Does lack of period means lack of fertility or will you conceive without getting periods for months together, these are some of the questions which will cross your mind if you are in a similar situation. However, it is also a good reason to visit doctor at the earliest. Amenorrhea is a condition where woman do not experience menstrual periods. It is not about having irregular periods but missing one or more periods even though you've been through puberty, aren't pregnant, and haven't gone through menopause. Although Amenorrhea is not a disease, it might be a symptom of a medical condition that needs immediate attention. Scroll down as Dr. Simi Kumari, Fertility Consultant at Nova IVF Fertility East, Patna explains everything about this condition.
Types of Amenorrhea
There are two types of Amenorrhea;
- Primary Amenorrhea is when a girl does not get her first period by the age of 15.
- Secondary Amenorrhea refers to the absence of periods for three or more months in a row by someone who has had a regular menstrual cycle in the past.
- Hormone levels and anatomical problems can cause primary Amenorrhea.
- Pregnancy, birth control, menopause, and breastfeeding are the natural cause of secondary Amenorrhea.
- There are several medications like antipsychotics, cancer chemotherapy, antidepressants, allergy medications, and blood pressure drugs that cause periods to stop.
- Stress, depression, weight loss, poor nutrition, eating disorders, over-exercising, and other ongoing illnesses are also leading causes of Amenorrhea.
- Other hormonal imbalances like Polycystic ovary syndrome (PCOS), thyroid malfunction, pituitary tumor, and premature menopause can cause menstrual irregularities, including Amenorrhea.
- Genetic conditions are the leading causes of primary Amenorrhea. Other women in your family having Amenorrhea increases your chances of having it.
Contraceptives like birth control pills (oral contraceptives) also cause Amenorrhea. In most cases, it takes a long time to get regular ovulation and menstruation, even after stopping birth control pills. Moreover, contraceptives that are injected or implanted and types of intrauterine devices can also cause Amenorrhea.
Signs and Symptoms
Other than not having periods, some other Amenorrhea symptoms include;
- Milky nipple discharge
- No breast development and delay in other sexual secondary characteristics like public hair
- Hair loss
- Vision change
- Pelvic pain
- Excessive facial growth
- Face, hand, and feet swelling(Edema)
Amenorrhea and Fertility
One of the problems caused by Amenorrhea is not getting pregnant. Primary Amenorrhea or secondary Amenorrhea for several months may be a sign of a disease or chronic condition that can lead to infertility. Having irregular periods, no periods, or abnormal bleeding often suggests that the woman is not ovulating, this condition is known as anovulation. If you don't ovulate and don't have menstrual periods, you cannot get pregnant. Irregular or abnormal menstruation accounts for 30% to 40% of all cases of infertility. Amenorrhea caused by hormonal imbalance can also lead to miscarriage or other problems with pregnancy. When you have a pattern of not so regular periods, no periods at all or abnormal vaginal bleeding, this can be concluded towards the fact that you are not ovulating. The medical term for this condition is anovulation.
Treatment for Amenorrhea patients to achieve pregnancy
Once Amenorrhea is diagnosed, there are possible treatments to achieve pregnancy. Treatments for Amenorrhea usually focus on the condition that causes it.
- Several medications can be used to restore hormonal balance and fix conditions such as insulin resistance in patients with the polycystic ovarian syndrome.
- Women under 35 with no other infertility-causing symptoms can opt for ovulation induction with medications. A specialist must carefully monitor this process.
- However, if these medications are not helpful and other factors affect fertility, the best choice for a woman is In-Vitro Fertilisation (IVF).
- This process allows the experts to select the patient's best quality eggs and fertilize them to create embryos. These embryos are then transferred back into the patient's uterus.
- If the patient does not have any viable eggs, the best alternative is to choose an In-Vitro Fertilisation (IVF) and Egg donation (which offer success rates of up to 60 percent).
In severe cases where it is necessary to remove pituitary tumors, normalize the ovarian hormonal environment, or remove barriers that could obstruct menstrual blood discharge, patients must undergo surgical treatment. Although treating the medical condition causing Amenorrhea usually solves the symptoms, one should always incorporate a healthy lifestyle to help restore regular menstrual periods and fertility.
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