Amenorrhea- Symptoms and causes

Amenorrhea may be defined as the absence of menstrual periods in a woman of reproductive age.

What are the symptoms of amenorrhea:

  1. Headache
  2. Loss of hair
  3. Changes in vision
  4. Unwanted facial hair
  5. Pain in the pelvis
  6. Acne
  7. Milky discharges from the nipples
  8. Increased weight
  9. Dryness of vagina
  10. Sex drive may be altered


Amenorrhea may be natural and psychological in following conditions:

  1. Pregnancy
  2. Lactation
  3. Childhood
  4. Menopause- It is age related and normal process marked by the end of the menstrual cycle

Amenorrhea is divided into two types:

1.  Primary amenorrhea– It is a condition where menstruation or periods haven’t yet started even after the age of 15 years, while other symptoms of puberty such as pubic hair and developed breast have developed.

It is usually due to late puberty and is also called as delayed menarche. It is common in athletes and thin teenage girls.

Primary amenorrhea may occur even without other signs of puberty.

Causes of primary amenorrhea are:

  1. Incomplete development of genital or pelvic organs.
  2. Narrow or blocked cervix.
  3. The absence of uterus or vagina.
  4. The presence of vaginal septum.
  5. Imperforate hymen.

Secondary amenorrhea: It is a condition of absence of menses for about six months in a woman who was having normal periods or at least have one menstrual period.

 Causes of secondary amenorrhea are:

  1. Hormonal imbalance- This may occur due to following reasons:
  • Pituitary gland tumors
  • Overactive thyroid gland
  • The improper functioning of the ovary
  • Low level of estrogen hormone
  • Higher level of testosterone hormone
  1. Loss of appetite
  2. Chronic illness, for example, heart diseases.
  3. Infection in the womb after giving birth
  4. Poor nutrition
  5. Tumors
  6. Birth control pills
  7. Emotional stress
  8. Increased body weight
  9. Rigorous exercises
  10. Removal of the uterus by surgery
  11. Chemotherapy
  12. Premature failure of ovaries
  13. Polycystic ovarian syndrome

How to Diagnose amenorrhea:

  1. Your doctor may ask questions regarding the following:
  • Your last menstrual period
  • Any discomfort in the abdomen
  • Sex life
  • Birth control methods
  • Eating habits
  • Your weight
  • Stress level
  • About medications, you are taking
  • Unwanted body hair growth
  • Acne
  • Breast secretions
  • Hair loss
  • Bowel movements
  • Sensitivity to extreme temperatures

Tests that may identify the cause of amenorrhea are as follows:

  1. Blood test- To detect the hormonal imbalance, check the level of insulin, an adrenal hormone, thyroid hormone, FSH level and to rule out pregnancy.
  2. Urine test
  3. Ultrasound of pelvis- This will identify any structural abnormality present in ovaries and uterus.

Treatment of amenorrhea:

  • In the case of delayed menarche, no treatment is required. It goes away with time. Some preventive measure such as a balanced diet, ideal body weight, reducing stress and balanced workout helps.
  • In the case of genetic abnormality, the cause of the problem decides the treatment.
  • Surgery may be required to treat structural problems.
  • In secondary amenorrhea, treatment is done according to the underlying cause.

Consult your doctor if you don’t get menstruation periods, even after 15 years of age or if you miss 3 menstrual periods in a line.

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