An Introduction to Amenorrhea
Amenorrhea is the absence of menstruation. Basically, it means one or more missed periods. Keep on reading for more information about what is, what causes it, and then some treatment options.
Two Types of Amenorrhea: Primary and Secondary
To be officially diagnosed as having this condition, women need to have missed three of more periods in a row. This is known as “Secondary Amenorrhea.” Someone who has started menstruating, but later stopped for some reason.
Someone who hasn’t had their period by 15 is also considered to have this condition. This is known as “Primary Amenorrhea,” in that the woman has an absence of menstrual flow.
The most common cause is pregnancy. However, there are a number of other causes, so keep on reading to find out what they are, as well as when to see your doctor and treatment available.
Is it a sign of a menstrual disorder? Possibly, it depends on the cause. Keep on reading for all the details.
The main symptom is no period. However, there are also other symptoms that happen along with this one:
- Milky discharge from the nipples
- Hair loss
- Vision changes
- Facial hair (excessive)
- Pain in the pelvis
When to See a Doctor about this?
Missing one period isn’t such a big deal. The Mayo Clinic recommends seeing a medical professional if you’re missed three in a row (secondary Amenorrhea). Or, if you haven’t gotten your period by the age of 15 (primary Amenorrhea).
The good news is that many of the reasons for it are easy to treat.
There are some normal life-cycle reasons why you might miss some periods. They are known as natural causes. There are also some other reasons such as hormonal imbalances or lifestyle changes. We’ll give you the brief rundown here.
Natural Causes of Missed Periods
Find out more about the natural reasons behind it.
If you’re pregnant, you won’t continue to have your period. It’s obvious, but it’s also worth pointing out! If you’ve missed a period or two and have unprotected sex, it’s worth considering pregnancy as a possible cause.
When you’re breastfeeding, you also don’t menstruate as a result of this.
One of the things that can occur is missing some periods, especially as you begin to approach menopause.
Learn more about missed periods during this phase of life.
Also consider checking in with a medical professional about whether or not Hormone Replacement Therapy is right for you.
Do you want to get pregnant in your later years before menopause? Learn more about that here: Pregnancy in Perimenopause.
Menopause is the ceasing of periods. Officially, you’re considered to be menopausal when you haven’t had a period for a year.
For more people, menopause happens around 50, but some people may have premature menopause as early as in their 30’s.
Other Causes for Skipping Periods
There are a number of other reasons apart from the natural ones why you may be missing periods.
Birth Control Pills
There are some kinds of birth control/oral contraceptives that cause you to have no periods. Ask you doctor about what you can expect to experience when starting a new prescription of them.
Some of the brands names or oral contraceptives that allow you to have no periods, or only a few per year include Lybrel, Seasonale, and Seasonique.
And even after stopping them, it may take a while for your periods to get back to normal. Talk to your doctor about how you can manage this.
Certain medication can have the result of stopping periods, including:
- Chemotherapy (cancer treatment)
- Blood pressure drugs
- Allergy meds
Low Body Weight
Having a body weight less than 10% of normal can interrupt normal hormonal functioning. This can includes the hormones that regulate periods. This can often happen to people with with Bulimia or Anorexia, or those that have rapid weight loss.
Another reason why you might miss periods is because of excessive exercise. For example, training for an ultra-marathon. This can be due to stress, low levels of body fat, or some other factors.
Stress or Depression
High levels of stress can affect the part of the brain that regulates hormones, possibly causing an interruption in periods.
In addition, depression is a less frequent cause of menstruation to cease. If you lack emotional support networks in your life, please reach out for help to a counsellor.
If you’re undernourished and lack adequate nutrition, your body can go into crisis mode, and the nutrients and calories will go towards maintaining life. The reproductive process is considered to be less important, and your body may stop producing reproductive hormones.
This also applies to women who go on an extreme diet and either take in not enough food overall, or not enough varied vitamin intake.
Polycystic Ovary Syndrome (PCOS)
This condition causes hormone levels to remain relatively high throughout the menstrual cycle, rather than fluctuating as normal.
This can cause various menstrual cycle irregularities.
Thyroid or Pituitary Malfunction
Problems with the thyroid gland or pituitary gland can cause various menstruation conditions. For example, a Craniopharyngioma is a brain tumour near the pituitary gland that can cause menstrual cycle changes.
Asherman’s Syndrome is a condition in which scar tissue builds up in the uterine lining. The results is that the scarring can prevent normal buildup and shedding of the lining of the uterus.
Lack of Reproductive Organs, or Abnormalities
During fetal development, the reproductive organs may not have developed properly.
This is a condition in which the woman has normal menstrual cycles, but the outflow of menstrual fluid is blocked from exiting the vagina for some reason. This can lead to some serious health conditions.
