The reasons may be:
- certain female genital diseases,
- long-term medication of certain types,
- some changes in the state of the body of a woman or her lifestyle.
In this regard, physicians separate separately the so-called physiological amenorrhea, which is observed in women during pregnancy and the first few months after childbirth (if the woman is breastfeeding, of course), as well as its other types associated with certain pathologies. And depending on the reasons that prompted it, amenorrhea is often accompanied by some additional signs: increased hair growth, increased body weight, dryness and other unpleasant sensations in the vagina, hot flashes, headaches, irritability, etc.
To diagnose amenorrhea today, methods such as ultrasound scanning of the pelvic organs, the study of the level of hormones in the blood, as well as many other methods, including even X-rays of the skull, are used today. And of course, doctors take into account related events, which we discussed above. As for the treatment of this disease, it is determined by the reasons that prompted the occurrence of amenorrhea, and can vary from hormone therapy to surgery.
And in order to understand the features and nature of such a female disease as amenorrhea, let's first of all talk about the menstrual cycle as a whole.
What is the menstrual cycle?
When a healthy woman reaches puberty, special hormones begin to be produced in her body, on which the cyclical nature of all processes occurring in the female genital organs depends. These hormones are estrogen and progesterone, and it depends on their amount how well a woman develops. So, normally, in the first half of the menstrual cycle, estrogens should predominate in the body, since it is under the influence of these hormones that the follicles that contain eggs develop in the ovaries of a woman.
Also, these hormones affect the inner layer of the uterus of the woman, causing it to thicken (this is necessary for the normal adoption of a fertilized egg), and mammary glands.
However, the second half of the menstrual cycle is characterized, as a rule, by a change in the hormonal background of the woman. Here comes to the fore progesterone, the level of which in the body increases significantly. This is a pregnancy hormone, and if a woman's egg has not been fertilized this time, the inner layer of her uterus, under the influence of a hormone, is rejected. The menstruation begins directly, and after it ends, the cycle repeats again.
However, the menstrual cycle can be disturbed both under the influence of external factors (stress, change of environment, climate, physical exertion, etc.), and under the influence of internal factors (various changes in the woman's body).
Types of amenorrhea, which are allocated doctors today
First of all, amenorrhea can be divided into primary and secondary. Moreover, the primary can occur only in young girls who have puberty has already come, and menstruation has not yet been. Well, for women who have had menstruation, only secondary amenorrhea is characteristic.
In addition, amenorrhea is traditionally divided into ovulatory and anovulatory, depending on whether ovulation occurs.
The main causes of amenorrhea in women
The main causes of this condition, such as amenorrhea, doctors include:
3. Early menopause. It is manifested in women younger than 45 years old and is characterized, in addition to amenorrhea, hot flashes, mood swings, vaginal discomfort and other similar symptoms.
4. Frustration of the regulation of the menstrual cycle, associated with changes in hormonal levels, which may be the result of stress, excessive exercise, unhealthy diet, etc.
5. Polycystic ovaries (doctors call it “polycystic ovary syndrome”). This is quite a serious disease in which the ovaries of a woman increase in size and begin to actively produce androgens - the male sex hormones. Side effects of this disease are increased hair growth on the body, amenorrhea, and often infertility.
6. Bubble skid. This is not a very common and rather dangerous disease, and not everyone knows what it is. In fact, the cystic skid is a tumor that develops from a fertilized egg and is bearing signs of pregnancy. The disease is extremely serious and requires immediate treatment.
7. Use of a woman of certain hormonal drugs or antidepressants.
8. Diseases of the brain and disruption of the central regulators of the menstrual cycle. Such diseases may include various diseases of the pituitary gland, strokes, injuries, brain tumors. They are accompanied by many side effects, including amenorrhea.
9. If we are talking about primary amenorrhea, then the causes of its occurrence may be such congenital anomalies of the female genital organs, such as underdevelopment of the ovaries or uterus.
10. Diseases of the thyroid gland (both an increase and a decrease in its function), adrenal tumors, obesity and other similar diseases.
Thus, the causes of amenorrhea, there are many, and only correctly setting them in each case, physicians can provide women with qualified and effective assistance.
Typical symptoms of amenorrhea
The main symptom of this disease is, as mentioned above, the prolonged absence of menstruation, which is significantly longer than the usual delay of the cycle. However, it is characterized by amenorrhea and other noticeable symptoms, which, by the way, can determine the cause of this disease. And if amenorrhea is combined with obesity, increased hair growth on the body or the appearance of acne, it is most likely associated with polycystic ovary. If the symptoms associated with amenorrhea are: vaginal dryness, hot flushes, mood swings, etc., it is most likely a premature menopause. Amenorrhea can also be accompanied by swelling of the mammary glands and the release of milk from them, headaches, and in this case, it is most likely caused by a pituitary tumor.
