An Overview of Amenorrhea

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You haven't gotten your period in quite some time. "Am I pregnant?" you wonder. "I can't be pregnant!" It happens that you're not, and that feels like even more of a reason to be worried.

So what's really going on? This article looks at a number of causes for missed periods, also known as amenorrhea. It also focuses on how lifestyle choices may be linked with missed periods and what you can do to change them.

Modern Menstruation
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Symptoms

Amenorrhea is defined as missing three periods in a row if you usually have regular menstrual cycles, or none for more than six months if your periods are irregular. You may have primary amenorrhea if you were assigned female at birth and have not yet started your period by age 15, but this occurs in less than 1% of people in the United States.

Some of the other signs or symptoms you may experience with missed periods include:

  • Hair loss
  • Headache
  • Vision changes
  • Excess facial hair
  • Pelvic pain
  • Acne

Don't forget to tell all these symptoms to your healthcare provider because they may give a more complete story about the real reason for missed periods.

In most cases, an underlying condition is the reason for your missed periods. Call your healthcare provider for testing and diagnosis so you can find out why it's happening and how to treat the problem.

Causes

If it's not because of pregnancy, then there's another reason for why you stopped having your period. The cause may be linked to your lifestyle and level of stress, or any medications you take. It also may be a sign of problems with reproductive organs or the glands that help control hormone levels.

Natural Causes

Natural causes for missing your periods include:

Medications

Some medications can cause menstrual periods to stop. These include:

Lifestyle

There may also be some lifestyle factors linked to your missing period. These include:

  • Low body weight: This can interrupt the hormonal functions in your body, halting ovulation.
  • Eating disorders: People with anorexia or bulimia often stop having periods because of abnormal hormonal changes.
  • Excessive exercise: This can lead to missed periods due to low body fat, stress, and high energy activities that burn through calories.
  • Mental stress: Stress can temporarily change how the hypothalamus works. It's the part of your brain that controls hormones that keep your menstrual cycle regular.

Hormonal Imbalance

There are a few medical issues that can lead to hormonal imbalances that affect your period. They include:

Structural Causes

Problems with the sexual organs themselves can also cause amenorrhea. Examples include:

  • Scarring of the uterus
  • Lack of reproductive organs
  • Atypical shape and structure of the vagina

Recap

There are natural causes, other than pregnancy, for missing your period. There also are lots of other reasons and they include any medicine that you take. A rare physical condition may be at work, but it's far more likely that your missed periods are linked with diet, exercise, stress, and other lifestyle factors.

Diagnosis

Your healthcare provider will perform a pelvic exam to check for any problems. If you've never had a period, your healthcare provider will examine your breasts and genitals to check for the normal changes of puberty.

Because there are so many possible causes for missed periods, more than one test may be needed. Some of the tests your healthcare provider is most likely to want include:

If other tests show no specific cause, your healthcare provider may want to do a hysteroscopy. It's an exam with a thin, lighted camera that passes through the vagina and cervix to look at the inside of your uterus.

Treatment

The treatment your healthcare provider recommends depends on the underlying cause. In some cases, contraceptives (the pill) or other hormone therapies can help. In other cases, different drugs or even surgery will be the better choice. It all depends on the reason for missed periods.

Summary

There are a lot of reasons for why you may have missed periods but some of them are fairly common. Beyond your healthcare provider's suggestions, you may want to find a better balance in your exercise, diet plan, and more. Look for ways in which you may be able to lower the stress in your life. And as always, stay mindful of what your body is telling you.

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Article Sources
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  1. American College of Obstetricians and Gynecologists (ACOG). Amenorrhea: Absence of Periods. October 2020.

  2. Gasner A, Rehman A. Primary Amenorrhea. StatPearls Publishing. Updated July 11, 2021.

  3. Huhmann K. Menses requires energy: a review of how disordered eating, excessive exercise, and high stress lead to menstrual irregularitiesClinical Therapeutics. 2020;42(3):401-407. doi: 10.1016/j.clinthera.2020.01.016

  4. Shufelt C, Torbati T, Dutra E. Hypothalamic amenorrhea and the long-term health consequencesSemin Reprod Med. 2017;35(03):256-262. doi: 10.1055/s-0037-1603581

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