• Amenorrhea refers to the absence of menstrual periods. It may be either primary; a woman never developed menstrual periods. Or secondary; absence of menstrual periods in a woman who was previously menstruating.
• Genetic or inborn conditions are the most common causes of primary amenorrhea.
• Amenorrhea may result from disorders of the ovaries, Pituitary gland, hypothalamus, or uterus.
• Intensive exercising, extreme weight loss, physical illness, and stress can all result in amenorrhea.
• Amenorrhea is a symptom and not a disease in itself. Therefore amenorrhea can only be prevented to the extent of that the underlying cause.
• Infertility and possible bone loss (osteoporosis) are complications of amenorrhea.
• Treatments may include surgical correction of anatomical abnormalities, medications or hormone therapies, and treatment of any underlying conditions responsible for amenorrhea.
• The outlook for amenorrhea varies according to the cause of the amenorrhea.
Pregnancy is a prominent cause of amenorrhea and is the most common reason for secondary amenorrhea. Further causes are varied and may include conditions that affect the ovaries, uterus, hypothalamus, or pituitary gland.
Hypothalamic amenorrhea is due to a disruption in the regulator hormones produced by the hypothalamus in the brain. These hormones influence the pituitary gland, which in turn sends signals to the ovaries to produce the characteristic cyclic hormones. Many conditions can affect the hypothalamus:
• extreme weight loss,
• emotional or physical stress
• rigorous exercise, and
• severe illness.
Other types of medical conditions can cause secondary amenorrhea:
• tumors or other diseases of the pituitary gland that lead to elevated levels of the hormone prolactin (which is involved in milk production) also cause amenorrhea due to the elevated prolactin levels;
• elevated levels of androgens (male hormones), either from outside sources or from disorders that cause the body to produce too high levels of male hormones;
• ovarian failure (premature ovarian failure or early menopause);
• polycystic ovary syndrome (PCOS); and
• Asherman’s syndrome, a uterine disease that results from scarring of the uterine lining following instrumentation (such as dilation and curettage) of the uterine cavity to manage postpartum bleeding or infection.
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