Remember that prolonged amenorrhea negatively affects the woman's body, it leads to the leaching of calcium from the bones and to the exacerbation of cardiovascular diseases. And, moreover, much more dangerous diseases can stand behind amenorrhea, and therefore it must be diagnosed and treated in a timely manner.
Diagnosis of amenorrhea and tests that are given to women who suffer from it.
Diagnose primary amenorrhea in young girls in the event that menstruation has not come to 15 years.
Secondary amenorrhea is diagnosed in women whose menstruation is absent for more than 6 months, provided that the woman is not pregnant and does not breastfeed.
Here is a list of the main tests and studies that a doctor can prescribe to a woman suffering from amenorrhea:
1. Tests for hormones. These tests will be able to establish such causes of amenorrhea as various endocrine diseases, polycystic ovaries, adrenal tumors, pituitary tumors, and abnormal functioning of the thyroid gland.
2. Radiography of the skull. This study helps to establish the presence (or absence) of a pituitary tumor.
3. Ultrasound scan of the pelvic organs. It allows you to identify congenital malformations of these organs or acquired diseases.
Treatment methods for amenorrhea that doctors use today
All methods of treatment of amenorrhea imply, first of all, the elimination of the causes of its occurrence. And because they may vary somewhat. So, provided that the cause of amenorrhea is a tumor or congenital anomalies of the genital organs, it is used to treat, most often, surgery. And if it is associated with fluctuations in the level of certain hormones, the patient is prescribed hormone therapy.
But in any case, if the absence of menstruation has been observed for more than 6 months, and your gynecologist still does not know anything about it, you should immediately contact him for advice.
What is amenorrhea
This syndrome is characterized by the absence of menstruation for at least six months. The reasons for its development are different. When using the term "amenorrhea", doctors indicate that this is not a diagnosis, but only a symptom of a disease. Such clinical manifestations are observed when a violation occurs in a woman's body.
It is worth noting that amenorrhea and hypomenstrual syndrome are two different concepts. In the first case, there is a complete absence of menstruation, and in the second - their meager amount. Often, hypomenstrual syndrome precedes more serious reproductive disorders.
Types of amenorrhea
The classification is based on two types of amenorrhea: true and false. In the first form, all changes are preserved in the uterus and ovaries, but there are anatomical obstacles due to which menstrual flow is absent. Blood begins to accumulate in the uterus, fallopian tubes or vagina. This problem can often be solved only by surgery.
In the true form, the absence of menstruation is due to cyclical processes in the body. At the same time there is no ovulation and, accordingly, fertilization becomes impossible. Depending on the reasons that led to the emergence of this syndrome, distinguish between pathological and physiological varieties.
Physiological amenorrhea is a normal condition in which there are no menstrual flow. There is no reason for experiencing when periods do not appear in girls under the age of sixteen. Reduction of ovarian function during menopause is also considered normal. The disappearance of menstruation during this period is a physiological process.
There is a relationship between conditions such as amenorrhea and pregnancy. The normal function of the ovaries and uterus in women is preserved, but blood discharge from the genital tract is not observed. A few months after birth, they will resume.
Physiological amenorrhea is also characteristic manifested by a delay during lactation. Premature birth or spontaneous miscarriage can lead to opsymenorrhea (prolonged menstrual cycle of more than 35 days) and complete absence of discharge.
The syndrome is a disorder of menstrual function caused by various disorders in the body:
- inflammation of the reproductive organs,
- ovarian dysfunction,
- hormonal imbalance
- recent gynecological manipulations.
Primary amenorrhea is observed in girls at a fairly young age. The condition is caused by inhibition of the process of puberty, in which there is no menstruation at the age of 14. There is such a symptom in adolescents at 16, when there is no discharge, but there are secondary sexual characteristics. This disorder is characteristic of Turner syndrome.
In this period, false amenorrhea due to congenital abnormalities of the reproductive system is not excluded.in which changes in the ovaries and uterus are preserved. Blood can accumulate in the uterus, vagina and fallopian tubes, not having access due to the incorrect structure of these organs.
Secondary amenorrhea is manifested in women of reproductive age. Menstrual flow with this stop and are absent for at least six months. The most common is hypothalamic amenorrhea, caused by a slowing down or complete cessation of the production of gonadotropin-releasing hormone by the hypothalamus. Doctors say that it can appear on the background of intoxication, starvation, susceptibility to stress and a number of pathologies.
