Amenorrhea is the absence of menstrual periods.
- Some women never go through puberty.
- So periods never start.
- This disorder is called primary amenorrhea.
- In other women, periods start at puberty, then stops.
- Amenorrhea is normal only before puberty, during pregnancy, while breast-feeding and menopause.
- Primary amenorrhea may be caused by a birth defect in which the uterus or fallopian tubes do not develop normally or by a chromosomal disorder, such as turner syndrome.
- Primary amenorrhea can also result from malfunction of the hypothalamus, pituitary gland or ovaries.
- Sometimes it results from the malfunction of the thyroid gland.
- Young women who are very thin, particularly who have anorexia nervosa, may never menstruate.
- Secondary amenorrhea may result from malfunction of the hypothalamus, pituitary gland, ovaries, thyroid gland, adrenal glands, or almost any part of the reproductive tract.
- Malfunction of these organs may result from a tumour, an auto immune disorder or use of certain drugs. This includes hallucinogenic drugs, chemotherapeutic drugs and antidepressant drugs.
- Cushing’s syndrome and polycystic ovarian syndrome may cause periods to stop or be irregular.
- Other causes of secondary amenorrhea include a hydatidiform mole and Asherman’s syndrome.
- Stress due to internal or situational concerns may cause secondary amenorrhea, because interferes with brain’s control of the ovaries.
- Exercising too much or too little may also affect the brain’s control of ovaries.
- Either behaviour can cause the brain to signal the pituitary gland to decrease its production of hormones that stimulate the ovaries.
- As a result, ovaries produce less estrogen and periods stop.
- Amenorrhea may or may not be accompanied by other symptoms, depending on the cause.
- Primary amenorrhea is diagnosed when periods have not started by the age of 16.
- Girls who have no signs of puberty by the age of 13 or who have not started having periods within 5 years of starting puberty are evaluated for possible problems.
- Secondary amenorrhea is diagnosed when a woman of reproductive age has had no menstrual periods for at least 3 months.
- A physical examination can help doctors determine whether puberty occurred normally and may provide evidence of the cause of amenorrhea.
- Other procedures may be needed to confirm or identify the cause.
- Hormone levels in the blood may be measured.
- X – Rays of the skull may be taken to look for a pituitary tumour.
- Computed tomography, magnetic resonance imaging or Ultrasonography may be used to look for the tumour in the ovaries or adrenal glands.
- The underlying disorder is treated if possible. For example, a tumour is removed if it is the cause.
- Some disorders such as Turner syndrome and other genetic disorders cannot be cured.
- If a girl’s periods have never started and all test results are normal, she is examined every 3 to 6 months to monitor the progression of puberty.
- Progestin and sometimes estrogen may be given to start her periods and to stimulate the development of secondary sexual characteristics, such as breasts.
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