Amenorrhoea

Menstruation or periods is a phenomenon observed in women of reproductive age group.

The absence of periods in this age group is termed as amenorrhea.

Missing a period can be a sign of pregnancy which can be a ‘good news’ for those who may be expecting it. That would be totally different scenario with it’s obvious measures to be taken.

Apart from pregnancy, amenorrhoea can result due to other causes as well and it is very important to diagnose the cause and take necessary actions related to the same.

Ignorance regarding amenorrhoea may lead to worsening of the related condition or cause.

Causes:

Causes of amenorrhoea can be divided into various categories.

a) Physiological or natural amenorrhoea

Amenorrhoea can be observed as a normal phase in your life due to –

• Pregnancy.
• Breast feeding.
• Menopause.

b) Contraceptive

It is possible that you may not have periods if you are on any kind of contraceptives such as oral, injectable or implants. Regulation of menstruation may take a while after withdrawal of contraceptive measures.

c) Medications

Certain medications can cause amenorrhea.

Examples include-

• Antidepressants.
• Antipsychotics.
• Cancer chemotherapy.
• Allergy medications.
• Blood pressure drugs.

d) Medical issues

1. Polycystic ovarian syndrome (PCOS) –
Hormonal imbalance caused in PCOS can lead to amenorrhoea.

2. Thyroid dysfunction –
Amenorrhoea can result due to abnormal functioning of thyroid gland.

3. Pituitary gland tumour –
A pituitary tumour is mostly benign and causes dysfunction of hormones sometimes leading to amenorrhoea.

4. Premature menopause –
Amenorrhoea can result due to an early menopause that is around the age of 40 years which otherwise in the normal course occurs around 50 years of age.

e) Anatomical problems –

• Congenital problems are problems that occur by birth. Sometimes a baby girl may be born without some or all parts of her reproductive system. These problems come under the category of anatomical problems.
• Obstruction in vagina such as a membrane can prevent the menstrual flow.

f) Surgical complications –

Sometimes the endometrium which is the internal lining of the uterus may get damaged during surgical processes related to the uterus. This may impact the normal functioning of the uterus and in turn lead to amenorrhea.

g) Incorrect lifestyle –

Wrong kind of lifestyle is being a causative factor of numerous dysfunctions, amenorrhea being one of them. Erroneous eating habits, irregular sleep timings, long and strenous working hours, lack of exercise, mental stress, all contribute to a very wrong kind of lifestyle. This can lead to imbalance in hormones causing amenorrhea.

h) Lifestyle during menstrual cycle –

Ayurved has advised very specific instructions to be followed during the menstrual cycle. Most important of these include:

1. Having a healthy and balanced diet at regular timings which is light for digestion.
2. Avoiding physical exercise as well as exertion.
3. Trying to stay mentally relaxed.
4. Taking proper rest as needed.
5. Maintain good hygiene.

Defying these norms leads to disturbance in body metabolism including imbalance at hormonal levels. This in turn can lead to amenorrhea.

Diagnosis:

Correct treatment is a sequel of proper diagnosis. As for amenorrhea, diagnosis is made after following a certain direction of clinical examination, detail case history and further investigations as indicated by the clinical examination and case history.
Investigations can include blood tests such as complete blood count, Thyroid function test, hormonal assay.
Certain imaging techniques such as ultrasonography, CT Scan (computed tomography) or MRI (Magnetic resonance imaging.) may also be advised.