Amenorrhea : What can Cause the Absence of Menstruation

Amenorrhea is the absence of menstruation and does not always mean the presence of a pregnancy. It can also occur due to hormonal changes such as stopping contraceptives or excessive stress or even due to situations such as intense physical activity or anorexia.

In addition to this, the lack of menstruation for more than 3 months in a row also occurs in pre-menopause, in the first cycles after menarche and does not go back down after surgery to remove the uterus and ovaries, not being a situation That causes concern in most cases.

Main causes of Amenorrhea

Some common situations that can cause the absence of menstruation for more than 3 months in a row are:

• Intense physical activity, performed by marathoners, competition swimmers or gymnasts, being that in this case, the idea is to reduce the intensity of training to regulate menstruation again.
• Stress, anxiety disorders, and nervousness alter the menstrual flow but can be solved by finding calm and serenity again, which can be achieved through sessions of psychoanalysis or constant physical activity.
• Eating disorders such as a diet low in vitamins or diseases such as anorexia or bulimia. In this case, a nutritionist should be consulted to adapt the diet, so that the menstruation returns to normal.
• Alterations of the thyroid as in the case of hyperthyroidism or hypothyroidism. If this is a suspect, the doctor should request thyroid hormones in the blood test and prescribe appropriate medications if necessary.
• Use of medications such as corticosteroids, antidepressants, chemotherapy, antihypertensives, or immunosuppressants. In this case, you can try to use another medicine that does not have this side effect or evaluate the risk/benefit of using this medicine but only on the doctor's advice.
• Diseases of the reproductive system such as polycystic ovaries, endometriosis, myomas or tumors and, in this way only with the gynecologist-oriented treatment, menstruation can return to normal.
• The use of some contraceptive methods such as the use of the implant in the arm, the IUD and even the use of continuous contraceptive pills that do not have rest, can also cause the absence of menstruation.
• Alterations in brain functioning such as a malfunction of the pituitary gland and hypothalamus and, although this is not a common cause, it can be investigated with specific tests requested by the gynecologist or general practitioner.

The absence of menstruation also occurs in women with Cushing syndrome, Asherman syndrome and Turner syndrome.

The causes of the absence of menstruation are usually related to the decrease in estrogen that can prevent ovulation and the formation of the uterine tissue that flakes during menstruation, so there may be menstrual changes such as absence of flow or irregularity of the cycle.

Main Causes of Menstrual Delay

The menstrual delay can occur when the woman stops taking the birth control pill or stops using the implant, and in this case, the menstrual cycle can take 1 to 2 months to normalize. The morning-after pill may also change the day of menstruation decline, delaying it for a few days. And whenever pregnancy is suspected, a test is recommended to find out if it really is. See other causes in Delayed menstruation.

When to go to the Gynecologist

It is necessary to see a doctor in case of:

• A girl who shows no signs of puberty until age 13: lack of growth of pubic or axillary hair, no breast growth and no widening of the hips;
• In case the menstruation does not go down until the age of 16;
• If in addition to the absence of menstruation, the woman has other symptoms such as increased heart rate, anxiety, sweating, weight loss;
• When the woman is over 40 years old and her period has not gone down for more than 12 months, and the possibility that she is pregnant or that she has irregular menstruation has already been ruled out.

In either case, the woman should go to the gynecologist who can indicate the performance of blood tests or perform an ultrasound, to assess hormonal values and exclude the existence of any problem or disease in the ovaries, thyroid or adrenal glands.