The absence of menstruation or amenorrhea often triggers waves of thoughts in the minds of many women
I have put together in this page the basic info which I have found useful for many women seeking help about such questions.
What Is Amenorrhea?
Amenorrhea is basically the absence of menstruation. It results from an
interference with the processes involved in the normal menstrual cycle.
Late or Absent Menstruation
These three words have been used by women to talk about a similar
problem about absent menstrual flow. These words point to the same
direction but are not really the same in every respect practically.
Absence of menses could be used for all cases of amenorrhea whether for those who have had menses before or not.
Missed period implies the menstrual flow was expected but did not occur. A range of emotions can result the first time this is identified.
menstruation usually carries a similar connotation like missed
menstruation. Late menstruation implies the woman knows the expected
date of menses but the flow has not yet shown up as usual based on her
past experience. Women often allow some few days of waiting to make an
allowance for an unusual irregularity. As a woman waits and yet does not
see any menstrual flow, the term late is appropriate. It could
also be used if the late menses finally shows up but with an usual
delay. Such delays or unusual prolongation of the cycle is no longer
amenorrhea because the menses finally come but may be another indication
of an abnormal cycle.
The absence of menstruation has been traditionally divided in two
main types depending on the causes and its relationship to puberty. The
distinction is usually so obvious. The two groups are primary and
amenorrhea is the absence of menstruation and secondary sexual
characteristics such as pubic hair and breasts development, in a girl by
age 14 years or the absence of menstrual bleeding with normal
development of such secondary sexual characteristics in a girl by age
Secondary. Secondary amenorrhea
is the absence of menstrual bleeding in a woman who had been
menstruating but later stops menstruating for 3 or more months in the
absence of any of the known physiologic or drug-induced causes of
absence of menstruation.
Causes of Amenorrhea
The likely cause of the absence of menstruation depends on what type
of amenorrhea is at hand. Whether primary or secondary, similar
structures could be involved.
The causes of amenorrhea
may either affect structures that produce the female hormones( the
hypothalamus-pituitary gland-ovaries) or the genital structures involved
in bleeding( uterus and vaginal).
Women will often not seek medical care when they first notice a
missed menstruation except there is a specific reason prompting this.
adolescents, the parents often notice abnormal pointers or some girls
may report the abnormality often after discussing with friends. For
young girls, medical care should be sought whenever a girl is 14 years
old and does not yet show secondary sexual characteristics and menses or
is 16 years old with secondary sexual characteristics but does not yet
menstruate. Home therapy of whatever sort should not be attempted at home until a full medical evaluation has clearly deciphered the cause.
women who have been having regular menstrual flow, medical care should
be sought after three missed period in the absence of the known
physiologic and drug-induced causes mentioned above. For women with
previous irregular cycles, a time limit of 6 months is usually used to
defined amenorrhea and so these women with such cycles can wait for 6
months before seeking medical care.
The treatment of amenorrhea is cause-specific. The underlying
cause must be identified and a specific therapy instituted whether with
medications or surgery.
In general, diseases that alter
the hormonal functioning could be addressed with medications, for
instance Dopamine agonists like bromocriptine in treating high prolactin
levels or Hormone Replacement Therapy with deficient menstruation
hormones like estrogen. The regular birth control pills could also be
used in some cases.
Surgery is usually used to treat structure genital tract abnormalities like vaginal septum or in some cases of tumors.
Home care will be required following medical evaluation for
functional absence of menstruation. As mentioned above, no home care
should be identified until full medical evaluation is done and the
specific therapy instituted including those that could be continued as
Do remember that the functional causes above are only identified as the culprit only after other causes have been excluded.
The following strategies are used to treat or even prevent causes of functional amenorrhea
Healthy balanced diet to resolve the problems about malnutrition.
to relieve stress if stress is identified as the cause. All should be
done to address the origin of stress and not just rely on medications.
of physical activity. A mild to moderate exercise should be implemented
if possible if excessive physical activity is identified as the likely
Maintenance of an idea body weight. Both overweight and underweight should be corrected.