Amenorrhea: causes, symptoms, treatment methods

What is amenorrhea?

Amenorrhea is a menstrual disorder in women and young girls of all ages, characterized by the absence of menstruation in a sexually mature woman for six months or more.

This condition can be physiological (for example, amenorrhea during pregnancy) or pathological, indicating the presence of gynecological or endocrine diseases.

Types of amenorrhea

Primary amenorrhea

Primary amenorrhea occurs in adolescents and is associated with developmental disorders of the female reproductive organs. In these patients, one may observe

• Preservation of childhood physical characteristics;
• underdevelopment of breast glands;
• an imbalance between weight and height;
• absence of menstruation before the age of 16.
• Genetic disease.
• Congenital malformation of the reproductive organs that blocks menstrual flow (e.g., hymenal agenesis)

Secondary amenorrhea

Secondary amenorrhea develops in women who previously had a regular menstrual cycle. Causes may include

• illnesses;
• prolonged use of hormonal or psychotropic medications;
• significant stress or emotional upheaval.

Causes of amenorrhea

Amenorrhea can be caused by various factors, including

• Genetic anomalies: congenital anomalies of the sexual system and changes in chromosome typing.
• Genital anomalies: absence of uterus, vagina, or ovaries.
• Endocrine disorders: polycystic ovaries, adrenal hyperplasia, diabetes mellitus.
• Psychological causes: stress, depression, emotional overload.
• Metabolic disorders: obesity or anorexia.
• Uterine pathologies: chronic endometritis, synechiae.

Classification by duration

1. First degree: 6 to 12 months.
2. Second degree: 1 to 3 years.
3. Third degree: more than 3 years.

This classification allows the physician to determine the severity of the condition and choose the appropriate treatment strategy.

Consequences of amenorrhea

Failure to treat amenorrhea can lead to:

• infertility;
• ectopic pregnancy;
• cardiovascular diseases;
• osteoporosis and joint problems;
• menopausal symptoms (hot flashes, vaginal dryness);
• irritability and depression.

Diagnosis of amenorrhea

For diagnosis, the following are used

• Pelvic ultrasound: to detect anatomical anomalies;
• Infection tests: to check for urogenital discharges;
• Cytological analysis: examination of the cervical epithelium;
• Hormonal blood tests: FSH, prolactin, progesterone, LH, thyroxine (T3 and T4), TSH.

Treatment methods

Main approaches

1. Treatment of the underlying cause: therapy for diseases that caused amenorrhea.
2. Hormone therapy: use of estrogen and progesterone to restore hormonal balance.
3. Management of complications: correction of osteoporosis and urogenital disorders.
4. Reproductive technologies: use of assisted reproductive techniques, including in vitro fertilization (IVF), to treat infertility.
5. General strengthening of the body: vitamin therapy, balanced diet, physical activity.

Early diagnosis and a comprehensive approach to treatment can restore the menstrual cycle and improve the reproductive health of women.