> Amenorrhea: the symptoms, causes, diagnosis, and treatment

Cos’è amenorrhea

For amenorrhea means the absence of menstruation for one or moreù menstrual cycles. In general, this is amenorrhea when a woman occurs to the absence of three menstrual cycles, and when a girl at the age of 15 years has not yet had her period (but in some families it is normal to have your first period più later).

The pregnancy is the cause more common of the amenorrhea. The other causes are due to problems that affect the reproductive organs or the glands that regulate hormone levels.

Sintomi amenorrea

The main symptom is the absence of menstrual cycles. Depending on the cause, together with the absence of menstruation may be no other signs or symptoms, for example:


  • Acne
  • the

  • pelvic Pain
  • the

  • visual Disturbances
  • the

  • hair Loss;
  • the

  • milky Secretion from the nipple.
  • the

  • Headache;
  • the

  • Excess facial hair.

it is good to go to the doctor when the woman has missed three consecutive cycles or if a girl of 15 years has not yet had menarche.



  • Infertilità. Caused by the absence of menstrual cycles.
  • the

  • Osteoporosis. The risk of osteoporosis rises when the amenorrhea is prolonged and is caused by low estrogen levels.

Cause amenorrea

The reasons may be different. First of all, the absence of menstruation può to depend on causes rather normal that can occur in a woman’s life. Other causes can be caused by a health problem or più simply be the side effect of a drug.

Cause naturali

a woman’s life goes through different stages in the course of which the causes are of natural origin, like for example:


  • breast-Feeding
  • the

  • Pregnancy
  • the

  • Menopause


There are women who take the contraceptive pill, and who do not have menstruation. Even if this method of contraception is discontinued, può be necessary to wait a certain time before returning to the ovulation is regular and the recovery of the menstrual cycle. Other systems that contraceptives such as the plant or intrauterine devices (spiral) can cause amenorrhea.


There are also some categories of medications which may cause amenorrhea, such as:


  • Medications for hypertension
  • the

  • Antidepressants
  • the

  • Chemotherapy
  • the

  • Antipsychotics
  • the

  • anti-allergy Drugs
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Styles, and living conditions

The amenorrhea può also be caused by life-styles that are incorrect, for example:


  • the Condition of mental stress. A period characterized by particular emotional stress può temporarily alter the functioning of the hypothalamus, that is; the part of the brain designated for the hormonal control that regulates the menstrual cycle. Consequently, può happen a suspension of ovulation and menstruation. In general, if the stress condition is found to be missing or reduces, menstrual cycles resumed.
  • the

  • the body Weight excessively low. Be below the normal weight può affect hormonal functions of the body, and to provide a stop to ovulation. Women who suffer from eating disorders such as anorexia or bulimia are often subject to the absence of menstruation.
  • the

  • the Excess of physical exercise. The women who practice an activityà physics rigorous in the time and effort can have a break of menstruation. Think of the girls who embark on careers in the arts such as the ballet or sports careers-competitive. A low percentage of body fat, the high energy expenditure and stress are a mix of conditions that can bring the athletes to the amenorrhea.

The body in this case records at the central level stress as a signal of alarm for the survival of all primordial. And just like in the età of the stone the danger sarà the lack of food, presence of predators, difficultyà environmental of each type. Get pregnant under these conditions is a threat to the subject and for the species, then ovulation stops. In addition, the ovaries in block ovulation secrete the male hormones light that, in addition to be acne and body hair, increase resistance to fatigue, lack of sleep, and stress. From an evolutionary view point if it is in danger for any reason &it is much better to be ready to escape, to fight and to work hard rather than be vomiting, or sleep, the typical symptoms at the beginning of a pregnancy.

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hormonal imbalance

The causes of hormonal imbalance can be different, including these:

Tumor of the Pituitary gland (or hypophysis). Not è particularly malignant, however, has important functions in hormone regulation and its malfunction can have important effects on health. Among these, to interfere with the regular performance of the menstrual cycle.

early menopause. In general, women enter menopause around 50 years of age. However, even before the age of 40 can; occur a out-of-production ovarian. In this case, the menstrual cycles cease.

polycystic Ovary. Polycystic ovary syndrome (PCOS) può result in relatively high levels and for prolonged periods of hormones. Può be genetically determined but canò also be, as is said above, caused by stress, a form that in this case sarà easily reversible after discontinuing the cause.

thyroid Dysfunction. Hyperthyroidism, that is; the adhd)à of the thyroid or hypothyroidism (low activity;) can be the cause of irregularityà menstruation, including amenorrhea.

Cause organiche

The amenorrhea può also be caused by problems with the sexual organs. Let’s make some examples:


  • Absence of reproductive organs. During fetal development problems can occur which prevent the full and complete development of the reproductive system. A girl can be born without uterus, of the vagina or cervix.
  • the

  • structural Abnormality of the vagina. Può be a membrane or a wall that prevents the menstrual bleeding.
  • the

  • Scarring uterine. In the clinical history of a woman we can be, the causes which have led to the syndrome of asherman’s, a condition in which scar tissue accumulates in the lining of the uterus. Thereò può happen for several reasons such as a caesarean section, or the treatment of uterine fibroids or a curettage. The scar of the uterus prevents the accumulation of normal and the uniform spread of the uterine lining.

risk Factors

The risk of amenorrhea può increase in the presence of the following factors:


  • Activitiesà physics. Women who engage in athletic training rigorous can meet to a greater risk.
  • the

  • eating Disorders. Women who suffer from anorexia or bulimia, are più high risk of developing amenorrhea.
  • the

  • family History. If in a family, other women have had to do with the amenorrhea, it is possible to a predisposition to the problem.

Diagnosis of amenorrhea

With the gynecological examination, but basically with an ultrasound, testing for the presence of any structural problems in the reproductive organs. In girls who have never mestruato, we proceed with a remark to verify the normal changes of pubertà.

However, the amenorrhea può be a disorder caused by a complex mix of hormonal problems. To accurately identify the cause you may need to use different types of examinations and, at times, this può take a very long time.

laboratory Testing

Here are a few:

  • Test of prolactin. The low levels of prolactin can be a sign of a tumor in the pituitary gland.
  • Test functionalityà thyroid. Detect the quantityà of the hormone TSH in the blood.
  • the

  • pregnancy Test. To exclude a pregnancy in the act.
  • Test functionalityà of the ovary. Detect the quantityà of the hormone FSH.
  • Test of the male hormone. Può be required in the event of an increase of hair on the face or in the presence of a timbre of voice low.

challenge Test hormone

To check if the absence of menstruation is caused by estrogen deficiency, administering a medication hormonal to cause the cycle.

instrumental Examinations for images


  • magnetic resonance imaging (MRI).
  • the

  • Ultrasound.
  • The computed tomography (CT).


The treatment depend on the causes identified. Sometimes the problem resolves itself, other times it is sufficient to take birth control pills or other hormonal therapies. If the amenorrhea is caused by problems with the pituitary or the thyroid, the treatment will usually be pharmacological. In the cases in which the absence of menstruation due to a tumor or from an impediment in the workforce, willà be necessary to resort to surgery.


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