With elevated concentrations of the pituitary hormone, which stimulates the function of the ovaries, hypergonadotropic amenorrhea is observed. In case of insufficient amount of these hormones in the blood, a slightly different form of the syndrome is manifested - hypogonadotropic amenorrhea.
Risk factors leading to amenorrhea
There are a number of factors that affect the reproductive system and can increase the risk of developing amenorrhea. Gynecologists note that reproductive disorders are more common in such cases:
- the presence of this syndrome in relatives,
- anorexia or bulimia,
- increased, exhausting physical activity,
- improper, inadequate diet.
Causes of Amenorrhea
Doctors say that the causes of amenorrhea can be very diverse. Among the main ones, the following are distinguished:
- Polycystic ovary. Organs become larger, hair growth and androgen production increases, infertility sets in and menstruation stops.
- Early menopause. It is noted in women aged less than 45 years. There are clinical manifestations such as suppression of libido, hot flashes, dryness in the vaginal area and sudden mood swings.
- Lactation. During lactation, menstrual flow may be absent up to three years. This condition is considered natural and does not cause concern.
- Pregnancy. Considering the causes of amenorrhea, this is called the most common among women who are sexually active.
- Hormonal disbalance. Factors causing this disorder can be stress, unhealthy diet, diseases occurring in a chronic form, and increased physical exertion. At the same time, the work of the hypothalamus and pituitary - the main regulators of the cycle - is disturbed and hypothalamic amenorrhea appears.
- Pathology of the brain and cycle regulators.
- Acceptance of drugs. In gynecology, it is noted that the use of hormonal, anticancer drugs and antidepressants can lead to dysfunction of the reproductive system.
- False pregnancy. This pathology requires immediate treatment.
- Congenital malformations of genital organs. Due to the fact that the regulation of the cycle is violated, primary amenorrhea appears.
- Diseases affecting the endocrine system. Depending on the type of pathology, the syndrome is accompanied by another symptom: intolerance to cold or heat, severe weakness, change in body weight, trembling in the hands.
Symptoms besides lack of menstruation
Among the main symptoms are the absence of menstrual discharge for six months and infertility. Concomitant symptoms of this syndrome can be:
- obesity. Indicates a hormonal imbalance,
- no signs of puberty,
- symptoms of increased testosterone. Hair growth on the body becomes enhanced, the shape and voice change, excessive sweating is observed,
- galactorrhea. Non-pregnant women have milk in their breasts,
- symptoms of menopause. In connection with a decrease in ovarian function, pain in the region of the heart, feeling of heat and sweating are noted,
- sleep disorders.
Why you should not self-medicate
Lack of menstruation for a long time should be a reason to visit the gynecologist. In a mature woman, this symptom may appear when a pregnancy occurs. You can refute this fact or confirm using the test. When you receive a negative result, it should be understood that it is impossible to independently understand the reasons for such changes in the body. Only a doctor is able to identify the factors that provoke the manifestation of this syndrome.
Consultation with a gynecologist is also needed in case of primary symptoms, which can be dangerous for a teenage girl. Often, changes in the ovaries and uterus are preserved, and the menstrual flow accumulates in the vagina, as well as the uterus and fallopian tubes. It is possible to rectify the situation only by surgical intervention.
The doctor must be diagnosed. At the same time, the medical history is carefully studied, an examination is carried out and laboratory tests are appointed. Additionally, the gynecologist may refer the woman to other narrow specialists in order to identify the cause of the prolonged absence of menstrual flow.
Treatment of amenorrhea is prescribed only after identifying the underlying cause. Medications and hormones can be used in the course of therapy. In the case of the presence of tumors or disorders of the structure of the reproductive system, when blood accumulates in the uterus, surgical intervention is performed. It is imperative that nutrition with amenorrhea be regular and balanced.
Self-medication is strictly prohibited. The process of therapy should be strictly controlled by a doctor. In the case of the appointment of hormonal drugs can not interrupt the course and independently change the dosage. Such actions can lead to the development of complications and aggravate the state of the reproductive system. Only if all medical recommendations are followed, women will have a chance to become pregnant.
Consequences of amenorrhea
Если нет месячных на протяжении длительного времени, у женщин отмечается нарушение репродуктивной функции. For this reason, pregnancy with amenorrhea does not occur. Infertility is considered the main complication. In the absence of proper treatment, other, no less dangerous consequences are possible:
- uterine cancer,
- hyperplasia of uterine endometrium.
