Amenorrhea: Meaning, Symptoms & Causes

Amenorrhea is the absence of a menstrual period due to various causes in the female body. This type of health problem arises most commonly during pregnancy. However, fluctuations in hormonal levels also cause amenorrhea to a great extent. In this article, we’ll discuss amenorrhea meaning, its symptoms and its causes in women.

What is amenorrhea?

Amenorrhea is known as the absence of menstruation or periods, which happens when you miss one or two periods consecutively. This can also be irregular periods. Primary amenorrhea and secondary amenorrhea are the two types of amenorrhea commonly seen.

1. Primary Amenorrhea

Primary amenorrhea is when there is an absence of menstrual periods from the onset of puberty until the girl child reaches the age of 15. This means that the child has not had her first period since birth.

2. Secondary Amenorrhea

Secondary amenorrhea is the absence of a period for someone who has had periods in the past. If you have had periods in the past, but your periods have stopped for the last three months, you could be suffering from amenorrhea.

What are the symptoms of amenorrhea?

Along with the absence of periods, depending upon the cause of amenorrhea, you may experience the following amenorrhea symptoms:

1. Milky nipple discharge

Milky nipple discharge or galactorrhea is a sign of amenorrhea in a female. The changes in hormonal levels lead to the development of galactorrhea or milky nipple discharge.

2. Hair loss

Excessive hair loss can also be a sign of amenorrhea.

3. Headaches

The development of regular headaches is common during amenorrhea. The condition affects not only your reproductive system but also affects your entire body.

4. Vision changes

Vision changes are also very common for women who face amenorrhea.

5. Excess facial hair

The hormonal changes that happen when you go through amenorrhea can also lead to the development of excess facial hair.

6. Pelvic pain

Pelvic pain and irritation can also be a sign of amenorrhea setting into your body.

7. Acne

The hormonal changes also affect your skin and lead to the development of acne.

What causes amenorrhea?

Many risk factors of amenorrhea come into play when changes in hormones and lifestyle occur. If you have a family history of early menopause or amenorrhea, you are more likely to face amenorrhea. Your genes also affect and determine your menstrual flow. Sometimes, genetic changes or genetic triggers lead to the onset of amenorrhea.

If you are facing obesity issues or are malnourished, there is a chance of developing amenorrhea. Similarly, if you are developing an eating disorder and disruptive eating patterns are common, you can develop amenorrhea. Poor diet and stress and any chronic illness can also put you at risk of amenorrhea.

Sometimes, primary ovarian insufficiency leads to amenorrhea when you experience menopause before age 40. Pituitary disorders that affect the secretion of hormones like prolactin can also lead to the development of amenorrhea. You might also face hormonal issues such as polycystic ovary syndrome, adrenal disorders, or hypothyroidism. Sometimes, the development of ovarian tumors also leads to amenorrhea. Surgical removal of ovaries or uterus can also lead to secondary amenorrhea.

The main causes of amenorrhea, in short, are

• Chromosomal or genetic problem
• Hormonal issues stemming due to the hypothalamus or the pituitary gland
• A structural problem with the reproductive organs

Common causes of secondary amenorrhea include:

• Pregnancy
• Breastfeeding
• Menopause
• Some birth control methods
• Chemotherapy and radiation therapy for cancer
• Previous uterine surgery with subsequent scarring
• Stress
• Poor nutrition
• Weight changes
• Excessive low body weight
• Chronic illness

How is amenorrhea diagnosed?

Various factors can cause amenorrhea, and the cause primarily determines the treatment of the condition. Therefore, it's important to diagnose amenorrhea to start with the right treatment at the earliest.

The following can be some useful points for diagnosing amenorrhea:

• It is important to learn the medical symptoms and history related to amenorrhea, which often involves issues regarding sexual relations, reproductive health, the nature of past periods, and any other specific concerns of the patient.

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• The diagnosis of amenorrhea can be done by a variety of blood tests such as pregnancy test, thyroid function test, ovary function test, prolactin test, and male hormone test since it helps clarify any hormonal abnormalities that may be related to the disorder.

• A hormone challenge test may be recommended if an estrogen deficiency is considered the root of amenorrhea.

• Other diagnostic tests involve ultrasound imaging and magnetic resonance imaging (MRI). If other diagnostic testing techniques fail to identify, your doctor might suggest a hysteroscopy. During this procedure, a narrow, illuminated camera is inserted into your vagina and cervix to view the interior of your uterus.

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Final Words

Numerous factors can contribute to amenorrhea. It does not imply that a woman is infertile and will never be able to conceive. Amenorrhea can be treated successfully. You should seek medical assistance if your irregular periods stop for at least 6 months or if your regular periods stop for 3 months or longer.

References

1. Klein DA, Paradise SL, Reeder RM. (2019). Amenorrhea: A Systematic Approach to Diagnosis and Management. Am Fam Physician. NCBI

2. Liu JH, Patel B, Collins G. (2000). Central Causes of Amenorrhea. NCBI

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