Androgenix Blog

What Is Amenorrhea?

Amenorrhea is a condition where a woman misses her period consistently; the absence of menstrual periods. Apart from pregnancy, childhood, menopause, and breastfeeding, the absence of periods can be a result of an issue caused by the reproductive system. 

To be diagnosed with amenorrhea, there are two qualifications:

• A woman who has missed three or more consecutive periods
• Young girls who do not begin menstruation by 16 years old

What Are The Causes Of Amenorrhea?

The causes of amenorrhea will differ based on the type of amenorrhea present. The primary type of amenorrhea occurs in young girls who have not experienced their first period by the age of 14 years old and there are no signs of other sexual characteristics (such as public hair and developing breasts.) The other alternative is the period has not started by 16 years old, despite other sexual characteristics presenting themselves. 

 

The secondary type of amenorrhea occurs in women who have experienced puberty and a normal cycle but have not had a period for more than 3 months. The main cause of amenorrhea is when the body’s hormones are disrupted. The body’s ability to produce female hormones such as estrogen and progesterone can be affected by the following:

The Menstrual Cycle

The brain structures called the pituitary gland and hypothalamus control a woman’s menstrual cycle. The hypothalamus triggers the pituitary gland to make hormones that will trigger the ovaries to produce progesterone and estrogen. These particular hormones make the lining of the uterus (womb) thicker as the body prepares for future pregnancy. 

If pregnancy does not occur, hormone levels drop and the lining of the uterus falls away. Once that process is completed, what’s known as a period or menstruation presents itself. The cycle continues to occur repeatedly until menopause happens. There are various disorders of the hypothalamus, ovaries, and the pituitary gland which causes menstruation causing amenorrhea.

Primary Amenorrhea Causes

This type of amenorrhea is normally due to anatomical or genetic abnormalities. 

Genetic Abnormalities

Turner syndrome is a condition in which a girl is born without an X chromosome and is the most common cause of primary amenorrhea.

Androgen insensitivity syndrome is a condition where a girl has high levels of testosterone. 

Pituitary gland abnormalities and hypothalamus are conditions that lead to hormonal imbalances which can ultimately delay menstruation in girls. 

Other Less Common Causes Of Primary Amenorrhea Are The Following:

• Delay of puberty (this can be associated with acute or chronic illness and is more common in boys than girls)
• Functional hypothalamic amenorrhea 
• Mullerian agenesis (a lack of development in the female’s vagina, with or without the uterus, which typically occurs in the early development of the fetus)

Primary Amenorrhea Is Less Frequently Caused By:

• Low energy availability
• Excessive energy use
• Decreased calorie intake
• Excessive exercise
• Being an elite athlete
• Eating disorders
• Transverse vaginal septum – which is a birth defect that results in a wall of tissue across the vagina, running horizontally, blocking a part of it. 
• Imperforate hymen – is a congenital disorder in which the female’s hymen completely obstructs the vagina and has no opening. 
• High prolactin levels due to a pituitary tumor 
• Congenital adrenal hyperplasia
• Enzymes deficiencies
• Hypothyroidism 
• Stress

Secondary Amenorrhea Causes

Breastfeeding, menopause, and pregnancy are natural causes of amenorrhea. There is a huge range of factors that can affect how the hypothalamus works therefore causing amenorrhea.

Some medications can cause women to miss their periods such as:

• IUD’s (intrauterine device for birth control)
• Birth control pills
• Blood pressure medications
• Antidepressants
• Chemotherapy and radiation 

Women who experience the following are considered secondary amenorrhea causes:

• An eating disorder
• Emotional distress
• Low body weight 
• Nutritional deficiencies (that can occur with celiac disease)
• Strenuous exercise participation (elite athletes)
• Certain medications used to treat mental health conditions
• Disorders of the endocrine system (such as having an underactive thyroid gland or hypothyroidism)
• Physical stress 

Other Disorders That Can Cause Amenorrhea

Hyperandrogenaemia

When the body produces high levels of male sex hormones, the reproductive system can be affected. This can be caused by the adrenal gland or ovarian tumors, or certain conditions present at birth. 

Hyperprolactinemia

This occurs when the body produces high levels of the breastfeeding hormone called prolactin. The levels rise because of a possible pituitary gland or a possible tumor on the gland. 

Early Menopause (Also Known As Premature Ovarian Insufficiency Or Ovarian Failure)

The low levels of estrogen cause ovulation to stop, therefore stopping the menstrual cycle. 

Polycystic Ovarian Syndrome

The ovaries develop clusters of ovarian follicles also known as eggs which look like small cysts. The symptoms include added hair growth and irregular periods. When women experience PCOS, they are more at risk of amenorrhea when they put on weight. 

What Are The Risk Factors Of Amenorrhea?

