What is Amenorrhea?

If you experience a non-existent or irregular period, you’re not alone.  Amenorrhea -- classified as the loss of a period for more than three months or not having received a period by the age of fifteen-- affects an estimated 3-4 percent of the population. While the practical convenience of not having monthly visits from your Auntie Flo could draw temptation to turn a blind eye, the reality of amenorrhea is that there may be underlying issues in need of addressing. 

In this article, we’ll cover everything you need to know about amenorrhea, including the different types, symptoms, and causes. If you’re looking for even more great women’s wellness tips, check out our blog. For now, let’s dive in!

Amenorrhea: What You Need To Know 

Simply put, amenorrhea is when your time-of-the-month is absent during the reproductive years, between puberty and menopause. Despite what many people may think, it’s not a disease, and it doesn’t mean that a person is infertile, but it can, however, be a sign of a health problem that needs a little TLC. 

Around puberty, menstruation starts, and then it normally occurs about once a month until around the age of fifty -- at this time, periods stop altogether as menopause begins. During pregnancy, your period also stops, and it’s common for it to stop during breastfeeding, as well. 

If menstruation doesn’t occur at times when people normally expect it to -- this is amenorrhea. But don’t worry, with a little bit of guidance, a dash of patience, and the right treatment, you can get your body back on track to functioning at its very best --, and we’re here to help! But first, it’s important to understand what type of amenorrhea you have to plan the best course of action. 

Types of Amenorrhea 

Did you know that there are actually two types of amenorrhea? 

Primary amenorrhea is when your periods don’t start during puberty. And we know what you’re thinking -- no periods throughout grade school?! Sign me up! -- but the truth is that not having your period during puberty may be a sign of a more serious issue and should be checked out by a doc. 

In the U.S., primary amenorrhea is pretty rare, affecting fewer than 0.1 percent of Americans. 

Secondary amenorrhea, on the other hand, is when menstruation starts but ceases to occur. This is normal, of course, during pregnancy or while breastfeeding your tiny tot, but it may also mean that there’s a problem if it happens at other times. 

In the U.S., this type of amenorrhea is thought to affect around 4 percent of individuals during their lifetime. Now, to be clear, missing one period is usually not a sign of a health problem, although many ladies will ask for a pregnancy test when this happens. A doctor will consider secondary amenorrhea is an individual:

• Used to have irregular periods and then doesn’t have any for six months
• Used to have regular periods and then doesn’t have any for three months

Okay, So What Causes Amenorrhea? 

The causes of amenorrhea differ a bit between the two types -- we’ll explain:

Primary amenorrhea

One of the common causes of primary amenorrhea is a family history of delayed menstruation. However, sometimes there is a genetic problem. 

Genetic conditions that can prevent the ovaries from working at their best include:

• Mullerian defects
• Androgen insensitivity syndrome -- which leads to high levels of testosterone
• Turner syndrome

A Mullerian defect is a malformation of the reproductive organs. Simply put, the fallopian tubes and uterus don’t form as they should.

There may be a structural issue relating to the genitals that is present from birth. Occasionally, the fallopian tubes and uterus may be missing. Sometimes, there are issues of fusion -- in which the tubes don’t come together correctly. 

In Mullerian agenesis or Mayer-Rokitansky-Kuster Hauser (MRKH) syndrome, the breasts, ovaries, and clitoris form correctly, but there is no vaginal opening, and the uterus and cervix may not form properly. In this case, reproductive development won't follow the normal pattern, and getting a period just might not be possible. 

Secondary amenorrhea

Monthly visits from Auntie Flo may stop for a number of reasons. 

Low body max index (BMI): When BMI falls below 19, the risk of developing secondary amenorrhea increases significantly. 

Stress, exercise, and weight loss: Serious weight loss can result from an eating disorder or a physical illness which is a common cause of secondary amenorrhea. Stringent exercise can also cause this type of amenorrhea, along with severe emotional upheaval or extreme stress. 

