Amenorrhea (Absence of Menstruation)

Amenorrhea is the absence of menstrual periods in a woman of reproductive age. It can be classified into two types:

• Primary Amenorrhea: When menstruation has never started by the age of 15.
• Secondary Amenorrhea: When a woman who previously had regular periods stops menstruating for three or more consecutive months.

Causes of Amenorrhea

Amenorrhea can result from a variety of factors, including hormonal imbalances, structural issues, and lifestyle influences.

1. Natural Causes

• Pregnancy: The most common reason for missed periods.
• Breastfeeding: Can suppress ovulation, leading to temporary amenorrhea.
• Menopause: Natural cessation of menstrual cycles, typically occurring around age 45-55.

2. Hormonal Imbalances

• Polycystic Ovary Syndrome (PCOS): A condition that disrupts ovulation due to excessive androgen levels.
• Thyroid Disorders: Both hypothyroidism and hyperthyroidism can interfere with menstrual cycles.
• Hyperprolactinemia: Elevated prolactin levels can suppress menstruation.
• Premature Ovarian Insufficiency (POI): Early menopause before the age of 40.

3. Structural or Genetic Causes

• Müllerian Agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome): A congenital condition where the uterus and vagina do not develop properly.
• Asherman’s Syndrome: Scar tissue in the uterus, often due to repeated surgeries or infections.
• Chromosomal Abnormalities: Turner syndrome or other genetic disorders affecting ovarian function.

4. Lifestyle Factors

• Excessive Exercise: Overtraining can disrupt hormonal balance, leading to amenorrhea.
• Extreme Weight Loss or Anorexia: Low body fat can prevent ovulation.
• Chronic Stress: High stress levels can impact the hypothalamic-pituitary-ovarian axis, stopping menstruation.

5. Medications and Medical Conditions

• Birth Control Pills: Some hormonal contraceptives can lead to missed periods.
• Certain Medications: Antipsychotics, antidepressants, and chemotherapy drugs may disrupt cycles.
• Chronic Illnesses: Conditions like diabetes, celiac disease, and pituitary tumors can contribute to amenorrhea.

Symptoms Associated with Amenorrhea

In addition to the absence of periods, other symptoms may include:

• Hot flashes and night sweats (if related to early menopause)
• Weight changes (sudden gain or loss)
• Acne and excessive hair growth (due to high androgen levels)
• Headaches or vision changes (if related to a pituitary tumor)
• Breast discharge (galactorrhea)

Diagnosis of Amenorrhea

To determine the cause of amenorrhea, a healthcare provider may conduct:

1. Medical History & Physical Examination

   • Assess menstrual history, stress levels, diet, and exercise habits.
   • Pelvic examination to check for anatomical abnormalities.

2. Blood Tests

   • Pregnancy test: To rule out pregnancy.
   • Hormone levels: Check FSH, LH, prolactin, thyroid hormones, and estrogen.
   • Androgen levels: To evaluate for PCOS.

3. Imaging Tests

   • Ultrasound: To check for ovarian cysts, uterine abnormalities, or pregnancy.
   • MRI or CT scan: To assess for pituitary gland tumors.

4. Genetic Testing

   • For cases of primary amenorrhea with suspected chromosomal abnormalities.

Treatment of Amenorrhea

Amenorrhea can be treated successfully with Homoeopathic medicines.

Complications of Amenorrhea

• Infertility (if ovulation is absent)
• Osteoporosis (due to low estrogen levels)
• Increased risk of heart disease (in cases of premature menopause)

When to See a Doctor?

Seek medical advice if:

• You have missed three or more consecutive periods.
• You are over 15 and have never had a period.
• You experience symptoms like headaches, vision problems, or unusual hair growth.

Conclusion

Amenorrhea is a symptom rather than a disease, and its causes can range from normal life changes to serious medical conditions. Identifying the underlying reason is essential for proper treatment and maintaining reproductive and overall health.