There are a variety of risk factors that have the power to increase the likelihood of developing amenorrhea.

• Obesity 
• Family history of amenorrhea and menopause
• Anorexia nervosa 
• Excessive exercise
• Having the FMR1 page, also known as genetic composition 

What Are The Symptoms Of Amenorrhea?

It’s essential to keep in mind that the primary sign of an individual having amenorrhea is missing a period for three or more consecutive months. 

Other symptoms of amenorrhea include the following:

• Headache
• Hair loss
• Pelvic pain 
• Vision changes
• Discharge from the nipple
• Growing facial hair
• Acne

How Hormones Have A Role In Causing Conditions Such As Amenorrhea?

Numerous factors can cause amenorrhea if the hypothalamus stops releasing (GnRH) which is the gonadotropin-releasing hormone that starts the menstrual cycle. 

Gynecologic conditions that can lead to hormone imbalances such as fragile X and polycystic ovarian syndrome are both associated with primary ovarian insufficiency. 

Thyroid problems include hyperthyroidism and hypothyroidism.

A tumor on the pituitary gland has the potential to interfere with the body’s regulation of hormones that affect menstruation.

What Is The Diagnosis And Treatment Of Amenorrhea?

The diagnosis and treatment of amenorrhea follow certain criteria. When an individual attends a doctor’s office showcasing symptoms of amenorrhea, the first step the doctor will cover first is performing a pregnancy test through blood or urine to rule out pregnancy before running any other tests. Once the pregnancy test comes back negative, the doctor will run a series of blood tests aimed to evaluate the following three areas in the body:

• Estrogen
• Testosterone 
• Hormones 

The doctor will also perform a physical examination to evaluate the individual’s overall health to see if other sexual characteristics such as pubic hair or breast growth have developed. The medical history such as contraceptive methods and gynecological history will be utilized. 

Amenorrhea Diagnosis

Hormone Challenge Test

The doctor will supply the patient with medication for amenorrhea, known as hormone medication that main focus is to trigger menstruation. This particular test will evaluate the amount of estrogen in the female’s body. If the estrogen levels are really low, that could be the explanation for the regular missed periods. 

The hormone tests are utilized and check that the following aspects are working properly:

• Pituitary glands
• Thyroid glands
• Adrenal glands
• Hypothalamus
• Ovaries

Diagnostic Imaging 

In some instances, the doctor will utilize diagnostic imaging to acquire detailed images of the woman’s internal organs. The tests that might be performed are:

• Ultrasound
• CT scan 
• MRI

An ultrasound of the reproductive organs is utilized to check the following factors:

• The presence of eggs and follicles in the ovaries
• Size of organs
• The presence of an open vagina and uterus 

Scope Tests 

 During the hysterectomy, a lightened camera is inserted into the uterus via the vagina. The doctor might order a hysterectomy to get a close-up view of the inside of the uterus to look further for abnormalities or cysts. 

Amenorrhea Treatment

To provide adequate treatment, a doctor will need to determine what is causing the female’s amenorrhea to treat it effectively. The treatment provided will be based on the underlying condition of the woman. For example, if an individual has amenorrhea because they exercise too much or havePhysical experienced a significant amount of weight loss, treatment will be encouraging the individual to gain healthier body weight. 

There are other treatment options geared towards weight loss if an individual is managing an underlying medical condition or is overweight. Hormone therapy such as a combined oral contraceptive pill will cause regular periods to return but does not treat the underlying cause.

Medications

The hormonal imbalances caused by issues from the pituitary gland and thyroid might be treated with synthetic or supplemental hormones.

Surgery 

The structural growths and issues such as:

• Scar tissue buildup
• Tumor
• Ovarian cysts

When the above items are in the uterus, there might need to be a surgical intervention performed. 

Lifestyle Changes

If amenorrhea is being experienced due to factors such as the following:

• Not consuming enough calories
• The individual is experiencing mental or physical stress
• The person is exercising too much 

When the above items are being experienced, the condition can be treated by making lifestyle changes. 

How Androgenix Can Help Treat Amenorrhea With Hormone Replacement Therapy?

Androgenix can help treat amenorrhea with various options of hormone replacement therapy. For example, estrogen therapy is known as (HRT) hormone replacement therapy and can improve the lives of both men and women. It can be injected in a variety of ways:

• Injections
• Creams
• Gels
• Skin patches
• Tablets

Get Help At Androgenix Today

Here at Androgenix, Advanced Health and Wellness Center, in North Palm Beach, FL, we offer various hormone therapies aimed to assess levels to determine which therapy will benefit you the most. We will assist you in getting back on the journey of your better self in no time. 

References:

https://www.mercy.com/health-care-services/gynecology-obstetrics-womens-health/conditions/amenorrhea

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstruation-amenorrhoea