Amenorrhoea

A woman does not menstruate before puberty and after menopause, and the only time she stops menstruating during the reproductive age is during pregnancy and lactation. Amenorrhoea is a condition in which a woman has no periods during her reproductive age. The reasons behind this condition may vary from individual to individual.

Amenorrhoea can be classified into primary amenorrhoea and secondary amenorrhoea.

Primary amenorrhoea
This occurs when a girl reaches the age of puberty (around 15 years), and has had no sexual physical development or goes through all the other changes that occur during puberty but does not menstruate. Absence of periods can be due to a number of reasons and changes occurring in various glands, reproductive organs and hormones.

Causes

  • Poorly developed reproductive organs
  • Problems related to ovaries
  • Absence of a reproductive organ (like uterus, vaginal septum, imperforate hymen or cervical stenosis)
  • Problems in the pituitary gland
  • Hormonal imbalance
  • Problems in central nervous system
  • Various conditions like extreme anorexia, morbid obesity, cystic fibrosis etc.

Secondary amenorrhoea
When a woman, who has had regular periods, but due to some pathological reasons has no periods for more than 3-6 months is said to be suffering from secondary amenorrhoea.

Causes

  • Lack of nutrition
  • Being extremely underweight
  • Depression and other stress related disorders
  • Extreme exercising and endurance training
  • Sudden fluctuation in weight
  • An underlying illness such as PCOS and related hormonal imbalance
  • Ovarian failure
  • Thyroid gland disorders
  • Contraceptives and psychiatric drugs, which cause hormonal imbalance

Complications associated with amenorrhoea
Amenorrhoea can also lead to infertility but that depends on the severity. If the condition is due to hormonal imbalance caused by low levels of oestrogen it can also lead to osteoporosis.

Treatment
The line of treatment depends on the causes and underlying ailment. Hence, detailed diagnosis and detection of the underlying ailment is a must.
If the condition is a result of lifestyle factors, stress and depression then taking a break or meditation, following a healthy lifestyle and eating a balanced diet can prove to be extremely useful in reviving the regular menstrual cycle.
If absence of periods is due to weight fluctuations, it can be managed by making an effort to maintain proper weight. In case hormonal imbalance or thyroid problems are responsible for the condition, one needs to rectify the hormonal imbalance and treat the thyroid problem as soon as possible.

Menstruation cycle can be regularised through medication for poly cystic ovarian syndrome, regular exercise and diet control. If amenorrhoea is because of premature ovary failure, a hormone replacement therapy can help the patient get regular periods.

Underdeveloped genitals or any problems in genitals can be rectified by surgery, and there are chances of reviving and regularising menstrual cycle.

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