Loss of Menses

Amenorrhea
Two types - primary and secondary amenorrhea

1. Primary amenorrhea: Period does not start even after attaining the age of 16 years.
2. Secondary amenorrhea: Period starts at normal age but stops afterwards.

Amenorrhea is normal only before puberty, during pregnancy, while breastfeeding, and after menopause.

Causes of primary amenorrhea:

Ø Birth defect in development of uterus or fallopian tubes
Ø Genetic disorder
Ø Problems with one of the three organs - the hypothalamus part of the brain, thyroid gland and pituitary gland
Ø Anorexia nervosa (lack of appetite)
Causes of secondary amenorrhea:

Ø Problems with the hypothalamus, pituitary gland, thyroid gland, adrenal glands, ovaries, or other parts of the reproductive system.
Ø Hormonal abnormalities
Ø Stress induced hormonal imbalance
Ø Heavy exercise
Ø Tumor in the reproductive system
Ø Scars on the inside wall/ lining of the uterus after surgery or any other infection
Secondary symptoms of amenorrhea may exist from time to time. But they are very individualized.

Diagnosis:

Primary amenorrhea – Periods have not started by age of 16
Secondary amenorrhea - No menstruation in adult women for last 3 months except pregnancy, breastfeeding and menopause.

Confirmatory tests:

Hormone levels in the blood
Diagnosis for a pituitary tumor by x-ray
Ultrasonography for possible tumors in the ovary or adrenal glands.

Amenorrhea is an abnormality. It is advisable to visit the doctor at the very beginning so that any other complications do not get aggravated.