Amenorrhea

INDEX:

1. What is amenorrhea?
2. Prognosis of the disease
3. Symptoms
4. Diagnosis of amenorrhea
5. What are the causes?
6. Prevention
7. Treatments for amenorrhea
8. What expert treats it?

What is amenorrhea?

Amenorrhea is the lack of menstruation in women of childbearing age. The periods of life in which a woman physiologically experiences this situation are:

• Puberty
• Menopause
• Pregnancy
• Breastfeeding

Outside these periods, amenorrhea is caused by pathologies affecting the genital system or other diseases that alter the general conditions.

Amenorrhea is divided into two types:

• Primary amenorrhea (commonly called simply amenorrhea): when it occurs in females who have not yet had a menarche (first menstruation) by the age of 16 years, but who have developed all the secondary sexual characteristics: breast, pubic hair, etc. Or when it occurs in persons who, at the age of 14, have not yet had a menarche and have not developed secondary sexual characteristics.
• Secondary amenorrhea: is the lack of menstruation for 3 months in women who have never experienced irregularities in the menstrual cycle or for 9 months in women who have experienced oligomenorrhea (delay of more than four days in the menstrual cycle) and who are not pregnant, breastfeeding or in menopause.

Prognosis of amenorrhea

The prognosis of secondary amenorrhea depends on the cause. It may be favorable if the disease is curable; if it is a particularly serious condition (uterine cancer) or one that is not easily curable, it may have an unfavorable prognosis.

Symptoms of amenorrhea

Symptoms that may occur in amenorrhea situations, depending on the cause, include:

• Headaches
• Visual disturbances
• Hirsutism (excessive facial hair growth)
• Acne
• Pelvic pain
• Vaginal dryness
• Hair loss
• Galactorrhea (abnormal leakage of milk from the breast)
• Hot flashes
• Night sweats
• Sleep disturbances
• Body weight gain or loss

Medical tests for amenorrhea

In order to establish a diagnosis to understand the causes of the onset of amenorrhea, the following tests should be performed:

• Analysis of the symptoms perceived by the patient.
• Pelvic examination
• Examination of the breasts and genitalia
• Pregnancy test (to know if we are in the presence of pregnancy)
• Check hormone levels of FSH, LH, TSH and prolactin in the blood.
• Pelvic ultrasound (to rule out the presence of anatomical abnormalities)
• CT SCAN
• MRI of the head (to rule out tumors of the hypothalamus or pituitary gland)
• Hysteroscopy
• Hysterosalpingography (if pelvic examination and pelvic ultrasound have not produced satisfactory results).

What are the causes of amenorrhea?

The conditions that can determine the onset of amenorrhea are many and may depend on:

• Natural conditions such as pregnancy, lactation and menopause.
• Use of contraceptives
• Taking certain medications such as antipsychotics, chemotherapy, antidepressants, blood pressure medications, and allergy medications.
• Weight loss due to conditions such as anorexia nervosa or bulimia
• Severe obesity
• Excessive physical exercise
• Stress
• Drug abuse
• Hormonal imbalances caused by pituitary or hypothalamus tumors
• Kallmann’s syndrome
• Turner syndrome
• Malnutrition
• Sheehan’s syndrome
• Gonadal dysgenesis
• Polycystic ovary syndrome
• Thyroid disease
• Cushing’s syndrome
• Prolactinoma
• Atypical anatomy of the genital tract: scarring of the uterus or intrauterine adhesions, total or partial absence of the uterus, lack and malformations of the vagina
• Radiotherapy for cancer treatment
• Galactosemia, sarcoidosis and fragile X syndrome.
• Depression and general psychiatric disorders
• Tuberculosis

Can it be prevented?

Amenorrhea can only be prevented if triggers are controlled and avoided:

• Anorexia nervosa
• Excessive physical activity
• Malnutrition
• Stress
• Obesity

Treatments for amenorrhea

The treatments used in situations of amenorrhea favored by controllable causes are:

• Diet (slimming or not), aimed at achieving a normal body weight (when the disorder is due to conditions of anorexia nervosa or bulimia, the treatment should be accompanied by psychotherapy.
• Reduction of the hours devoted to physical exercise, if excessive physical activity is the cause.
• Interruption of the use of medications that favor the appearance of amenorrhea.
• Relaxation techniques, if the pathology is caused by stress.
• Surgical treatment, if amenorrhea is caused by: pituitary tumor, intrauterine adhesions and genital tract anomalies.
• Pharmacological treatment, if the amenorrhea is caused by a polycystic ovary.

Which specialist treats it?

The trusted specialist in the process of diagnosing amenorrhea is the expert in Gynecology, who will perform all the tests to confirm or not the disease and prescribe the best possible treatment.