The absence of menstrual periods, also known as amenorrhea, can have several causes depending on whether it's a first-time occurrence or a cessation of existing periods.
Types of Amenorrhea
Amenorrhea is broadly classified into two types:
- Primary Amenorrhea: This refers to the absence of menstruation by age 16, despite the presence of other signs of puberty, like breast development and pubic hair.
- Secondary Amenorrhea: This occurs when regular menstrual periods stop for three or more consecutive months.
Possible Causes
The causes of amenorrhea vary depending on the type:
Primary Amenorrhea
Potential causes include:
- Genetic or chromosomal abnormalities: Conditions like Turner syndrome.
- Problems with the reproductive organs: This could involve issues with the ovaries, uterus, or vagina.
- Hormonal imbalances: Affecting the hypothalamus or pituitary gland.
- Delayed puberty: Sometimes puberty starts later than usual for no identifiable reason.
Secondary Amenorrhea
Possible causes include:
- Pregnancy: One of the most common reasons for a missed period.
- Breastfeeding: Hormones released during breastfeeding can suppress menstruation.
- Stress: High levels of stress can disrupt the menstrual cycle.
- Significant weight loss or eating disorders: Anorexia nervosa or bulimia.
- Excessive exercise: Especially in athletes.
- Polycystic ovary syndrome (PCOS): A hormonal disorder common among women of reproductive age.
- Thyroid problems: Both hypothyroidism and hyperthyroidism can affect menstruation.
- Premature ovarian failure: When the ovaries stop working before age 40.
- Certain medications: Including some antidepressants, antipsychotics, and chemotherapy drugs.
- Problems with the uterus: Such as Asherman's syndrome (scar tissue in the uterus).
- Menopause: The natural cessation of menstruation, typically occurring between ages 45 and 55.
Diagnosis and Treatment
It's important to consult a healthcare professional to determine the underlying cause of amenorrhea. Diagnosis often involves a physical exam, blood tests (to check hormone levels and thyroid function), and possibly imaging tests (such as an ultrasound). Treatment depends on the cause and may include hormone therapy, lifestyle changes, or surgery.
