Amenorrhea Causes

Amenorrhea is a medical term used for describing the condition, characterized by the absence of menstrual period in women of reproductive age. Usually, women stop menstruating during pregnancy, after menopause, and if their ovaries or uterus have been removed surgically. Absence of menstrual cycle under these conditions are quite normal and therefore, physicians always rule out these possibilities before considering other possible causes of amenorrhea.

Basically, there are two types of amenorrhea, primary and secondary. Primary amenorrhea refers to the condition, where a girl has never experienced menstrual period by the age of 16 years. In other words, primary amenorrhea is a condition, where menstrual cycle never starts. Secondary amenorrhea on the other hand, refers to the cessation of menstrual cycle in a woman who was menstruating previously.

Primary amenorrhea is more commonly congenital and caused by genetic and chromosomal abnormalities, as well as developmental defects of the reproductive tract. On the other hand, secondary amenorrhea is more often associated with hormonal fluctuations, premature menopause, intake of certain drugs and other health conditions.

Primary Amenorrhea
Primary amenorrhea more often results from genetic and chromosomal defects. It can be the condition, 'gonadal dysgenesis', where there is premature depletion of the follicles and egg cells. This results in premature failure of the ovaries, and in that case ovulation and menstruation cannot take place. On the other hand, women with Turner syndrome do not have all or a portion of one of the two X chromosomes. This prevents the normal development of the ovaries and so, leads to primary amenorrhea and premature ovarian failure.

The hypothalamus, which is present at the base of the brain plays a crucial role in the regulation of menstrual cycle in women. So, disorder of the hypothalamus can sometimes manifest as amenorrhea. It is known as functional hypothalamic amenorrhea. Some of the main risk factors are, eating disorders including, anorexia nervosa and bulimia nervosa, too much of physical and physiological stress and excessive or vigorous exercising.

Like hypothalamus, pituitary is another gland that controls the menstrual cycle, and so, conditions such as, tumor or any kind of invasive growth in the pituitary gland can lead to amenorrhea. Some other possible causes of primary amenorrhea are, lack of certain reproductive organs such as, uterus, vagina or cervix, congenital adrenal hyperplasia and polycystic ovary syndrome. Moreover, structural abnormalities of the vagina can also result in amenorrhea, as it can block the flow of blood from the uterus and cervix.

Secondary Amenorrhea
Pregnancy is perhaps the most common cause of secondary amenorrhea, though it is not a disease or disorder. Other than pregnancy, secondary amenorrhea can have many other causes like, the use of contraceptives. Generally, if a woman stops taking contraceptives, she might take a few months, about 3 to 5 months to resume her menstrual cycle. Like oral contraceptives or birth control pills, certain medications like, antidepressants, corticosteroids and chemotherapy drugs can also cause amenorrhea. Sometimes, amenorrhea can be experienced by breastfeeding mothers as well.

Like primary amenorrhea, secondary amenorrhea can also result from excessive weight loss and too much exercising. It has been observed that both low body weight or low body fat, and strenuous physical activities can interrupt menstrual cycle in women. Similarly, too much of mental stress can have an effect on menstruation. It has been observed that prolonged and excessive mental stress can adversely affect the functioning of the hypothalamus, which in turn, can stop menstruation temporarily. Some other common causes of secondary amenorrhea are, hormonal fluctuations caused by polycystic ovarian syndrome, a underactive thyroid gland or hypothyroidism, and development of tumor in the pituitary gland.

Apart from these, two other possible causes of secondary amenorrhea are, uterine scarring and primary ovarian insufficiency. Sometimes, scar tissues can develop in the uterus, especially after uterine procedures like, cesarean section. Such a condition can prevent the build up, as well as shedding of the uterine lining, leading to light or no menstruation. Primary ovarian failure or insufficiency, also known as premature menopause can stop the normal functioning of the ovaries quite early, usually before 40 years. This is the reason why it is called premature menopause. In general, menopause occurs at the age of 45 to 55 years.

Most of the time, amenorrhea does not result from a serious underlying condition. However, sudden cessation of menstrual cycle at an early age, as well as not been able to get the first menstrual period can be a troubling experience for any women. But, before coming to any conclusion, it is better to get the condition evaluated by your physician. This can help you to avoid unnecessary mental stress, and identify the underlying causes. Lastly, it needs to be kept in mind that your diet and lifestyle can have a great impact on the functioning of various body systems including, the reproductive system. Excessive diet restrictions coupled with vigorous exercising in an attempt to lose weight quickly can sometimes take a toll on your health and interrupt your menstrual cycle. Both obesity and too low body weight can disrupt your normal menstrual cycle. So, try to maintain an ideal body weight, and be sure to talk to your physician if you observe any kind of irregularities in your menstrual cycle, or if you have not experienced the first menstrual cycle till the age of 16 years.