What is amenorrhea?
Amenorrhea is the absence of periods (menstrual bleeding) for more than 6 months. Absence of periods
during 2-6 months called oligomenorrhea.
Amenorrhea could be primary or secondary.
• Primary amenorrhea is the absence of menstrual bleeding and secondary sexual characteristics (for
example, breast development and pubic hair) in a girl by age 14 years or the absence of menstrual bleeding
with normal development of secondary sexual characteristics in a girl by age 16-17 years.
• Secondary amenorrhea is the absence of periods in girls and women who had been menstruating but
later stop menstruating for 6 or more months in the absence of pregnancy, menopause, hormonal treatment
and/or hormonal contraception.
General Overview
For a woman to have regular menstrual cycles, her hypothalamus, pituitary gland), ovaries, and uterus should
all be functioning normally. The hypothalamus stimulates the pituitary gland to release follicle-stimulating
hormone (FSH) and luteinizing hormone (LH). FSH and LH cause the ovaries to produce the hormones
estrogen and progesterone. Estrogen and progesterone are responsible for the cyclical changes in the
endometrium (uterine lining), including menstruation (period). In addition, a woman’s genital tract should be
free of any abnormalities to allow the passage of menstrual blood.
Amenorrhea Causes
Amenorrhea can result because of an abnormality in the hypothalamic-pituitary-ovarian axis which could be
functional or anatomical.
Main functional causes:
Stress;
Anorexia and/or bulimia;
Chronic diseases (e.g. diabetes, tuberculosis);
Excessive weight gain or weight loss;
Malnutrition;
Psychiatric disorders and/or depression;
Drug addiction and/or drug abuse;
Very intensive physical exercises (for example, Olympic competitions);
Cycle suppression (for example with hormonal birth control pills).
Main ovarian causes:
Polycystic ovary syndrome (hormonal disorder, high blood levels of male hormones);
Anovulation (lack of hormones and absence of ovulation);
Premature ovarian failure;
Turner Syndrome (a genetic disorder characterized by underdeveloped ovaries);
Gonadal dysgenesis (defective development of the ovary);
Anatomical abnormalities of the genital tract;
Intrauterine adhesions (the opposing surfaces of the uterine cavity stick together);
Aplasia (absence of an organ or tissue) of the vagina, the cervix, or the uterus;
Autoimmune oophoritis (cells of the ovaries destroyed by the body’s own defense system).
Main pituitary causes:
Prolactinemia (high blood levels of prolactin);
Pituitary tumors;
Post-delivery pituitary necrosis (death of pituitary cells after a woman delivers a baby);
Autoimmune hypophysitis (cells of the pituitary gland destroyed by the body’s own defense system).
Main hypothalamic causes:
Low body weight;
Nutritional deficiency;
Tumors;
Kallmann syndrome (deficiency of gonadotropins, which are hormones capable of promoting growth
and function of reproductive organs)
What could be during amenorrhea (additional symptoms)?
Additional symptoms may be present depending on the causes of amenorrhea. But in general the following
additional symptoms could be discovered:
Headache;
Galactorrhea (breasts milk production in a woman who is not pregnant and not breastfeeding);
Reduced peripheral vision;
Increased hair growth in unexpected places (hirsutism);
Vaginal dryness;
Hot flashes and/or night sweats and/or sleep disorders;
Obesity and/or weight gain or weight loss.
What should be done?
Immediately visit your doctor for proper analysis and adequate complex treatment.
You can discover Natural Remedies for Amenorrhea on next page.
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