Depending on what exactly caused the appearance of this syndrome, there may be other complications, including vascular dystonia, diabetes, extragenital pathologies developing on the background of changes in hormone levels, atherosclerosis, hirsutism and obesity.
Every woman should know what leads to a long absence of menstruation. Despite the fact that this violation is not a disease, you can not leave it unattended. It is proved that such changes in the body often indicate serious problems. Only with timely and properly selected therapy will it be possible to avoid undesirable complications and restore reproductive function. The fair sex still has a chance to learn all the joys of motherhood.
Causes and types of amenorrhea
For reasons of occurrence, there are several types of amenorrhea: false and true. False, as the name implies, does not imply violations of the hormonal cyclicity. Monthly at the same time come according to the schedule, but there is no discharge. The reason is any obstacle in their way along the sexual channel. Most often, this type of amenorrhea occurs when the congenital abnormal development of the vagina and hymen - atresia (adhesions), which is quite simply eliminated surgically. In the absence of disturbances in the hormonal sphere, ovaries and other genitals, the absence of cyclic menstrual bleeding is called true amenorrhea.
Depending on the developmental mechanisms, physiological and pathological amenorrhea is isolated. The processes leading to true physiological amenorrhea are considered completely natural.
It is possible to talk about primary amenorrhea if a girl at the corresponding age does not have menarche. There are many reasons for this condition, but it is still quite rare. Most often there is a genetically determined failure of the ovaries and menstruation occurs at a rather late age - after 17 years. Otherwise, if the monthly has not come, you should look for organic pathology at any level of the sexual sphere.
Clinically, primary amenorrhea can manifest itself as a complete lack of puberty, its underdevelopment, against the background of virilization (enhanced development of male traits) or the normal female phenotype, which suggests the level of localization of the pathology.
The complete absence of puberty is associated with a deep underdevelopment of the gonads due to chromosomal abnormalities.
Delayed sexual development is most often caused by an organic lesion of the brain structures (tumors, injuries, meningitis, encephalitis, intoxication). At the forefront of such women is increased psycho-emotional excitability, about which they are often registered with psychiatrists. Functional disorders of the hypothalamic-pituitary regulation are caused by impaired production of sex hormones by the hypothalamus or pituitary (hypothalamic or pituitary hypogonadism). Manifested by delayed puberty against the background of poorly expressed secondary sexual characteristics (poor body hair, underdeveloped mammary glands), reduced size of the body of the uterus and ovaries, reduced levels of estrogen in the blood and the almost complete absence of luteinizing and follicle-stimulating hormones.
The absence of menarche against the background of pronounced virilization (increased hair growth, male-shaped body development, voice coarsening) is most often associated with impaired functional activity of the adrenal cortex, hormone-producing tumors of the ovaries and adrenal glands formed in the prepubertal period.
Congenital malformations of the female genital organs lead to primary amenorrhea, in which the phenotype is typically female, since the hormonal activity is not disturbed. These include aplasia of the uterus and vagina (complete or partial absence of these organs), as well as gynatresia (adhesions along the sexual canal). Atresia of the vagina can develop as a result of past infectious children's diseases (measles, diphtheria) or traumatic injuries in the perineal area.
Diagnosis and treatment of amenorrhea
Diagnosis of amenorrhea is based on clinical data, patient complaints about the absence of menstruation for six months or more, and the results of a comprehensive laboratory and instrumental examination.
A number of tests that determine the hormonal activity of the hypothalamus, pituitary, functional state of the ovaries and uterus are carried out; examination by a gynecologist is obligatory. In some cases, MRI or radiography of the head with the area of the Turkish saddle where the pituitary gland is located is prescribed.
After determining the cause of the violation in the female genital area, appropriate treatment is prescribed. The mechanisms of development of the disease, the level of damage to the reproductive system and its hormonal regulation, the environment of the woman, and the presence or absence of children should be taken into account. Normalization of diet, proper rest, walks in the fresh air, moderate exercise, restorative procedures, iodized food supplements, vitamin therapy and immunomodulators are necessary. For hypothalamic-pituitary system and ovarian hypofunction, appropriate hormonal preparations are prescribed to stimulate the ovulatory function of the ovaries. Hyperprolactinemia, due to the long-term use of oral contraceptives, is successfully cured by taking bromocriptine, the dose and duration of treatment depend on the level of prolactin in the blood. Primary amenorrhea is treated with estrogens, which are used cyclically to normalize the development of the genital organs.