Amenorrhoea

Amenorrhoea

Amenorrhea is the absence of menstruation — one or more missed menstrual periods..

The most common cause of amenorrhea is pregnancy.

Symptoms

The main sign of amenorrhea is the absence of menstrual periods. Depending on the cause of amenorrhea, you might experience other signs or symptoms along with the absence of periods, such as:

• Milky nipple discharge
• Hair loss
• Headache
• Vision changes
• Excess facial hair
• Pelvic pain
• Acne

When to see a doctor

Consult your doctor if you’ve missed at least three menstrual periods in a row, or if you’ve never had a menstrual period and you’re age 15 or older.

Causes:

Amenorrhea can occur for a variety of reasons. Some are normal during the course of a woman’s life, while others may be a side effect of medication or a sign of a medical problem.

Natural amenorrhea

During the normal course of your life, you may experience amenorrhea for natural reasons, such as:

• Pregnancy
• Breast-feeding
• Menopause

Contraceptives

Some women who take birth control pills may not have periods. Even after stopping oral contraceptives, it may take some time before regular ovulation and menstruation return. Contraceptives that are injected or implanted also may cause amenorrhea, as can some types of intrauterine devices.

Medications

Certain medications can cause menstrual periods to stop, including some types of:

• Antipsychotics
• Cancer chemotherapy
• Antidepressants
• Blood pressure drugs
• Allergy medications

Lifestyle factors

Sometimes lifestyle factors contribute to amenorrhea, for instance:

• Low body weight. Excessively low body weight — about 10 percent under normal weight — interrupts many hormonal functions in your body, potentially halting ovulation.
• Excessive exercise.
• Mental stress.

Hormonal imbalance

Many types of medical problems can cause hormonal imbalance, including:

• Polycystic ovary syndrome (PCOS).
• Thyroid malfunction.
• Pituitary tumor.
• Premature menopause.

Structural problems

Problems with the sexual organs themselves also can cause amenorrhea. Examples include:

• Uterine scarring.
• Lack of reproductive organs.
• Structural abnormality of the vagina.

Risk factors

Factors that may increase your risk of amenorrhea may include:

• Family history. If other women in your family have experienced amenorrhea, you may have inherited a predisposition for the problem.
• Eating disorders. If you have an eating disorder, such as anorexia or bulimia, you are at higher risk of developing amenorrhea.
• Athletic training. Rigorous athletic training can increase your risk of amenorrhea.

Complications

Complications of amenorrhea may include:

• If you don’t ovulate and have menstrual periods, you can’t become pregnant.
• If your amenorrhea is caused by low estrogen levels, you may also be at risk of osteoporosis — a weakening of your bones.