Absence of menstruation (amenorrhea) may develop during adolescence or later. Primary amenorrhea is the absence of menstrual cycles till the age of 16. Secondary amenorrhea is observed when a woman who has had normal menstrual cycles stops getting her monthly period. If your period is delayed, the first thing to consider is pregnancy. But of course there are many other reasons. Amenorrhea is not a disease, is a sign, i.e. a symptom of a disease or condition.This is rarely a serious condition. However, waiting to menarche without knowing its etiology is very hard. But you don’t need to panic. Consulting your doctor, you will discover the cause and treatment will be initiated according to its etiology.
What are the symptoms?
Of course the main symptom is the absence of menstruation. We should consider the following parameters to determine if it is primary or secondary amenorrhea. Primary amenorrhea; No menstruation till the age of 16. Secondary amenorrhea; No menstruation for three to six months or longer time. The other complaints including galactore, headache, blurred vision, excessive hair may occur depending on the etiology.
Why it happens?
Primary amenorrhea may develop due to several reasons including chromosomal anomalies, hypothalamus diseases in the brain (there is a center which controls the menstrual cycle), pituitary diseases, congenital absence of reproductive organs (such as uterus, vagina), abnormal vaginal structure (if there is an obstruction in the vagina, there will be no blood flow). Secondary amenorrhea is more common than primary amenorrhea. There are several reasons for this. The first one is pregnancy. Birth control pills, needles, hormone spirals can stop your menstrual bleeding. Menstrual bleeding may stop during the breastfeeding period. Severe stress may affect the hypothalamus region in the brain and menstrual cycle may be impaired. Several medicines including antidepressants, cortisone, some chemotherapy drugs may terminate your menstrual bleeding. Chronic diseases may delay your menstrual bleeding.
After this disease is improved, your menstruation will return to normal. Hormonal disorders including polycystic ovary disease may stop your menstrual bleeding. Being underweight, excessive exercise may also cause hormonal disorder and stop your menstrual bleeding. Dysfunction of the thyroid gland also affect the menstrual cycle. The tumor in the pituitary gland impairs the menstrual bleeding by increasing prolactin release. This condition may usually be treated with medication. However, sometimes surgery is needed. Early menopause may also cause of amenorrhea. Menopause usually occurs between the ages of 45-55. if it occurs before the age of 40 it is called early menopause. It may develop due to genetic reasons or other diseases.
When to admitted to the doctor?
If you have not seen menstruation till the age of 16, or if you have had normal menstrual cycles but then stopped for 3 months, consult your doctor.
How to diagnose:
Amenorrhea is not a life-threatening disease. But several assays are needed to discover the underlying etiology, and they take time. Firstly pregnancy is investigated by gynecological exam. Then abnormalities of reproductive organs are investigated. Hormonal abnormalities are investigated by blood tests. Other assays are planned according to the other complaints and symptoms.
Ultrasound, computed tomography, MR (magnetic resonance), sometimes assays for internal organs such as laparoscopy or hysterescopy may be required by examining directly.
How to treat:
Treatment also depends on the underlying cause. Life style change will be required if there are weight problems, excessive physical activity or stress. If there is polycystic ovary syndrome, birth control pills will be prescribed. If the etiology is associated with thyroid or pituitary gland diseases, relevant medicines should be given to improve menstrual cycle.
What things you should care?
You must have a regular life to improve menstrual cycle. Maintain ideal weight, eat properly, and do exercise. Pay attention to working and resting hours in your business life. Avoid a stressful life. If you can’t take care of yourself, don’t hesitate to ask help from your family, friends or even your doctor.
Record the start and finish dates of your menstrual bleeding to show your doctor easily. Investigate if your mother, sister or close relatives have such problems and inform your doctor.
