Understanding Amenorrhea: Know Causes & Symptoms

There can be many reasons for amenorrhea, and you must get it evaluated by your doctor. Let's learn more about amenorrhea's causes, signs, and symptoms and how it is managed in this blog!

What are the Different Types of Amenorrhea?

There are two types of amenorrhea: primary and secondary amenorrhea, depending upon the cause. When periods do not start in young girls, it is called primary amenorrhea. When periods do not occur in women who are not pregnant but were menstruating, it is called secondary amenorrhea.

What are the Causes of Amenorrhea?

There are different causes for amenorrhea.

Primary amenorrhea

This may occur due to the following reasons:

• Genetic conditions like Turner syndrome, androgen sensitivity

• Conditions that affect the hypothalamus or pituitary gland

• Problems that affect the development of the uterus, vagina, or the hymen

• Delayed puberty

Secondary amenorrhea

This may be due to the following reasons:

• Low body weight

• Sudden or rapid weight loss

• Eating disorders

• Polycystic ovarian syndrome (PCOS)

• Stress

• Premature ovarian failure

• Other chronic medical conditions

What are the Symptoms of Amenorrhea?

The most common symptom of amenorrhea is the absence of a period. Other symptoms may include:

• Excess body hair

• Headache

• Lack of breast development (seen in primary amenorrhea)

• Milky discharge from the breasts

• Hair loss

• Vision changes

• Inability to ovulate

What are the Risk Factors for Amenorrhea?

While your genes play a significant role in the development of amenorrhea, other risk factors include:

• Family history of amenorrhea or early menopause

• Obesity

• Exercising too much

• Eating disorders

• Hormonal (thyroid or pituitary) disorders

• Medications

• Build-up of scar tissue in the uterus

• Pituitary tumors

How is Amenorrhea Diagnosed?

If you are sexually active and have missed or not got your period, it may help to take a pregnancy test. You can buy a pregnancy kit at your nearest pharmacy or consult your doctor. They may also perform a pelvic exam.

If a pregnancy is ruled out, other tests that your doctor may use to diagnose amenorrhea include:

• Imaging tests like magnetic resonance imaging (MRI) and Computerized Tomographic scan (CT scan)

• Blood tests to confirm levels of hormones like prolactin, thyroid, and FSH (follicle-stimulating hormone)

• Hysteroscopy

• Genetic screening

Amenorrhea in Adolescents with Disabilities

The onset of puberty and maturation in adolescents with disabilities is similar to that of those without. However, there may be a difference in the timing of maturation. 

For most adolescents with intellectual disabilities, although the pattern of pubertal maturation is similar to adolescents without disabilities, the tempo and timing of maturation may vary. Parents need to work with their child's pediatrician to evaluate their overall physical and reproductive development, even before menstruation begins. Menstrual management of adolescents with amenorrhea may also vary, depending upon the causative factors.

How is Amenorrhea Treated?