What is Amenorrhea? Causes, Consequences and Treatment

What is Amenorrhea

Prolonged menstruation is a disorder that is called amenorrhea and is more common than you think and, in fact, can affect women at any stage and at any age. Do you know what the causes, symptoms and consequences are? We’ll tell you then.

To be considered a case of amenorrhea, the rule must be withdrawn for a minimum period of three months. The absence, in addition, must occur after several menstrual cycles occur in a normal way.

This disorder, which affects once in your life 4% of women, is very common, for example, among elite athletes or people who undergo very extreme diets. In addition, it is associated with eating disorders such as bulimia or anorexia.

Thus, amenorrhea is usually resolved when a treatment that resolves the underlying condition is initiated, so the absence of a period during pregnancy and lactation is not considered amenorrhea.

But, what other causes can it be due to and what are the symptoms and consequences?

What are the types of amenorrhea?

There are two types of amenorrhea: primary and secondary amenorrhea. Primary amenorrhea occurs in women who have never menstruated and the limit to suffering it is 16 years, although it is an orientation limit.

These are cases in which the adolescent has developed the sexual organs and has grown normally and, nevertheless, does not menstruate.

On the other hand, secondary amenorrhea occurs in the rest of women who, having menstruating, stop having their period for several months in a row, at least six.

There is, on the other hand, the natural amenorrhea that occurs, as the name implies, for natural causes: pregnancy, lactation period and menopause.

Causes of amenorrhea and symptoms to learn to identify it

The absence of a rule may be motivated by natural causes, as we have said, or caused by hormonal disorders or as a side effect of medication intake.

Amenorrhea caused by medications or contraceptives

Amenorrhea can be caused by the consumption of oral contraceptives and the use of injected contraceptives or intrauterine devices, which can cause menstruation to be removed. The rule may even take time to return after you stop using these contraceptives.

Some other types of drugs, such as antihistamines, antidepressants, antipsychotics, chemotherapy or medication to regulate blood pressure can also cause amenorrhea.

Changes in lifestyle

Abrupt changes in our lifestyle or some factors related to it can cause the rule to be removed. This is the case of people who gain or lose a lot of weight. For example, if due to a diet or an eating disorder, normal body weight drops by 10%, hormonal functions are affected, so ovulation can stop.

Excessive physical exercise or too low body fat index may also have this effect. That is why many elite athletes suffer from amenorrhea. Intense

Stress and anxiety are two other factors that can affect the menstrual cycle since they can alter the functioning of the hypothalamus, responsible for regulating hormone levels. When stress and anxiety decrease, the rule should return normally.

Hormonal imbalances and disorders

Polycystic ovary syndrome (PCOS) is one of the most common causes of amenorrhea since it is a very common ailment. This disorder causes very high levels of hormones that are maintained over time, not allowing these levels to fluctuate as they would be in a normal menstrual cycle.

Hyperthyroidism and hypothyroidism, caused by irregular functioning of the thyroid gland, and pituitary tumours – in the pituitary gland – can also be a cause of amenorrhea.

Women who experience premature menopause also suffer amenorrhea, which would occur around age 30 when normal menopause is usually experienced between 45 and 50 years.

The premature withdrawal of the menstrual cycle may also be due to a premature ovarian failure associated with the fragile X chromosome, a genetic disease whereby the ovaries cease to function normally before their 40th birthday.

Structural problems in the vaginal canal, uterus or ovaries

This is the case of women suffering from scars or lesions in the uterus. An example is Asherman’s syndrome, a pathology where, after a C-section or dilation, scar tissue forms in the lining of the uterus.

Those born with an incorrect or insufficient development of the genital organs or those with structural abnormalities in the vagina – such as a vaginal obstruction in which a membrane blocks blood flow to the cervix – can cause the absence of a period.

Finally, amenorrhea may be motivated by family history from which a predisposition to suffer from it is inherited. If this is your case, and you want to prevent it, it is best to keep a good diet, always exercise moderately and moderate the consumption of tobacco and alcohol.

It seems obvious to think that amenorrhea is identified by the same absence of rule, but the truth is that it is a disorder that can be accompanied by many other symptoms depending on the cause that has caused it, especially in cases where it has been caused due to hormonal alterations. These symptoms can be:

  • Increase or decrease in breast size
  • Breast Secretion
  • Fall of the hair
  • Impaired vision
  • Pelvic pains
  • Vaginal dryness
  • Sudden gain or loss of weight
  • Acne breakouts
  • Increase in body hair
  • Voice changes
  • Headaches

Treatment and solutions

If you are 15 or 16 years old and have not yet had your first period, you should consult your doctor. You must do the same if the cycle has been withdrawn for at least three consecutive months.

To make a diagnosis, the doctor must perform a series of tests that determine the cause and appropriate treatment.

The first one will be a test that confirms or discards a pregnancy. In addition to that, a blood test will be performed with which to check hormone levels and ovarian thyroid function. Two other common tests in this diagnosis are:

  • Hormone stimulation test: supply of hormones for several days to cause bleeding. This test confirms that amenorrhea has occurred due to lack of estrogen.
  • Hysteroscopy and diagnostic imaging tests: ultrasound, computed tomography and magnetic resonance imaging. These tests are performed to rule out abnormalities in the sexual organs.

The treatment of amenorrhea will depend on the cause that motivates it. Thus, if it is due to an eating disorder, the menstrual cycles will be restored normally when the patient returns to normal weight and follows a balanced diet.

If, on the other hand, it is due to a hormonal problem, this background disorder should be treated with medication. In many of these cases, birth control pills and hormonal therapies are used.


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