Amenorrhoea
Menstruation is a constant cause for concern in the life of every woman. But amenorrhea can bring even more worries. Constant thoughts: "What if there is an unwanted pregnancy?" or, conversely, the fear that there is no ovulation at all. Yes, a visit to the doctor is mandatory, but there is no need to panic. How to cope with this condition and what is important to know - read the article.
specialists
equipment
treatment
Reasons for the absence of menstruation
Absence of menstruation (amenorrhea) can be caused by various factors that affect the reproductive and endocrine systems. Let's look at the main reasons for the cessation of menstruation.
- Hormonal disorders. Dysfunction of the hypothalamic-pituitary system, ovaries, or thyroid gland can lead to a failure in the regulation of the menstrual cycle. For example:
- Polycystic ovary syndrome (PCOS) is a common cause of cessation of menstruation.
- Hypothyroidism or hyperthyroidism are problems with thyroid hormones.
- Prolactinoma is a pituitary tumor that causes an increase in prolactin levels.
- Stress and emotional tension. Long-term stress, anxiety, or extreme stress can disrupt the connection between the brain and the ovaries, causing a temporary absence of menstruation.
- Sudden weight loss or nutritional deficiencies. Low body fat, vitamin and nutrient deficiencies, extreme dieting, or anorexia can stop menstruation as the body “saves resources.”
- Being overweight. Hormonal imbalances caused by obesity can cause periods to stop. Excess estrogen, which is produced by fat tissue, disrupts ovulation.
- Physical activity. Excessive training, especially in athletes, often leads to cycle irregularities due to stress on the body and decreased hormone levels.
- Pregnancy and breastfeeding. These are natural causes of irregular periods. During pregnancy and lactation, hormone levels change, which suppresses ovulation.
-
Pathologies of the reproductive organs. Some congenital or acquired diseases can interfere with the normal functioning of the uterus or ovaries:
- Asherman's syndrome (adhesions in the uterine cavity).
- Agenesis of the uterus or vagina.
- Ovarian tumors.
- Taking medications or hormone therapy. Certain medications, including contraceptives, antidepressants, and cancer drugs, can cause amenorrhea as a side effect.
Ovarian failure can occur naturally after age 45, or prematurely, before age 40.
Types of amenorrhea
Primary amenorrhea
Primary amenorrhea is diagnosed if a girl over 16 years of age has no periods, but secondary sexual characteristics are present, such as breast growth and hair in the genital area. If these signs also disappear, we are talking about primary amenorrhea in girls over 14 years of age. The causes may be congenital pathologies of the reproductive system, genetic disorders such as Turner syndrome, or hormonal disruptions in the pituitary gland and hypothalamus.
Secondary amenorrhea
This type occurs in women who used to have periods but have stopped for more than three months. This condition is associated with factors such as stress, weight changes, hormonal imbalances, pregnancy or lactation. Sometimes the cause is chronic diseases such as PCOS or hypothyroidism.
Physiological amenorrhea
This type is considered normal at certain periods of a woman's life. Unstable menstruation is observed before puberty, during pregnancy, lactation and after menopause. It does not require treatment, as it is caused by natural processes of the body.
Pathological amenorrhea
Pathological amenorrhea indicates a malfunction in the body. It may be associated with endocrine diseases, such as hyperprolactinemia or ovarian failure, as well as with anatomical disorders, such as adhesions in the uterus. This condition requires mandatory medical intervention.
Iatrogenic amenorrhea
Occurs as a result of medical interventions or taking certain medications. Often occurs after reproductive surgery, such as removal of the uterus or ovaries, or as a side effect of chemotherapy, hormonal drugs, or antidepressants.
Amenorrhea treatment
Therapy for irregular menstruation begins with determining the cause. Without eliminating the source of the problem, it is almost impossible to restore the menstrual cycle.
- Hormone therapy to restore balance If irregular menstruation is caused by a hormonal imbalance, treatment begins with correcting hormone levels. For example, if there is a lack of estrogen and progesterone, the doctor may prescribe hormone replacement therapy, which helps restore ovarian function and normalize the cycle. For patients with polycystic ovary syndrome, drugs are used to regulate testosterone levels and stimulate ovulation. In case of hypothyroidism, thyroid hormones such as levothyroxine are prescribed to stabilize the endocrine balance.
- Lifestyle modification as part of treatment In case of functional amenorrhea associated with underweight, excessive loads or chronic stress, the main focus is on lifestyle changes. Restoring normal weight is one of the first tasks. The doctor helps to create a diet that includes enough proteins, fats and carbohydrates to achieve optimal body weight. If irregular menstruation occurs in athletes, it is recommended to review the training schedule and reduce the intensity of training. Psychotherapy, meditation or yoga classes are effective in reducing stress levels, which help restore hormonal balance.
- Drug treatment of inflammatory diseases If amenorrhea is caused by infections or inflammations of the pelvic organs, drug therapy is prescribed. For example, in case of inflammation of the appendages, the doctor may prescribe broad-spectrum antibiotics in combination with anti-inflammatory drugs. It is important to complete the course of therapy in full to prevent chronicity of the process and possible complications.
- Surgical methods for eliminating anatomical obstacles In cases where irregular menstruation is associated with anatomical causes, such as adhesions in the uterine cavity or tumors, surgical methods are necessary. Hysteroscopy allows for the removal of adhesions, septa or polyps with minimal tissue trauma. In cases of endometriosis or ovarian cysts, laparoscopy is performed, which helps preserve reproductive functions. Surgical intervention is indicated only after a thorough examination and in the absence of alternative treatment methods.
