Secondary
amenorrhea:
It is
common for women to have irregular menstrual cycles and even
skip a period occasionally. Therefore, secondary amenorrhea
is said to occur when a women who was previously menstruating
has an absence of her period for six months or longer.
Causes
of amenorrhea
Primary
amenorrhea should be investigated if a girl has not had her
first menstrual cycle by the age of 16. Causes of primary
amenorrhea include chromosomal abnormalities, congenital defects
and/or obstructions or the reproductive system, hormonal imbalance,
syndromes such as PCOS, anorexia, bulimia, excessive exercising,
and stressful life events.
Secondary
amenorrhea is a primary indicator of pregnancy. When pregnancy
is not the cause, there are several other common reasons for
a women not to menstruate including breastfeeding, hormonal
imbalance, and medications such as birth control pills and
certain tranquilizers. Anorexia, bulimia, excessive exercise,
weight gain or weight loss, and stress can also cause an absence
of your period.
What
should I do if my child has an absent period?
Any time
a child has not started menstruating by the age of 16, she
should be evaluated by a doctor. Her doctor may run blood
work to rule out pregnancy. She may also check for thyroid,
pituitary, or adrenal disorders. She will perform a pelvic
exam to check for any structural abnormalities such as imperforate
hymen (hymen with no opening). She will want a thorough history
including exercise and diet habits, recent stressors, current
medication, and any past medical history. Her doctor may also
perform an ultrasound to check for congenital birth defects
such as absence of uterus or ovaries or other congenital abnormalities.
Other lab work may include chromosomal studies and pap smear.
What
should I do if I have amenorrhea?
If you
have missed two or more periods, you will want to see your
doctor. Your doctor will likely perform blood work to check
for pregnancy. She may run tests to check thyroid levels,
progesterone levels, and other hormones. She will want a thorough
medical history including diet, exercise, medications, and
diseases that might effect menstruation. She may also investigate
symptoms of menopause.
Treatment
of amenorrhea
Amenorrhea
in and of itself is not a disease or illness. It is merely
a symptom. Therefore, treatment will vary depending on the
cause.
Congenital
abnormalities and defects: If amenorrhea is caused
by a congenital birth defect, it may not be correctable. Conditions
such as imperforate hymen can be corrected by surgery.
Hormonal
imbalances: Many hormonal causes of amenorrhea can
be corrected with appropriate medication.
Pregnancy:
Pregnancy is the most common reason for an absent period.
Prenatal care should be sought out if pregnancy is determined
to be the cause.
Breastfeeding:
Breastfeeding can cause an absence of menstruation. The medical
term for this is lactation induced amenorrhea. It is very
common for menstruation to not occur during the course of
breastfeeding. However, it should be noted that breastfeeding
alone is not recommended for birth controls since pregnancy
can occur when breastfeeding even with an absence of menstruation.
Diet,
exercise, and nutrition: Women who are underweight
or perform strenuous exercise regularly, such as runners and
gymnasts, may experience amenorrhea. Your doctor will want
to work with you on modifying your diet and exercise routine
to a healthy level to ensure the return of menstruation.
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