Amenorrhea

Amenorrhea refers to the absence of menstrual periods in women who are of reproductive age. There are two types of amenorrhea: primary amenorrhea and secondary amenorrhea. Primary amenorrhea occurs when a girl has not yet started menstruating by the age of 16, while secondary amenorrhea refers to the absence of periods for at least 3 months in women who have previously had regular menstrual cycles.

Pathophysiology:

There are several potential causes of amenorrhea, including hormonal imbalances, structural abnormalities of the reproductive organs, and certain medical conditions. Hormonal imbalances, such as those caused by polycystic ovary syndrome (PCOS) or thyroid disorders, can disrupt the menstrual cycle and lead to amenorrhea. Structural abnormalities, such as a blockage of the cervix or uterus, can also prevent menstruation from occurring. Medical conditions that can cause amenorrhea include eating disorders, excessive exercise, and certain medications.

Signs and Symptoms:

The primary symptom of amenorrhea is the absence of menstrual periods. Women who experience secondary amenorrhea may also notice other symptoms, such as hot flashes, vaginal dryness, and mood swings.

Investigation:

A doctor may perform a physical examination and order blood tests to check for hormonal imbalances. Imaging tests, such as an ultrasound, may also be used to identify any structural abnormalities in the reproductive organs.

Treatment:

Treatment for amenorrhea depends on the underlying cause. In cases where hormonal imbalances are the root cause, hormone therapy may be prescribed. If structural abnormalities are identified, surgery may be necessary to correct the issue. For women with amenorrhea caused by lifestyle factors, such as excessive exercise or eating disorders, changes to their lifestyle may be recommended.

Dos and Don’ts:

Women who experience amenorrhea should consult with a healthcare provider to determine the underlying cause and receive appropriate treatment. In cases where lifestyle factors are contributing to the issue, it is important to make changes to improve overall health and wellbeing.

References:

• Welt CK. Evaluation and management of amenorrhea. UpToDate. Updated June 2021
• American College of Obstetricians and Gynecologists. Practice Bulletin No. 194: Polycystic Ovary Syndrome. Obstet Gynecol. 2018;131(6):e157-e171. doi: 10.1097/AOG.0000000000002650
• Kaur S, Kaur H, Kaur R. Amenorrhea: A comprehensive review. J Fam Med Prim Care. 2021;10(3):985-989. doi: 10.4103/jfmpc.jfmpc_1251_20