Monthly Menstrual Cycle
|Missed Periods - What Is Amenorrhea?
Many women of reproductive age will miss a period at some stage in their life. Usually this is nothing to worry about. Menstrual cycle changes can be caused by normal life situations such as stress, a change in contraceptive pill, breastfeeding or an unhealthy diet. Of course one of the most common reasons for a missed period is pregnancy. However, if you are not pregnant and periods do not return within 6 months, you may have amenorrhea. Amenorrhea is the absence of menstrual periods in pre-menopausal women.
There are three types of amenorrhea. Primary amenorrhea is where a girl fails to start menarche (her first period) by the age of 16 but her breasts have already started to develop. This condition affects about 1 in every 1,000 teenagers (see, when should my periods start?). Secondary amenorrhea is defined as an absence of periods for 6 months or longer in women who previously had regular periods but who are not pregnant or breastfeeding. Physiologic amenorrhea is the absence of periods during pregnancy and breastfeeding which is perfectly normal.
Although it may be tempting to say that life is more convenient without periods, primary and secondary amenorrhea should be investigated. The female body is naturally designed to have monthly bleeds, and the absence of periods suggests some sort of hormone imbalance or underlying gynecological disorder which may need treating. Additionally, not having a menstruation increases the risk of osteoporosis in women. Amenorrhea can also affect a woman's fertility, although this does not mean a woman with amenorrhea cannot become pregnant - some form of birth control method still needs to be used if pregnancy is not desired.
Pregnancy: A missed period is one of the first early signs of pregnancy. Maybe obvious, but this can quickly be ruled in or out with a pregnancy test. If you are not pregnant, the following are other potential causes:
Breastfeeding: Mothers who breastfeed often experience missed periods, but as ovulation can still occur without a menstrual bleed, pregnancy precautions should still be taken.
If you have missed 3 periods in a row, you should consult your doctor for a professional diagnosis (particularly if you also experience hair loss, blurred vision and breast secretions).
Primary amenorrhea does not usually require diagnosis or treatment until the age of 18 if there are other signs of normal puberty such as underarm hair and breast enlargement. If you are concerned however, a doctor can carry out a quick pelvic exam to determine if there are any blockages or any other causes. After the age of 18, if periods still do not occur, more extensive testing will be carried out. Before diagnosing secondary amenorrhea, pregnancy and menopause (see menopause testing) will need to be ruled out. If this happens, a complete history of your menstrual cycle will be taken. A pelvic exam should happen and certain hormone tests. Alternatively a blood test may be carried out to check if ovulation is occurring. In certain cases, tests for thyroid, PCOS and other suspected conditions may be completed.
If an underlying condition has been diagnosed, treatment for amenorrhea will involve treatment for the condition. Once this has been resolved, your periods should return. However, where there is no apparent reason for missing periods, the following options are available:
The 'Pill': Doctors often prescribe the contraceptive pill with estrogen to teenagers who have not started their periods (menarche) by the age of 15. It may also be recommended to women in their 20s and 30s who wish to have their menstrual cycle regularized.
Healthy Diet: A healthy Low GI plan may be recommended to help the body develop a natural rhythm. Women who are above the healthy BMI range for their height usually find premenstrual symptoms (PMS) also reduce with weight, as well as symptoms to do with heavy periods or premenstrual dysphoric disorder.
Vitamins and Minerals: Calcium, magnesium, zinc and B-vitamins are recommended for any women with menstrual problems. A B-vitamin complex (100 mg per vitamin) can help ovary/egg production. Zinc (15mg per day) is important for hormone production and it may be lacking if you have been on the pill for a few years. Magnesium (300 mg per day) is nature's 'tranquillizer' and is good for keeping the body balanced during stressful times. See also PMS treatment for more ideas.
|Related Articles on Missed Periods
For more about menstrual cycles, see the following:
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