during pregnancy, and after menopause. However, if a woman does not menstruate when she normally should, it may be the symptom of a medical condition. While amenorrhea is a condition and not a disease, it can be worrisome for many women. This condition can usually be treated by identifying and treating the underlying cause.
Types of Amenorrhea
There are two types of amenorrhea: primary and secondary.
Primary amenorrhea typically occurs when an adolescent girl has not begun menstruation by the age of 18. Primary amenorrhea is considered rare and is usually caused by genetic factors.
Secondary amenorrhea occurs when a woman with normal menstrual cycles suddenly stops getting her monthly period for three or more months. Secondary amenorrhea is much more common and may be caused by a large number of physical, lifestyle and psychological factors. It may be the result of contraceptive use, obesity, excessive exercise, stress, medication or hormonal imbalances.
Causes of Amenorrhea
Amenorrhea may be caused by problems with a combination of hormones, organs, or glands involved in the menstrual cycle.
Causes of primary amenorrhea may include:
- Abnormal function of the ovaries
- Missing uterus or vagina
- Irregular function of the central nervous system or pituitary gland
- Delay in the development of puberty
- Vaginal septum
Possible causes of secondary amenorrhea include:
- Hormonal disturbances from pituitary or hypothalamus glands
- Contraceptive use
- Intrauterine scar formation
- Eating disorders
- Extreme weight loss or weight gain
- Excessive exercise
Additionally, a woman who has had a hysterectomy will also stop menstruating.
Diagnosis of Amenorrhea
A woman may consult with a doctor to diagnose the cause of amenorrhea. The doctor will perform a physical examination and a full medical history review, and the following tests may also be administered:
- Pregnancy test
- Thyroid function test
- Ovary function test
- Hormone testing
In addition, imaging tests such as a CT scan or MRI scan may be performed to analyze detailed images of the reproductive organs and tissue.
Treatment of Amenorrhea
Treatment for amenorrhea may vary depending upon the underlying condition. Amenorrhea may require hormone medications and if it is caused by thyroid or pituitary disorders, it may also be treated with medication. If a tumor or structural blockage is causing the condition, surgery may be necessary.
In cases of secondary amenorrhea, an absent menstrual period can usually be treated by making simple lifestyle changes. Amenorrhea is not usually a serious condition, but the patient should still seek medical attention if she does not get a regular menstrual period, since this may be a sign of a more serious health issue.