It shows up most often in younger women who go to their doctor at 15 or 16 because they haven’t had their period yet.
More details here: Cryptomenorrhea (Blocked menstrual flow).
During a normal menstrual cycle, an egg is released. If it’s not fertilized, the woman menstruates, and the next menstrual cycle begins.
However, there are times when an egg is not released, which is known as annovulation. This is not so uncommon for it to happen once in a while. The woman may, or may not experience bleeding that month.
Pelvic Inflammatory Disease
PID is an infection of the reproductive organs and often happens as a result of an untreated STI. It’s dangerous, and can even be life-threatening.
Pelvic Inflammatory Disease can cause irregular bleeding, including a missed menstrual flow.
Type 2 Diabetes
There is some initial research linking irregular periods with Type 2 diabetes. It may be related to PCOS, and weight gain. More details here.
Many women develop cysts or tumors on their ovaries. They’re often non-cancerous, but they can also be cancerous, and it’s known as ovarian cancer.
A result may be irregular, or skipped periods. It’s likely that you’ll experience other symptoms besides this such as pelvic pain, bloating, difficultly eating, pain during sex, chronic fatigue, etc.
Those who are higher risk for this are advised to get screening checks done, which often involves a transvaginal ultrasound.
A hormonal imbalance of the reproductive hormones, estrogen and progesterone can cause irregular or skipped periods. There are a number of underlying reasons why this might occur, so you should check in with your doctor about it.
Some genetic disorders such as Turner Syndrome or Sawyer syndrome can cause late menstruation/primary Amenorrhea.
Illegal Drugs or Alcohol
We tried to find information about how illegal drugs and excessive alcohol intake affected menstruation, but were a little disappointed. There just isn’t that much good information about it. What we did find suggested that they may have an impact on periods and the menstrual cycle, but not much is known.
Risk Factors for Absence of Menstruation
There are three main risk factors for lack of menstrual flow. They include:
If other members of your family have had it, you’re at a higher risk yourself.
They are a frequent reason why you may not have a period. Two of the most common ones are anorexia and bulimia.
People who are engaged in serious athletic training often have no periods, or irregular ones.
Future Complications of Amenorrhea
No periods…seems kind of awesome, right? You don’t have to deal with your period! However, it’s not ideal for a few reasons.
Complications from the Reason Why You Don’t Have Periods
Depending on what’s causing you to not menstruate, you may have problems beyond just no period now. For example, eating disorders can damage parts of your body.
If you want to become pregnant, you need to have a period.
If you have Amenorrhea due to low estrogen levels, you could be at an increased risk of Osteoporosis (weak bones) and be more susceptible to broken bones as you get older.
Treatment Options for Amenorrhea
As you can see, there are a number of reasons or underlying conditions why someone might be missing periods. The treatment depends on what’s causing them.
For example, if it’s related to excessive exercising, or an extreme diet, your doctor may work with you to increase your calorie intake and reduce your exercise to a more reasonable level.
Perhaps it’s related to a new oral contraceptive that is not the correct dosage for you. Your doctor will work with you to correct this.
Some things like pelvic abnormalities may require surgery.
If it’s related to diabetes, your doctor may help you manage your blood sugar levels in a better way.
Please see a medical professional if you’re older than 15, and don’t have your period. Or, if you’ve missed more than three periods in a row. They can help you determine the cause and best course of treatment.
Natural Treatments for Missed Periods
There are some causes of lack of menstruation that are within our control. For example, stress, and excessive exercise.
Evaluate your life, and see if there are any lifestyle changes you can make to:
- Exercise less, if you are engaging in serious athletic training (or eat more food)
- Get more sleep
- Build in some time to relax, or enjoy activities with family and friends
- Eat healthier food
- Drink less alcohol
Learn more about Natural Treatments for Irregular Periods.
Pregnancy and Amenorrhea
Want to know how Amenorrhea and Pregnancy are related? There are two things to consider:
#1: Pregnancy is the main cause of lack of periods after you’ve begun menstruating. If you see your doctor for this, the first course of action is usually a pregnancy test.
#2: If you don’t ovulate of have a period, you can’t get pregnant. If this is what you want, then you’ll need to find out why you don’t have periods (see your doctor).
More details here: Pregnancy and Amenorrhea.
I Have Periods, just Not Frequently
Okay, so you have regular periods, but they’re just very infrequent. It could be Oligomenorrhea. The term can also refer to a very light flow.
It can be brought upon by excessive exercise or dieting, as well as a host of other things. Check with your doctor for a proper diagnosis. Learn more here: Oligomenorrhea Symptoms, Causes, and Treatment.
Amenorrhea: Have your Say!
Any comments of questions about missed periods? Leave a comment below and share your thoughts with us.
Reference, and for more information: Mayo Clinic