A missed period can be a joyful sign of pregnancy if you’re trying for a baby. Your period may also be missing in action if you are breastfeeding or even going through menopause. But in other instances, the absence of menstrual periods or amenorrhea may point to underlying health issues. And that’s when you need to probe further.
But before taking a look at the symptoms associated with amenorrhea, let’s first understand how your body regulates the menstrual cycle. The hypothalamus, a part of your brain, stimulates your pituitary gland to release hormones known as luteinizing hormone and follicle-stimulating hormone. These trigger the production of the female hormones progesterone and estrogen, which in turn regulate the cyclic changes that happen in your uterus, including menstruation.
Any problems in the functioning of your pituitary gland, hypothalamus, or reproductive organs such as the ovaries or uterus, as well as factors like stress, can disrupt regular menstruation and lead to amenorrhea. As can abnormalities in the anatomy of your vagina or cervix. Certain medication and procedures like D&C or even chemo or radiotherapy can lead to missed periods. You may also not get your period for as long as 3 months to a year after you stop taking birth control pills.
The Absence Of Menstrual Periods: The Primary Sign Of Amenorrhea
Amenorrhea means missed or absent periods and is a symptom of other conditions rather than a disorder in itself. Depending on what’s causing it, other signs may be associated with it.
This sign is also essentially the definition of amenorrhea. If a girl hasn’t had her first menstrual period by the age of 16, it is termed primary amenorrhea. Secondary amenorrhea, on the other hand, indicates a missing period for 3 or more months in someone who’s been menstruating regularly.1 2 3
Low Body Mass Index
An increase in body fat usually accompanies puberty and prompts the start of menstruation. Being underweight or having a low body mass index is often a sign seen in young girls who have primary amenorrhea. Meanwhile, secondary amenorrhea occurs often in women who participate in activities like gymnastics or ballet which are linked to low body weight. If you engage in intense exercise, have a restricted diet or poor nutrition habits, it can affect your menstrual periods.
Having a low percentage of fat in the body, low body weight, taking in insufficient calories, intense exercise, and emotional stress are all commonly seen in women with a kind of amenorrhea known as hypothalamic amenorrhea. This condition develops when your hypothalamus stops or slows down the production of gonadotropin-releasing hormone. This hormone, in turn, is involved in releasing luteinizing hormone and follicle-stimulating hormone.4
Weight Gain When Associated With PCOS
Amenorrhea can be caused by polycystic ovary syndrome (PCOS), a medical condition characterized by hormonal imbalance and problems with how your ovaries function. If this applies to you, you may experience weight gain alongside amenorrhea.5
Milky Discharge From Your Breasts
An abnormal milky discharge seen along with amenorrhea can be indicative of a tumor on your pituitary gland. Your pituitary gland controls the production of many hormones. And though pituitary gland tumors are usually not cancerous, they may disrupt the way your hormones regulate menstruation. Sometimes, a tumor can make excessive amounts of a hormone produced by the pituitary gland. If high levels of the hormone prolactin are produced, it can result in an abnormal milky discharge from your breasts.6
Severe Headaches Or Changes In Your Vision
Headaches or vision problems like double vision, blurred vision, loss of peripheral vision, and blindness are sometimes associated with amenorrhea. These can all be signs of a growing pituitary tumor pressing on nearby brain parts and nerves.7
Male Pattern Baldness Or Increased Facial Hair
Women who have PCOS have excess levels of male hormones or androgens. Since these hormones regulate the development of male characteristics like facial hair and male pattern balding, you may develop these symptoms alongside amenorrhea if you have PCOS. Ovarian or adrenal tumors, as well as Cushing syndrome, where your body has excess levels of the hormone cortisol, may also cause these symptoms.8
Acne is another sign associated with PCOS. You may notice acne on the face, upper back, or chest along with amenorrhea.
Treat Amenorrhea Depending On The Underlying Problem
Treatment for amenorrhea depends on its cause. A proper diet or exercise program may be all that’s needed in some cases while a stress management course can help others. Hormone treatments may be used to correct hormonal imbalances while medicines, radiation, chemotherapy, or surgery may be needed for tumors.
|↑1||What are the symptoms of amenorrhea?. National Institutes of Health.|
|↑2||What causes amenorrhea?. National Institutes of Health.|
|↑3||Amenorrhea: An Approach to Diagnosis and Management. American Family Physician.|
|↑4||Amenorrhea. Harvard Health Publications.|
|↑5||What is PCOS?. U.S. Department of Health and Human Services.|
|↑6||Signs and Symptoms of Pituitary Tumors. American Cancer Society.|
|↑7||Secondary Amenorrhea. The New York Times.|
|↑8||Polycystic ovary syndrome. U.S. Department of Health and Human Services.|