Amenorrhea, when women don't menstruate: Symptoms, causes, and treatment

First, have you ever heard what is meant by amenorrhea? It should be noted that amenorrhea is a condition when women do not experience menstruation or menstruation, even though they have gone through puberty, are not pregnant, and have not yet gone through menopause.

A woman experiences amenorrhea if she does not menstruate for three consecutive cycles or more, or until the age of 15 years she has not menstruated. Apart from this, amenorrhea is a different condition from irregular menstruation, Bun. 

What is Amenorrhea?

Amenorrhea is a medical term used to describe the absence of menstruation, which is the monthly menstrual bleeding that typically occurs in females of reproductive age. It is not considered a disease in itself but rather a symptom or a sign of an underlying medical condition or situation.

Types of Amenorrhea

There are two types of amenorrhea that you need to know, namely primary and secondary amenorrhea. The following is the explanation.

1. Primary Amenorrhea 

Primary amenorrhea is when a young woman has not experienced her first menstruation after the age of 15. Even so, he has gone through another phase of puberty. 

2. Secondary amenorrhea

Meanwhile, secondary amenorrhea is a condition when a woman who has a normal menstrual cycle stops having a monthly period for 3 months or more. In fact, she hasn’t reached menopause yet. 

What are the factors that cause amenorrhea?

According to the Mayo Clinic website, amenorrhea can occur due to various factors. Amenorrhea can be a normal condition in some women, but it can also be a side effect of medication or a sign of a medical issue.

At this time, here are various factors that can cause amenorrhea:

1. Natural Amenorrhea

Usually, women may experience amenorrhea for natural reasons, such as:

• Pregnancy
• Breastfeeding
• Menopause

2. Contraception

Women who use birth control pills may not experience menstruation. The same goes for injectable and implant contraceptives, which can also cause amenorrhea.

3. Medications

In fact, certain types of medications can cause menstruation to stop. These include some types of:

• Antipsychotics
• Cancer chemotherapy
• Antidepressants
• Blood pressure medications
• Allergy medications

4. Certain lifestyle factors

Lifestyle also contributes to amenorrhea, for example:

• Low body weight. This condition disrupts many hormonal functions in the body, potentially stopping ovulation. Women with anorexia and bulimia are also at risk of experiencing amenorrhea due to abnormal hormonal changes.
• Excessive activity. Women who engage in strenuous activities or exercise have a risk of disrupted menstrual cycles.
• Stress. This condition can alter the function of the hypothalamus, the area of the brain that controls the hormones regulating the menstrual cycle. Therefore, managing stress is important to prevent amenorrhea.

5. Women who have hormonal imbalances

Usually, women who have hormonal imbalances may experience amenorrhea. These hormonal imbalances include the following:

• PCOS (Polycystic Ovary Syndrome)
• Thyroid disorders
• Pituitary tumors
• Experiencing early menopause

6. Structural Issues

Problems with the reproductive organs themselves can also cause amenorrhea. Examples include:

• Uterine scar tissue. Asherman’s syndrome, a condition where scar tissue builds up in the uterine lining, sometimes occurs after dilation and curettage, cesarean section surgery, or treatment for uterine fibroids. Uterine scar tissue prevents normal uterine lining buildup and shedding.
• Reproductive organ deficiencies. Sometimes issues arise during fetal development that result in a female baby being born without major parts of her reproductive system, such as the uterus and cervix. Due to the incomplete development of the reproductive system, she cannot have a menstrual cycle.
• Vaginal structural abnormalities. Vaginal obstructions or blockages can impede menstrual bleeding. Membranes or vaginal walls may block the flow of blood from the uterus and cervix.

Symptoms of Amenorrhea

In addition to the absence of menstruation, there are other symptoms of amenorrhea that women may experience. These include:

• Hair loss
• Headaches
• Changes in vision
• Excessive facial hair growth
• Pelvic pain
• Acne
• Lack of breast development
• Deepening of the voice similar to males
• Last but not least, milky discharge from the breasts, even when not breastfeeding, due to elevated prolactin levels.

Diagnosis and Treatment of Amenorrhea

In diagnosing amenorrhea in women, doctors typically perform a series of physical examinations, medical interviews, and diagnostic tests such as thyroid function tests, ultrasound (Ultrasonography), ovarian function tests, and other tests.

In addition, the treatment of amenorrhea is then based on the underlying cause. Some treatments that may be implemented include:

1. Administering medications and hormonal therapy aimed at inducing the menstrual cycle. In addition, hormonal therapy may involve estrogen replacement therapy for amenorrhea caused by primary ovarian insufficiency and androgen reduction therapy for conditions caused by polycystic ovary syndrome (PCOS).
2. Surgery may be performed as a treatment option if amenorrhea is caused by tumors or scar tissue.
3. A healthy lifestyle is also one way to address amenorrhea. This condition can sometimes be caused by an unhealthy lifestyle. You may be advised to consume a balanced diet, engage in regular exercise, get adequate rest, and maintain a healthy body weight.

Is amenorrhea dangerous?

It should be noted, that women should be cautious if experiencing amenorrhea, or if their daughters who are over 15 years old have not yet started menstruating. This is because amenorrhea can lead to more serious complications, such as:

• Infertility: Not experiencing ovulation and menstruation can make it difficult for women to become pregnant.
• Osteoporosis: If amenorrhea is caused by low estrogen levels, it may increase the risk of osteoporosis.

When to see a doctor? 

Immediately consult a doctor if you have missed at least three menstrual periods in a row. Or if you have never experienced a menstrual period even though you are over 15 years old.

Lastly, this is information regarding amenorrhea that can be experienced by women. I hope this information is helpful.

Translated with permission from theAsianparent Indonesia

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