1 What is Amenorrhea?

Amenorrhea refers to the absence of menstruation.

Amenorrhea is divided into two types:

  • Primary amenorrhea – with this condition, menstruation does not occur during puberty. If the girl does not have menstruation by 16 years old, it is considered amenorrhea.
  • Secondary amenorrhea – menstruation stops for more than six months or longer, after having had at least one menstrual period.

Pregnancy is the most common cause of amenorrhea. Birth control use, certain medications, and hormone shots also lead to amenorrhea.

Amenorrhea is usually controlled by treating the underlying condition.

2 Symptoms

The absence of menstrual periods is the main symptom of amenorrhea.

Some other common symptoms of primary amenorrhea include:

  • Headaches
  • Abnormal blood pressure
  • Vision problems
  • Acne
  • Unwanted hair growth

Secondary amenorrhea is characterized by:

  • Swelling in breasts
  • Headaches
  • Vision problems
  • Increased thirst
  • Goiters
  • Color changes in skin
  • Nausea

Some people may also have hot flashes, depression, mood swings and vaginal dryness.

3 Causes

There are several causes of Amenorrhea.

Amenorrhea may happen as part of a normal life occurrence, like pregnancy, breast-feeding, and menopause.

In some cases, it may be a sign of other problems or conditions such as:

  • Certain medications – antipsychotics, chemotherapy, antidepressants, drugs for hypertension, and allergy medications.
  • Hormonal imbalance – a number of medical conditions result in hormonal imbalance like polycystic ovary syndrome (PCOS), thyroid malfunction, pituitary tumors, and premature menopause. These conditions affect the hormonal regulation of menstruation, resulting in menstrual irregularities. PCOS maintains the hormones at a higher level, disrupting the normal changes in menstruation. In women with premature menopause, the release of eggs from the ovaries stops by 40 years old. This disrupts the cycle and stops menstrual periods.
  • Problems in the reproductive organs – Scarring of the tissue lining the uterus affects the menstrual periods and stops menstruation. In some children, the reproductive system fails to develop properly and hence there is a complete absence of menstruation. Menstrual bleeding may also be stopped by an obstruction in the vagina.
  • Lifestyle factors – certain lifestyle factors like low body weight, excessive exercise, and stress also cause amenorrhea. Menstrual cycles are interrupted by strenuous physical activity. Stress affects the functioning of the hypothalamus and hormonal regulation of menstruation.

Some of the common risk factors for amenorrhea include:

4 Making a Diagnosis

Making a diagnosis of Amenorrhea is done by pelvic examination, which identifies problems within the reproductive organs.

These tests are recommended to check for the underlying cause of the amenorrhea:

  • A pregnancy test is one of the first tests suggested.
  • Thyroid tests help to check for impaired thyroid functioning.
  • Functioning of the ovaries is determined by an ovary function test.
  • A prolactin test identifies pituitary gland functioning.
  • A hormone challenge test helps to identify the hormonal causes of the condition. In this test, hormonal medication is given for few days to see whether menstrual bleeding is triggered.
  • Imaging techniques are suggested based on the underlying cause of amenorrhea. Ultrasound scan aids are used to visualize the structure and functioning of reproductive organs. CT scans and MRI help to check the structure and functioning of internal organs. They also help to locate tumors that result in amenorrhea.
  • Hysteroscopy, a method in which images of the cervix and vagina are obtained, is recommended when no specific cause of the condition is revealed.

5 Treatment

Treatment for Amenorrhea is based on the underlying cause of the condition.

Hormonal therapies are recommended to trigger menstruation.

Medications that control thyroid disorders and pituitary problems help to prevent amenorrhea.

Surgery is used in cases of amenorrhea caused by a blocked vagina or tumors.

6 Prevention

Maintaining an optimum body weight and exercising regularly helps to prevent amenorrhea in teenage girls.

Lifestyle changes are equally important in preventing this condition.

A balanced diet, moderate exercise, stress management, a work-life balance, and avoiding alcohol and smoking prevent amenorrhea.

7 Alternative and Homeopathic Remedies

Pulsattilla, ignatia, aconite, belladonna, calcarea carb, ferrum metallic, and cimicifuga are recommended homeopathy remedies for treating amenorrhea.

Angelica sinensis, false unicorn, lemon balm, blue cohosh, dill weed, sweet fennel, fenugreek, chaste berry, tomato juice, cinnamon, and saffron are common herbal remedies for amenorrhea.

8 Lifestyle and Coping

Regular exercise, good nutrition, and a good work-life balance is very important in coping with amenorrhea.

Reducing stress at home and work also helps.

It is useful to track changes in the menstrual cycle and inform your doctor regarding such

This helps to make a decision regarding the treatment options.

9 Risks and Complications

Infertility and osteoporosis are the two most common complications associated with amenorrhea.

10 Related Clinical Trials