Amenorrhea is the medical term for something many women have experienced throughout their lifetimes: the absence of the regular menstrual cycle. To be sure, women?s relationships with their monthly cycles can sometimes be complicated and nuanced. Some women may view an interruption with anxiety, while other women might feel relief.
These reactions are not mutually exclusive. Treating amenorrhea, then, depends on the context of the condition, its root causes, and the goals of the patient.
What is Amenorrhea?
Amenorrhea occurs when you miss a regular menstrual cycle. This can happen for a wide variety of reasons. In fact, it?s not at all uncommon for women to miss a month here or there throughout their lives. You should generally consider consulting with a doctor or midwife when:
- A female is 15, but has not yet experienced her first menstrual cycle.
- A woman?s menstrual cycle is interrupted for three consecutive periods (the general rule is three months, but the true number of days depends on the duration of your average cycle).
Other accompanying symptoms to note might include:
- Changes in hair growth (including hair loss or excess hair growth).
- The development of acne.
- Pain in the pelvic area.
- Headaches or changes in your vision.
- A milky discharge from the nipples.
Associated symptoms can help your doctor or midwife determine the underlying cause and risks–if any–associated with your amenorrhea.
What Causes Amenorrhea?
The single most common cause of amenorrhea is pregnancy. Women who are pregnant will stop menstruating for the duration of the pregnancy, and nursing can extend the effect. In fact, nursing women can go months, and in some cases, years without experiencing a period.
But pregnancy is not the only possible cause of amenorrhea. Other possible causes include:
- Use of contraception: Various contraceptive methods can cause a woman?s period to become light, infrequent, or erratic. Some contraceptives can cause women?s periods to dissipate altogether. Regular ovulation returns once you stop using the contraceptive, though with some methods this take a while.
- Medication: There are some medications that can interrupt or depress a woman?s menstrual cycle. This includes some types of antidepressants, blood pressure medication and so on. If you suspect your medication is causing amenorrhea, you should check with your doctor or midwife.
- Structural issues: In some cases, amenorrhea can be caused by structural problems or anomalies in the sex organs themselves. For example, obstructions in the vagina can limit visible bleeding during your period. In other cases, uterine scarring can prevent the shedding of the uterine lining, which results in amenorrhea. And lack of reproductive organs–due to genetics or therapeutic surgery–can also make menstruation erratic, problematic, or impossible.
- Hormonal imbalances: Because menstruation is heavily directed by your body?s hormonal cycles, interruptions or imbalances in these hormones have been known to cause amenorrhea. Premature menopause or a malfunctioning thyroid, for example, can both result in the interruption of your monthly menstrual cycle. There are other hormonal conditions, such as polycystic ovary syndrome (or PCOS), which can also result in amenorrhea.
- Lifestyle issues: Stress and diet can both have an enormous impact on the presentation of your menstrual cycle. High stress, for example, can interrupt your monthly period. Likewise, low body weight can also lead to amenorrhea. Typically, when the stress abates or you regain a healthy body weight, your menstrual cycles will resume with more normal frequency.
None of these causes for amenorrhea are mutually exclusive. In some cases, multiple factors may contribute to the depression and interruption of your menstrual cycle.
Are There Types of Amenorrhea?
If you have noticed the disappearance of your period, you might be feeling a little worried and disconcerted, even if you are also relieved that you don?t have to experience the physical symptoms of your period.
In most cases, your OBGYN will determine whether your amenorrhea falls into one of two different categories:
- It will resolve on its own: This is the case when amenorrhea is caused by pregnancy, nursing, or other natural factors. In these circumstances, medical intervention is usually not required, though your OBGYN may wish to monitor your amenorrhea to ensure complications do not develop.
- It requires intervention: In some cases, a disruption to your period may have an underlying cause that requires medical treatment. Your doctor will be able to determine when best to administer therapeutics and how to treat underlying causes.
The cause of your amenorrhea may be crystal clear; but for some, it?s more opaque. Some cases of amenorrhea have been known to result in increased risk for infertility and osteoporosis, especially when left untreated. So if you have had amenorrhea for more than three months, it?s important to let your doctor know so they can determine the cause and any appropriate treatment.
Are There Treatments for Amenorrhea?
Your OBGYN can run a few different tests to confirm a diagnosis of amenorrhea and attempt to confirm the root cause. Some of these tests can measure your hormone levels, while others may examine the physical condition of your pelvic region. As a first step, patients who suffer from amenorrhea are usually given a pregnancy test in order to eliminate the most common possible cause.
Once causes have been confirmed or eliminated, your OBGYN will recommend a treatment plan. This plan may consist of:
- Wait and see: It?s not uncommon for your doctor to want to continue observations before committing to a course of treatment. How long this observation period lasts will usually depend on your comfort and your health.
- Contraceptives: If you are not currently taking contraceptives, your OBGYN may recommend you start. And if you are already taking contraceptives of some kind, your doctor may suggest that you change the contraceptive type. Contraceptives can help regulate your hormones, making them a viable treatment option for many cases of amenorrhea.
- Medication: Many medication-based therapies are hormone-based. The idea behind most such treatments is to help regulate or jump start your cyclical menstrual cycle.
- Lifestyle changes: In cases where your amenorrhea is caused or exacerbated by lifestyle decisions–such as harsh dieting or excess exercise–your OBGYN may recommend that you alter your lifestyle plans. Likewise, if your amenorrhea is caused by stress, your doctor may develop a treatment plan designed to help manage or ameliorate your stress levels.
Finding the right treatment for amenorrhea depends on identifying the root cause or the multiple causes behind the interruption in your period.
Do You Have to Treat Amenorrhea?
For some women, the depression of their menstrual cycle will represent a welcome change. They may not want their period to come back. But that?s a decision that should be made with the most medical context possible. You?ll need to know that the underlying condition causing your amenorrhea won?t necessarily cause more harm over the long run.
That said, many women look at their monthly period as a symbol of their femininity. That?s why you want an OBGYN who looks at your menstrual cycle as more than a medical curiosity, but as part of who you are.
In many ways, amenorrhea is a natural part of life. But if you want to know more about treatment options, if you have concerns, or if you want to learn more about the gynecological services we offer, contact our OBGYN offices in Wilmette or Glenview to make an appointment with our team.