Amenorrhea is a condition when menstruation or menstruation stops. What are the symptoms and causes? Check out the explanation about amenorrhoea here
A brief description of Amenorrhea
Amenorrhea is a condition when menstruation or menstruation stops. What are the symptoms and causes? Read an explanation about amenorrhea disease here.
Amenorrhea Definition
Amenorrhea is a condition when a woman does not have menstruation or menstruation. This is normal in the period before puberty, pregnancy, breastfeeding, and entering menopause.
Meanwhile, there are two types of amenorrhea classification, namely:
1. Primary Amenorrhea
Primary amenorrhea is a condition when a woman up to the age of 16 years has not had her period even though there are signs of secondary sex (growing breasts, growing pubic hair, etc.). Or, when a woman is 14 years old but does not develop secondary sex signs.
Primary amenorrhea occurs in 0.1–2.5 percent of women of reproductive age.
2. Secondary Amenorrhea
Secondary amenorrhea is a condition where a person has a normal menstrual cycle.
However, she then stopped menstruating for 3 months or more, consecutively.
Primary & Secondary Amenorrhea – Pediatrics According To Lecturio Medical
Amenorrhea
| Medical specialist | Obstetrics and gynecology specialist |
| Symptoms | No menstruation or menstruation |
| Risk factors | Family history, extreme activity, and diet, not ideal weight, genetics, stress, chronic disease |
| Cara diagnosis | History, physical examination, ultrasound, hysterosalpingography, hysteroscopy, MRI, hormone levels of FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone), Thyroid Stimulating Hormone (TSH), prolactin, Estrogen/ Progestogen Challenge Test |
| Treatment | Modification of healthy lifestyle, hormone therapy, vitamin D and calcium supplements, surgery |
| Drug | Estrogen hormone, vitamin D, and calcium supplements |
| Complications | Risk of the wrist and hip fractures, bone loss, fertility problems |
| When should you go to the doctor? | When not menstruating for more than 3 three months |
Reason
Amenorrhea can be caused by several things, among others:
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Natural amenorrhea
For example in pregnancy, breastfeeding, menopause, or the use of contraception.
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Lifestyle Factor
Lifestyle factors, such as low body weight, eating disorders, excessive exercise, and mental stress can also cause amenorrhoea.
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Drugs
Certain medications can trigger the cessation of menstrual periods, including cancer chemotherapy, antipsychotics, antidepressants, blood pressure medications, and allergy medications.
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Hormone Imbalance
Hormone imbalance conditions, such as polycystic ovary syndrome (PCOS), thyroid disorders, pituitary tumors, and premature menopause, can cause Amenorrhea.
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Structural Problems
Structural problems, such as uterine scarring or abnormalities in the structure of the vagina, can also cause menstrual cycle disturbances.
Risk Factor
Some risk factors for amenorrhoea include:
- Family history with amenorrhea or early menopause
- Genetic or chromosomal conditions that affect the menstrual cycle
- Obesity or underweight
- Eating Disorder
- Extreme sports
- Diet extreme
- Stress
- Chronic disease
Diagnosis
To diagnose amenorrhoea, doctors usually first conduct a medical interview.
The doctor will dig up information about diet, exercise, weight changes, previous menstruation (if any), drug use, any chronic diseases, and another medical history.
The possibility of pregnancy should always be ruled out before thinking about other causes.
Furthermore, a physical examination of the condition of amenorrhea can find conditions such as:
- Found failure of growth of secondary sexual organs, such as breast and pubic hair growth
- In other cases, growth disorders can also be found
Furthermore, additional examinations can also be carried out. Here’s the explanation.
- In primary amenorrhea, if secondary sexual development is found, it is necessary to examine the reproductive organs, such as the ovaries and uterus.
An examination can be done by ultrasonography (USG), hysterosalpingography, hysteroscopy, and magnetic resonance imaging (MRI) procedures.
If there are no signs of secondary sex development, it is necessary to check the levels of FSH ( follicle stimulating hormone ) and LH ( luteinizing hormone ).
- In secondary amenorrhea, of course, the first thing to do is to rule out the possibility of pregnancy.
After that, a thyroid stimulating hormone (TSH) test can be performed. This is because thyroid hormone levels can affect prolactin levels in the body.
In addition, the level of the hormone prolactin in the body also needs to be checked. If the levels of the TSH and prolactin hormones are normal, the estrogen/progestogen Challenge test can be done.
This is to see the work of the hormone estrogen on the endometrial lining in the uterus. It can then be evaluated by MRI.
Treatment
Amenorrhea is treated according to the cause. If menstruation stops due to menopause or pregnancy, amenorrhea does not need to be treated.
In other cases, treatment will depend on the cause, including:
- Lose weight through diet and exercise (if being overweight is the cause)
- Gaining weight through an individual diet plan (if extreme weight loss is the cause)
- Stress management techniques
- Changing the training level
- Hormonal treatment (drugs), according to the doctor’s instructions
- Surgery (for rare cases)
In addition, your healthcare provider may recommend several treatments to help with the side effects of amenorrhea, including:
- Estrogen therapy to relieve hot flashes and vaginal dryness
- Calcium and vitamin D supplements to keep bones strong
- Strength training
Surgical treatment for amenorrhoea is not common but may be recommended under certain conditions, including:
- Uterine scar tissue. This scarring sometimes occurs after fibroid removal, cesarean section, or curettage (tissue removed from the uterus to diagnose or treat heavy bleeding or to clean the lining of the uterus post-miscarriage).
The removal of scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle.
- Pituitary tumors. Medications may be recommended to shrink the tumor. If this doesn’t work, surgery may be needed to remove the tumor.
Pituitary tumors are not malignant, but they can cause problems as they grow. Pituitary tumors can put pressure on nearby blood vessels and nerves, such as the optic nerve, which can cause vision loss.
Amenorrhoea is treated by obstetricians and obstetricians.
Prevention
A healthy lifestyle can help prevent some of the causes of secondary amenorrhea. Things that can be done include:
- Maintain an ideal body weight and live a healthy diet
- Pay attention to the menstrual cycle regularly (so you know when your period is late)
- Regularly check-up with a gynecologist, including examination of reproductive organs and pap smears
- Get enough rest and regularly
Complications
Amenorrhea is not life-threatening but can result in an increased long-term risk later in life.
Several studies suggest an increased risk of wrist and hip fractures in women with amenorrhea. There is also a risk of bone loss and fertility problems.
When to go to the doctor?
You should see your doctor if you miss your period within three months. Or, you miss a period with the following conditions:
- Having problems with balance, coordination, or vision, which could indicate a more serious condition
- Produce milk when you haven’t given birth
- Excessive body hair growth
- Are over 15 years old and haven’t had their first menstruation