Medications: Some meds -- such as progesterone-only contraceptives and a number of psych drugs -- may cause your period to come to a screeching halt. Other popular medications that affect menstruation include:

• Cancer chemotherapy
• Antidepressants
• Antipsychotics
• Allergy meds
• Blood pressure drugs

Long-term health conditions: Secondary amenorrhea can also result from a long-term illness, such as:

• Premature ovarian failure
• Thalamic pituitary problems
• Polycystic ovary syndrome (PCOS)

An underactive thyroid or pituitary problems can lead to hormone imbalance which can be the culprit behind a non-existing period as well. This could be due to:

• An under-or overactive thyroid gland
• A cancerous or benign tumor in the pituitary gland

What Are Some of the Common Symptoms? 

The main telltale symptom of amenorrhea is a lack of menstruation. However, depending on the cause, you just might experience a few other symptoms, such as:

• Hair loss
• Additional facial hair
• Headache
• Milky nipple discharge
• Vision changes
• Lack of breast development (primary amenorrhea)

How Is Amenorrhea Diagnosed? 

Often the first step in reaching an amenorrhea diagnosis includes simple blood tests that can rule out pregnancy as well as menopause. Once these are ruled out, your doc will order additional tests to determine why you’re not ovulating. 

One of these tests is a progesterone withdrawal test. The patient is given an orally-active dose of the ovarian hormone progesterone. If the patient gets her period, that’s evidence her uterus is working -- but she’s not ovulating. 

Next, tests are also done to see whether the pituitary gland is producing two essential hormones called luteinizing hormone (LH) and follicle stimulating hormone (FSH). If levels of FSH are higher than normal, then something is likely wrong with the ovaries. If they are low, on the other hand, then the ovaries aren’t getting the stimulation they need for ovulation to occur. 

From there, imaging studies of the pituitary gland are then needed to clarify why the egg developing hormone (FSH) is not available and to identify the cause for this deficiency. 

What Can You Do About Amenorrhea? 

By now, you know what amenorrhea is and what causes it -- but what can you do about it?  

Treatment will depend on the cause. 

Primary Amenorrhea

If you’re struggling with primary amenorrhea, treatment may start with watchful waiting, depending on your age and the result of the ovary function test. If there's a family history of late menstruation, however, there’s a good chance you just might be a late-bloomer, and your period will start in time.

If there are physical or genetic problems that involve your reproductive organs, surgery may be necessary, but this is no guarantee that normal menstruation will occur.

Secondary Amenorrhea

This will depend on the underlying cause:

Lifestyle factors: If you’ve been pumping iron excessively at the gym, a change of exercise plan or diet may help to stabilize your monthly cycle.  

Stress: We all experience stress from time to time. If your period has been irregular or non-existent, think about what’s been going on in your life. Chances are your cycles' been thrown off due to an abundance of emotional or mental stress. But never fear! Love Wellness is here to help with the Less Stress Kit -- a powerful kit of targeted supplements paired together to keep you calm and resting peacefully at night while supporting digestion for overall bliss.  

Underactive thyroid: If your period stops because of an underactive thyroid, your doctor may prescribe treatment with thyroxine (thyroid hormone). 

Polycystic ovary syndrome (PCOS): If you’re battling PCOS, your doc will suggest appropriate treatment to regulate your period. 

Uterine scarring: Removal of old scar tissue resulting from a cesarean section, endometriosis, or other condition may be helpful in treating amenorrhea.  

Bottom Line 

There are so many things that can affect our cycles, from stress and weight gain to depression and even some prescription meds. The good news is that with a little bit of patience, the right treatment, and a good attitude, you just might be able to regulate your period and keep amenorrhea at bay. 

Take care of your reproductive health with Good Girl Probiotics from Love Wellness. This powerful supplement is made with eight strains of good bacteria, whereas most probiotics only contain one.

At Love Wellness, they take a sensible approach to self-care that’s body-positive, based in science, and made with YOU in mind. Whether you’re looking for the best probiotics on the planet or stress-fighting supplements to calm your worried mind -- Love Wellness has your back. Always. 

Sources:

Page:Assessment of primary amenorrhoea - Differential diagnosis of symptoms (bestpractice.bmj.com)

Chromosomal abnormalities and hormonal disorders of primary amenorrhea patients in Egypt (ncbi.nim.nih.gov)

Polycystic Ovarian Syndrome (mayoclinic.org)