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Amenorrhoea - Amenorrhoea symptom, treatment, causes

Amenorrhoea is the absence of menstrual periods during a woman's reproductive years. Amenorrhoea is normal during pregnancy and breastfeeding.

Amenorrhoea means absence of the menstrual period. Periods usually start about age 12 and occur every 24-35 days. It's not normal for women to have no periods, and there will be something at the root of the problem. Apart from during childhood, pregnancy, breastfeeding or menopause, the absence of the menstrual period may indicate a problem with the reproductive system. Pregnancy and menopause are two very natural reasons for menstruation to cease, known as Amenorrhoea. It is suspected that low body fat levels and exercise related chemicals disrupt the interplay of the sex hormones oestrogen and progesterone. 10-20% of women with infertility problems have amenorrhoea.

Primary amenorrhoea is when menses have not occurred by the time of the expected menarche.Secondary amenorrhoea is when menstruation has previously occurred but it has stopped for at least 6 consecutive months. Long term complications of untreated athletic amenorrhoea include susceptibility to broken bones and premature ageing. Your body is designed to have menstrual cycles when you are not pregnant, and if you are not having periods there is something out of balance or unnatural happening in your body. The interplay of female sex hormones can be disrupted by a wide range of events, including diseases of the reproductive organs, weight loss, emotional stress or overexercising. It is normal not to have periods whilst you are breastfeeding. The follicle then develops into a structure called the corpus luteum which produces oestrogen and progesterone. Treatment options include reducing the amount of exercise performed or hormone replacement therapy.

Causes of Amenorrhoea

The common Causes of Amenorrhoea

• Delay in hypothalamic-pituitary maturation.
• Olfacto-genital dysplasia, Kallmann syndrome.
• Pregnancy.
• Anovulation.
• Menopause.
• Breastfeeding.
• Diseases in the midbrain.

Symptoms of Amenorrhoea

• No menstrual period for at least three months.
• Irregular and heavy menstrual periods that only occur four times or less per year.
• Eating disorders.

Treatment of Amenorrhoea

• Relief of stress by the use of anxiolytics (anti-anxiety drugs).
• Allowing a small increase in body fat levels, such as two or three kilograms.
• Use of hormones like thyroid hormones, oestrogen, progesterone as appropriate, stimulating ovulation from the ovary, medicines to control tuberculosis infections are all various modalities of treatment.
• Surgical treatments like laparoscopy are rarely needed for the treatment of amenorrhoea.
• Dietary adjustments, such as increased calcium and additional daily kilojoules.
• 'Athletic' amenorrhoea has no effect on long term fertility once menstruation recommences. The best way to treat 'athletic' amenorrhoea would be to decrease the amount of, and the intensity of exercise.
• Reducing the amount and intensity of exercise.
• Counselling may be helpful if eating disorders are suspected.

There are two types of abnormal amenorrhoea:

Primary Amenorrhoea

Primary Amenorrhoea is failure to start menstruating during puberty. Most Australian girls have begun to menstruate by the age of 14, but a later first period is, more likely in girls who are very underweight. Possible causes of primary amenorrhoea include ANOREXIA NERVOSA, faulty development of the ovaries, uterus, vagina or hymen, and certain genetic and hormonal disorders. If other developments of puberty seem normal (growth spurt; breast, pubic and under arm hair develop-ment; hip-widening). there is generally no need to worry until the girl is about r6. If her general health is not good or there is any reason to suspect that puberty is nOt progressing normally. seek medical advice earlier.

Secondary Amenorrhoea

Secondary Amenorrhoea is failure to menstruate for more than 8 weeks (for reasons other than pregnancy or breastfeeding) between the menarche (first menstruation) and the menopause. Common causes include the following.

Change of environment - The part of the brain con-trolling the reproductive cycle may be disturbed by sudden changes in lifestyle. such as moving house. travelling. or going on night-shift. Periods usually resume when your body adjusts to the new lifestyle.

Excessive weight loss - A certain amount of stored fat is necessary to support a pregnancy. If you lose too much weight (especially if you lose it quickly) your body recognises that you are in no fit condi-tion for pregnancy. and ovulation and menstruation stop. Crash diets can play havoc with the menstrual cycle. This type of amenorrhoea is also seen in women undertaking intensive athletic training. who replace much of their body fat with muscle.

Emotional disturbances - Grief depression and pro-longed anxiety can disrupt the menstrual cycle.

Hormonal disorders Many illnesses can disturb the hormonal control of the menstrual cycle. resulting in amenorrhoea. Any woman who misses more than two periods should see her doctor to exclude pregnancy and to diagnose. and if necessary treat. other causes.