Cheers
May 6, 2024
Minutes To Read: 3

Amenorrhea: meaning, causes and treatments

You may never have heard of the name amenorrhea, but you have probably heard of women who have gone for a period without menstruating. Or girls who took a long time to have their first period.

Barbara Murayama, an obstetrician and gynecologist, explains that amenorrhea is a disorder of the menstrual cycle that causes the absence of menstruation. "It can be primary when menstruation does not begin until age 15, or secondary when menstrual periods are absent for more than three to six months in a woman who has had menstruation," he adds.

According to obstetrician and gynecologist Sang Chaa, this is a relatively common problem, which occurs in about 5% of women of childbearing age. ? Amenorrhea is more likely to happen at the extremes of childbearing age, at its onset, therefore at puberty, and at its end? would it be in climacteric when menopause occurs ?, he says.

When to seek medical help?

Barbara Gynecologist points out that while some women don't care about missing their menstrual period, these changes should always be discussed with a healthcare professional, as they can signal underlying medical conditions and potentially have long-term health consequences. term. A woman who loses more than three menstrual periods (consecutive or over a year) and a girl who did not menstruate until the age of 15, should consult a gynecologist ?, says.

The ideal is to maintain a routine follow-up, before puberty, so the doctor can understand and anticipate if there is a delay in the first menstruation. And whenever menstruation is more than three months without appearing it is imperative to look for the gynecologist ?, adds Barbara.

Amenorrhea and pregnancy

Barbara Murayama explains that pregnancy is the most common cause of secondary amenorrhea. "This can happen even in women who say they are not sexually active or are certain that sexual intercourse occurred at a" safe "time." It is also important to note that apparent menstrual bleeding does not exclude pregnancy since a substantial number of pregnancy cases are associated with some first trimester bleeding. Thus, a pregnancy test (measurements of human serum or urinary chorionic gonadotropin [hCG]) is recommended as a first step in the evaluation of any woman with amenorrhea, says the gynecologist and obstetrician.

Why does amenorrhea happen?

There are several factors that can influence in the absence of menstruation. In the case of primary amenorrhea, gynecologist and obstetrician Barbara Murayama points out:

Conditions that are present at birth but may not be noticed until puberty. "These conditions include genetic or chromosomal abnormalities and abnormalities of the reproductive organs (for example, if the uterus is not present or abnormally developed)," adds Barbara.
All conditions leading to secondary amenorrhea may also cause primary amenorrhea.

In the case of secondary amenorrhea, the professional highlights:

Pregnancy as the most common cause.
Ovarian conditions such as polycystic ovary syndrome and ovarian insufficiency (early menopause).
Hypothalamic amenorrhea: Occurs when the hypothalamus slows or stops releasing GnRH (gonadotropin releasing hormone).
• Hypothalamic amenorrhea is associated with low body weight (defined as 10% underweight), low body fat, eating disorders such as anorexia nervosa or bulimia nervosa, emotional stress, strenuous exercise, among others. situations. However, in some cases, there is no obvious explanation for hypothalamic amenorrhea ?, explains the gynecologist.
Increased prolactin hormone, thyroid gland disorders are also reasonably common causes. "And that's why we started the investigation," adds Barbara.

Symptoms

According to gynecologist and obstetrician Chaa, the absence of menstruation is often accompanied by increased body weight, irritability and water retention. But the symptoms depend on the cause of amenorrhea (which varies from case to case, as mentioned above).

How is the problem diagnosed?

Obstetrician and gynecologist Sang Chaa points out, first, that all amenorrhea needs to be investigated. This justifies the need to seek medical help as soon as the absence of menstruation (for three consecutive months) is noted, as well as the delay in starting the first period. "The diagnosis is eminently clinical and depends on each case," he says.

Barbara Gynecologist explains that a good clinical history is necessary to diagnose the problem to know the patient and her antecedents; a thorough physical, gynecological exam? complete if she is no longer a virgin and only of the external characters if she is a virgin - to assess, among other things, her development. Then we will go to the imaging and laboratory tests depending on the suspicions we have after the consultation. In general will be included pelvic ultrasound, pregnancy test, thyroid, prolactin ?, says.

How is amenorrhea treated?

You need to find out the cause to treat it specifically. • In patients with uterine synechiae, for example, curettage and intrauterine device placement are required; In patients with polycystic ovaries, oral contraceptives are required. In amenorrhea patients, however, without apparent cause, can menstruation be induced by the use of a cycle of hormones that induce endometrial proliferation ?, explains gynecologist Chaa.

Barbara cites yet other examples. • If your thyroid or prolactin hormone changes, you need to adjust and so on. Cases like imperforate hymen may require surgery. And yet, in genetic abnormalities where there is no uterus, the person will never menstruate ?, concludes the gynecologist and obstetrician.