Secondary amenorrhea happens when a woman who has had menstrual periods but stops menstruating for about 3 months or more consecutive months.
Secondary amenorrhea is a type of amenorrhea. Amenorrhea can be quite confusing and scary for a lady.
There are lots of factors which can cause amenorrhea. Such as emotional or physical stress, hormonal imbalances.
When you notice a cessation in your menstrual period for more than 3 months, it is very important you visit your doctor.
Amenorrhea is the absence of menstruation. This is when a woman who is of childbearing age fails to menstruate.
When you miss at least three menstrual periods in a row, you may just have amenorrhea. Same with girls who haven’t started menstruation by the age of 15.
The hypothalamus is responsible for regulating the menstrual cycle. The hypothalamus stimulates the pituitary gland which lies just below the hypothalamus at the base of the brain.
The pituitary gland releases two hormones which are responsible for regulating the female reproductive cycle, they are the luteinizing hormone (LH) and the follicle-stimulating hormone (FSH).
The luteinizing hormone and the follicle stimulating hormone influences the production of estrogen and progesterone. And these hormones are responsible for controlling the cyclic changes in the lining of the uterus. This also includes menstruation.
Therefore, for a woman to have regular menstrual cycles, her pituitary gland, hypothalamus, ovaries and uterus must be functioning effectively. Her vagina and cervix must also be of normal anatomy.
One of the most common causes of amenorrhea is pregnancy. Other causes of amenorrhea include problems which affect the reproductive organs or glands which help in regulating hormone levels.
Amenorrhea can be caused by various factors. Some of the causes like pregnancy are normal during the course of a woman’s life. Others may be as a result of a sign of an underlying medical problem or a side effect of a drug.
Some of the causes of natural amenorrhea include:
Other causes include:
- Some ladies who take birth control pills may not have periods. Sometimes, even after stopping the use of oral contraceptives, it still takes some time before ovulation and menstruation returns.
- Some drugs can cause amenorrhea. They include:
- Cancer chemotherapy
- Drugs for hypertension
- Drugs for allergy
- Emotional stress, mental stress, or intense physical stress can alter the functioning of your hypothalamus temporarily. The regular menstrual period usually begins after the stress is decreased.
- Low body weight. A body weight that is excessively low is capable of stopping many hormonal functions in your body. Which can also result in a stop in ovulation. Women who suffer from eating disorders such as anorexia nervosa or bulimia, often times stop having periods because of these abnormal hormonal changes.
- Excessive exercise. Women who are involved in activities requiring rigorous training, such as ballet, gymnastics, may also have interruptions in their menstrual cycles.
- Hormonal imbalances. There are lots of medical problems which can also cause an imbalance in your hormones. They include:
- Thyroid malfunction
- Polycystic ovary syndrome (PCOS)
- Premature menopause
- Pituitary tumor
- Structural or anatomical problems. This is when they are problems with the sexual organs. This can also cause amenorrhea. Examples of these structural problems are:
- Uterine scarring: This is also known as Asherman’s syndrome. It is a condition where scar tissues build up in the lining of the uterus, which can sometimes occur after a dilation and curettage (D&C), caesarean section. Uterine scarring prevents the normal shedding of the uterine lining.
- Abnormality in the structure of the vagina.
- Lack of reproductive organs.
Types Of Amenorrhea
There are two types of amenorrhea:
- Primary amenorrhea. This type occurs when a woman has not had her first menstrual period yet (menarche) even between the ages of 15 or 16.
This condition can also be referred to as delayed menarche, which is often due to last puberty.
This condition is very common in teenage girls who are very athletic or very thin. They are mostly underweight.
In some other girls, this delay in menstruation may be as a result of a genetic disorder. Or as a result of an abnormality in the reproductive organs.
- Secondary amenorrhea. Secondary amenorrhea occurs when there is a cessation of menstrual periods in a woman who has already has menstrual periods, which stops for 3 months or more.
Causes of Secondary Amenorrhea
Secondary amenorrhea can be caused by several factors, such as:
- Pregnancy (this is the most common cause)
- Physical or emotional stress
- Rapid weight loss
- Some hormonal birth control methods. This include birth control pills, long-acting progesterone, and the birth control patch.
- Strenuous exercises
- Polycystic ovary syndrome
- Premature ovarian failure
- Surgical removal of the uterus (Hysterectomy)
- Tumors of the pituitary gland
The main sign or symptom of amenorrhea is the absence of menstruation. Amenorrhea is also a symptom in itself, any associating symptom depends on the problem that is causing the amenorrhea
Some of the signs and symptoms that you might have along with the absence of menstruation include:
- Hair loss (alopecia)
- Altered sexual drive
- Weight gain
- Excessive body and facial hair
- Milky secretions from the breast
- Pelvic pain
- Changes in vision
They are some factors which increase your risk of amenorrhea, they include:
- Family history
- Athletic training
- Eating disorders. Like Anorexia nervosa, Bulimia nervosa.
Complications Of Amenorrhea
Some of the problems of amenorrhea include:
- When you do not have ovulations or menstrual periods, you cannot become pregnant.
- If the cause of your amenorrhea is low levels of estrogen, your risk for getting osteoporosis which is a weakening of your bones increases.
Test And Diagnosis
To read more on the test and diagnosis click here
Treatment For Amenorrhea
Treatment depends on the underlying causes of your amenorrhea. Amenorrhea that is caused by thyroid or pituitary disorders may be treated with drugs. If the cause is a tumor or structural blockage, surgery may be needed to correct the problem.
Primary amenorrhea that is caused by a delay in puberty does not often need treatment since the condition resolves itself in time.
But if the primary amenorrhea is caused by an abnormality in your genes, the treatment will be depend on the problem.
Secondary amenorrhea may be as a result of menopause or a surgical removal of the uterus. Treatment of secondary amenorrhea depends on the cause and may also involve taking prescribed drugs that might help in preventing problems of low estrogen levels.
Treatment of secondary amenorrhea that is caused by other factors also depends on the cause.
- Your doctor might recommend an exercise program, a change in diet to help also you lose weight and maintain a healthy weight.
- Your doctor may also advise that you enroll in a stress management course.
- Hormone imbalance. Supplemental hormones may also be prescribed for you.
- Excessive athletic training. You may be advised for a more moderate program instead. Which will help in normalizing your menstrual period.
- Tumors in the uterus, ovaries or pituitary gland. Treatment will depend on the type of tumor and the location of the cysts or tumors. Sometimes the best possible treatment for this is surgery.
- Polycystic ovary syndrome. Some medical treatments can also help in regulating your menstruations. Like Metformin, Clomiphene and a cyclical use of the female hormone.