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Amenorrhoea

What is Amenorrhoea?

Amenorrhoea is a medical condition characterized by the absence of menstrual periods in women of reproductive age. It can be categorized into two types: primary amenorrhoea, which occurs when a woman has not experienced her first menstrual period by the age of 16, and secondary amenorrhoea, which refers to the absence of menstrual periods for three consecutive cycles or more after previously having regular menstrual cycles.

Symptoms of Amenorrhoea

  • Absence of menstrual bleeding (Primary symptom).
  • Changes in weight.
  • Abnormal hair growth patterns.
  • Headaches.
  • Vision changes.
  • Hormonal imbalances.

When to see a doctor?

It’s essential to consult a doctor if you experience primary or secondary amenorrhoea, especially if it persists for several months. Additionally, seek medical advice if you experience other concerning symptoms alongside the absence of periods.

Questions to ask doctor regarding Amenorrhoea

  • What could be causing my amenorrhoea?
  • What tests will I need to undergo for diagnosis?
  • What are the potential complications of untreated amenorrhoea?
  • What treatment options are available for my condition?
  • How can I improve my chances of getting pregnant if I have secondary amenorrhoea?

Causes of Amenorrhoea

  • Hormonal imbalances.
  • Structural issues in the reproductive system.
  • Lifestyle factors such as excessive exercise or extreme weight loss.
  • Certain medical conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.

Risk factors of Amenorrhoea

  • Intense physical training.
  • Low body weight or obesity.
  • Stress.
  • Hormonal imbalances.
  • Certain medical conditions or treatments.

Complications of Amenorrhoea

  • Infertility.
  • Osteoporosis (weak and brittle bones).
  • Increased risk of cardiovascular diseases.

Diagnosis of Amenorrhoea

Here are common diagnostic steps:

  • Medical history: The doctor will ask about your menstrual history, including when you started menstruating, any irregularities, recent changes, and any other symptoms you may be experiencing.
  • Physical examination: A thorough physical exam may reveal signs related to the cause of amenorrhea. This may include assessing your body mass index (BMI), signs of excessive hair growth (hirsutism), acne, or any physical abnormalities.
  • Laboratory tests:
    • Pregnancy Test: This is often the first test to rule out pregnancy, as it can cause amenorrhea.
    • Hormone Levels: Blood tests can measure hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, and thyroid hormones (TSH, T3, T4).
    • Prolactin Level: High levels of prolactin, a hormone that stimulates milk production, can cause amenorrhea.
    • Androgen Levels: Elevated levels of androgens (male hormones) can indicate conditions like polycystic ovary syndrome (PCOS).
    • Thyroid Function Tests: Thyroid disorders can disrupt menstrual cycles, so testing thyroid function is important.
  • Imaging tests:
    • Pelvic Ultrasound: This may be done to check for structural abnormalities in the reproductive organs, such as ovarian cysts or polycystic ovaries.
    • MRI or CT Scan: These imaging tests may be ordered if there’s suspicion of a pituitary tumor or other brain abnormalities affecting hormone production.
  • Other specialized tests:
    • Gonadotropin-Releasing Hormone (GnRH) Stimulation Test: This test helps determine if the cause of amenorrhea is related to the hypothalamus or pituitary gland.
    • Endometrial biopsy: If there’s concern about the uterine lining, a small sample may be taken for examination.
    • Psychological assessment: In some cases, stress or psychological factors can contribute to amenorrhea. A psychological assessment may be helpful if other causes are ruled out.

Once the underlying cause is identified, treatment can be tailored accordingly.

Treatment of Amenorrhoea

The treatment of amenorrhea depends on the underlying cause. Here are some common approaches:

Hormone therapy:

  • Oral contraceptives: Birth control pills containing estrogen and progesterone can regulate menstrual cycles in women with hormonal imbalances.
  • Hormone Replacement Therapy (HRT): For women with premature ovarian failure or menopausal symptoms, HRT can replace estrogen and progesterone.

Medication:

  • Metformin: Often prescribed for women with polycystic ovary syndrome (PCOS) to improve insulin sensitivity and regulate menstrual cycles.
  • Prolactin-lowering medications: If high prolactin levels are causing amenorrhea, medications like bromocriptine or cabergoline may be prescribed to lower prolactin levels.

Surgery:

  • Laparoscopic ovarian drilling: In cases of PCOS where medication hasn’t been effective, a surgical procedure to puncture the ovarian cysts may restore ovulation and menstruation.
  • Surgical correction of Anatomic abnormalities: If structural abnormalities in the reproductive organs are causing amenorrhea, surgery may be necessary to correct them.

Lifestyle changes:

  • Weight management: For women with amenorrhea related to low body weight or excessive exercise, gaining weight or reducing exercise intensity may help restore menstruation.
  • Stress reduction: Stress management techniques such as relaxation exercises, counseling, or therapy can be beneficial for women whose amenorrhea is linked to stress.

Treatment of underlying conditions:

  • Thyroid disorders: Treatment with thyroid medication to normalize thyroid hormone levels.
  • Hyperprolactinemia: Treating the underlying cause of elevated prolactin levels, such as medication adjustment or removal of a pituitary tumor if present.

Fertility treatment:

  • For women who desire pregnancy, fertility treatments such as ovulation induction with medications like clomiphene citrate or assisted reproductive technologies (ART) like in vitro fertilization (IVF) may be considered after addressing the underlying cause of amenorrhea.

Why choose Shukan Hospital & IVF Centre in Ahmedabad for Amenorrhoea treatment?

At Shukan Hospital & IVF Centre, we offer comprehensive and personalized treatment plans for amenorrhoea tailored to each patient’s needs. Our team of experienced gynecologists and fertility specialists utilizes advanced diagnostic techniques and cutting-edge treatment options to ensure the best possible outcomes for our patients.

How to prevent Amenorrhea?

While some causes of amenorrhoea may not be preventable, maintaining a healthy lifestyle, achieving and maintaining a healthy weight, managing stress levels, and avoiding excessive exercise or drastic weight changes can help prevent amenorrhoea in some cases

FAqs

Can I get pregnant with Amenorrhea?

The ability to conceive depends on the underlying cause of amenorrhoea. In some cases, fertility treatments may be necessary to achieve pregnancy.

Should I keep track of my periods?

Yes, tracking your menstrual cycles can help identify any irregularities or changes in your menstrual pattern, which may indicate underlying health issues.

How long does Amenorrhea last?

The duration of amenorrhoea varies depending on the underlying cause. It may resolve on its own or require medical intervention for management.

Will my period return after treatment?

In many cases, with appropriate treatment and management, menstrual periods can return to normal.

Is Amenorrhea a type of infertility?

Amenorrhoea can contribute to infertility, especially if it is associated with ovulatory dysfunction or hormonal imbalances.

How much delay in periods is normal?

It’s normal for menstrual cycles to vary slightly in length, but a delay of more than a few weeks may warrant medical evaluation.

What is the best treatment for Amenorrhea?

The best treatment for amenorrhoea depends on the underlying cause and may include hormonal therapy, lifestyle modifications, or surgical interventions.

Can Amenorrhea heal naturally?

In some cases, amenorrhoea may resolve on its own, especially if it is related to lifestyle factors or temporary hormonal imbalances.