- Treatment of systemic diseases to restore the cycle If the irregularity of menstruation is due to systemic disorders such as hyperprolactinemia or diabetes, treatment is aimed at eliminating the underlying disease. If prolactin levels are elevated, drugs such as bromocriptine are prescribed to reduce prolactin levels and restore ovulation. In the case of diabetes, it is important to stabilize blood sugar levels through diet, physical activity, and medication.
- Reproductive technologies as a solution for pregnancy planning When other treatment methods are ineffective and the patient is planning a pregnancy, assisted reproductive technologies are used. For example, ovulation stimulation helps restore ovarian function and achieve egg maturation. For women with ovarian or uterine dysfunction, in vitro fertilization (IVF) may be offered.
General information
Health diagnostics in the absence of menstruation
If menstruation is absent for more than three months or does not occur at the expected age, it is important to understand the reasons. Correct diagnostics:
- Collecting anamnesis. The doctor will clarify when problems with the cycle appeared, possible factors (stress, sudden weight loss, chronic diseases) and hereditary features
- Gynecological examination. It is carried out to exclude anatomical disorders, inflammation or injuries that can affect the cycle
- Ultrasound of the pelvic organs. Allows you to assess the condition of the uterus, ovaries and tubes, identify cysts, adhesions or other pathologies
- Hormonal tests. The levels of prolactin, estrogen, progesterone, LH and FSH are examined to understand if there are hormonal imbalances
- MRI or CT. Prescribed if there is a suspicion of pathologies of the pituitary gland or hypothalamus to exclude tumors or other changes
- Blood lab tests. General analysis and biochemistry help to identify anemia, inflammation or metabolic disorders
In some cases, additional studies may be prescribed, such as hysteroscopy or laparoscopy. Hysteroscopy allows for a detailed examination of the uterine cavity, identifying polyps, adhesions or other anomalies. Laparoscopy is used to examine the condition of the pelvic organs, including the ovaries and fallopian tubes, and helps to detect endometriosis, cysts or adhesions.
Answers to popular questions
K+31 doctors have prepared answers to the most important questions of patients.
Can missing periods be normal?
In certain cases, menstrual instability is indeed a normal variant. For example, it is natural during pregnancy, lactation or menopause. However, in other situations (for example, adolescence or after stopping taking hormonal contraceptives), it is important to be monitored by a doctor to rule out pathology.
Can amenorrhea go away on its own?
If amenorrhea is caused by temporary factors such as stress, physical overexertion or sudden weight loss, menstruation may return once these causes are eliminated. However, without an examination, it is impossible to say for sure that the cause is harmless. It is important to consult a doctor to make sure that there are no serious disorders.
Does exercise affect menstruation?
Intensive training, especially when combined with a low-calorie diet, can lead to a decrease in hormone levels and disruption of the cycle. This condition is often found in professional athletes or women striving for a minimum percentage of fat mass. To restore the cycle, it is necessary to reduce physical activity and review the diet.
Can taking contraceptives cause amenorrhea?
Yes, taking hormonal contraceptives can cause temporary amenorrhea, especially if you use low-dose hormonal contraceptives or progestin-only IUDs. Your cycle will usually return within a few months of stopping the pill, but if it doesn't, you should consult your doctor.
Is it dangerous to miss periods during adolescence?
In adolescents, the menstrual cycle may be irregular during the first two years after the onset of menstruation, which is due to the immaturity of the hormonal system. However, if menstruation is absent after 15 years or is interrupted for a long time, this is a reason to consult a doctor.
Our doctors
This award is given to clinics with the highest ratings according to user ratings, a large number of requests from this site, and in the absence of critical violations.
This award is given to clinics with the highest ratings according to user ratings. It means that the place is known, loved, and definitely worth visiting.
The ProDoctors portal collected 500 thousand reviews, compiled a rating of doctors based on them and awarded the best. We are proud that our doctors are among those awarded.
Make an appointment at a convenient time on the nearest date
Price
Other services
Hormone therapy
Radio wave gynecology with the Surgitron device
Laser therapy using the Photona device
Sling operations Ectopic pregnancy Delayed menstruation Removal of the uterus (hysterectomy) Thrush (vaginal candidiasis) Prolapse of the uterus and vagina Uterine polyp (endometrial polyp) Cervical dysplasia Adenomyosis Treatment of sexual infections Vaginitis (Colpitis) Erythroplakia of the cervix Endometritis Bacterial vaginosis Symphysitis (symphysiopathy)Erosion and ectopia of the cervix
Vulvovaginitis Premenopause Uterine artery embolization for uterine fibroids Cervicitis Gynecologist consultationDysmenorrhea (painful periods)
Removal of the ovaries (oophorectomy)
Postmenopausal Sphinctermetry Treatment and intimate rejuvenation with the Fotona laserAdenomyosis (Endometriosis of the uterus)
Vulvitis Vaginal surgeries Inflammation of the appendages (adnexitis, salpingo-oophoritis) Labiaplasty (labiaplasty) Bartholinitis Surgery to remove an ovarian cyst Prolapse (prolapse) of the uterus and vagina Hormone replacement therapy (HRT) First menstruation
Appointment to the doctor
