Amenorrhea is usually defined as the absence of menstruation in a woman of reproductive age. There can be a number of causes for this condition, which are discussed in this HerHaleness article.
Amenorrhea is a medical term used for describing the condition, which is characterized by the absence of menstrual cycles in women of reproductive age. Usually, menstruation stops in women during pregnancy, after menopause, and when their ovaries or uterus are removed surgically.
The absence of menstruation in such conditions is quite normal, and therefore, physicians always rule out these possibilities before trying to find out the other causes of amenorrhea. Basically, there are two types of amenorrhea – primary and secondary. Primary amenorrhea refers to the condition, where menstruation does not start by the age of 16 years.
Secondary amenorrhea on the other hand, refers to the cessation of regular menstrual bleeding in a woman who was menstruating previously. Primary amenorrhea is more commonly congenital, and caused by genetic and chromosomal abnormalities, as well as developmental defects of the reproductive system. But secondary amenorrhea is usually associated with hormonal fluctuations, premature menopause, intake of certain drugs, and other health conditions.
Primary Amenorrhea
Primary amenorrhea usually results from a genetic or chromosomal defect. It can be caused by a condition, known as ‘gonadal dysgenesis’, where there is a premature depletion of the follicles and the egg cells. This in turn, results in the premature failure of the ovaries, for which ovulation and menstruation cannot take place. On the other hand, women with Turner syndrome do not have all or a portion of one of the two X chromosomes. This prevents the normal development of the ovaries, and thus leads to primary amenorrhea and premature ovarian failure.
The hypothalamus, which is present at the base of the brain plays a crucial role in regulating menstrual cycles in women. So, a disorder of the hypothalamus can sometimes manifest as amenorrhea, which is known as functional hypothalamic amenorrhea. Some of the main risk factors for this condition are, eating disorders (anorexia nervosa and bulimia nervosa), too much of physical and physiological stress, and excessive or vigorous exercising.
Like hypothalamus, pituitary is another gland that controls menstruation in women. So, the development of a tumor or any kind of invasive growth in the pituitary gland can lead to amenorrhea. Some other possible causes of primary amenorrhea are, the absence of certain reproductive organs, such as uterus, vagina, or cervix, congenital adrenal hyperplasia, and polycystic ovarian syndrome. The structural abnormalities of the vagina can also result in amenorrhea, as it can block the flow of blood from the uterus and cervix.
Secondary Amenorrhea
Pregnancy is perhaps the most common cause of secondary amenorrhea, though it is not a disease or a disorder. Other than pregnancy, secondary amenorrhea can be associated with the use of contraceptives. Generally, if a woman stops taking contraceptives, she might take a few months (about 3 to 5 months) to resume her menstrual cycle. Like oral contraceptives, certain medications such as antidepressants, corticosteroids, and chemotherapy drugs can also cause amenorrhea. Secondary amenorrhea is often experienced by the breastfeeding mothers as well.
Secondary amenorrhea can also result from excessive weight loss. It has been observed that both low body weight or low body fat, and strenuous physical activities can interrupt menstruation in women. Similarly, a high level of mental stress can also have an effect on menstruation. It has been observed that prolonged and excessive mental stress can adversely affect the functioning of the hypothalamus, which in turn, can stop menstruation temporarily. Some other common causes of secondary amenorrhea are, hormonal fluctuations caused by the polycystic ovarian syndrome, an underactive thyroid gland or hypothyroidism, and the development of tumor in the pituitary gland.
Apart from these, two other possible causes of secondary amenorrhea are, uterine scarring and primary ovarian insufficiency. Sometimes, scar tissues can develop in the uterus, especially after uterine procedures like cesarean section. Such a condition can prevent the buildup, as well as the shedding of the uterine lining, leading to light or no menstruation. Primary ovarian failure or insufficiency, also known as premature menopause can also disrupt the normal functioning of the ovaries quite early, usually before 40 years. In general, menopause occurs at the age of 45 to 55 years.
Amenorrhea usually does not result from a serious underlying condition. However, the sudden cessation of menstrual bleeding at an early age, and not getting the first menstrual period can be a troubling experience for any woman. But before coming to any conclusion, it is better to get the condition evaluated by a physician. This can help you avoid unnecessary stress, and identify the underlying causes.
Lastly, it needs to be kept in mind that your diet and lifestyle can have a great impact on the functioning of the various systems of the body, including the reproductive system. Excessive diet restrictions coupled with vigorous exercising in an attempt to lose weight can sometimes take a toll on your health, and interrupt your menstrual cycle. In fact, both obesity and low body weight can disrupt your normal menstrual bleeding. So, try to maintain an ideal body weight, and be sure to talk to your physician if you observe any kind of irregularities in menstruation, or if you have not experienced the first menstrual cycle till the age of 16 years.
Disclaimer: This article is for informative purposes only, and should not be treated as a substitute for professional medical advice.
