Amenorrhea

The work of the female body is completely dependent on the functioning of the hormonal system. The monthly cycle is the so-called indicator of its activity. Ignoring the first signs of amenorrhea – the absence or cessation of menstruation for more than six months – is fraught with the failure of other body systems. This is especially true for the period of menopause at an early age. The termination of the menstrual cycle associated with pathologies is dangerous by the rapid aging of a woman.

Symptoms of the disease

Usually every girl or woman keeps a menstrual calendar. If your period does not go on time, it is always alarming when it is not associated with natural causes: pregnancy, menopause, lactation. As a result of the absence of menarche, the first menstruation in girls, the following symptoms appear:

deficiency of secondary sexual characteristics: pubic hair growth, breast enlargement;
anomaly in the development of the genitals;
slow growth.

For women, whose cycle has always been accurate, a phenomenon such as amenorrhea always raises the question: what is it and what is caused? The absence of menstruation associated with various pathologies is preceded by irregularities in the cycle – rare, irregular, scanty or spotting bleeding. To them are added concomitant manifestations that occur in about half of the patients:

mood swings;
headache;
neuroses;
low pressure;
weight loss or gain;
oily skin;
depression.

If you do not take action, then the excess production of male sex hormones is added, which leads to body hair and coarsening of the voice. Sometimes milk secretion from the mammary glands is observed, which is not associated with lactation.

Causes of amenorrhea in a woman

The reasons for the absence of “critical” days can be very diverse. The list of causes of primary amenorrhea, in addition to being too young, includes the following diseases:

a tumor in the hypothalamus;
disruption of the pituitary gland;
chromosomal disorders of follicles and oocytes.
The motives causing the natural absence of menstruation with secondary amenorrhea are:

carrying a child;
lactation;
postmenopause.
Other types of amenorrhea are pathological and must be treated. They are most often caused by disorders of the pelvic organs, such as:

inflammation of the ovaries;
cysts, polyps, tumors in the genitals;
inflammatory process in the uterus;
organ fibroids;
endometriosis.
The list is supplemented by fungal and bacterial infections of the uterus and sexually transmitted diseases. Psychosomatic causes are:

nervous overwork;
stress;
false pregnancy, which occurs against the background of an excessive desire to have a child.

The absence of “critical” days can occur while taking medicinal psychopharmacological and hormonal drugs. The list is crowned by a sharp change in climatic zones, living in a hot climate.

Which doctor treats amenorrhea in women?

The list of factors provoking the termination of menstruation is so diverse that it is very difficult to figure it out on your own. Sometimes, for no apparent reason, the cycle returns to normal. Meanwhile, hormonal balance is so important for a woman’s health that one should not neglect the consultation of a specialist. All “female” pathologies are supervised by:

GYNECOLOGIST

His duties at the first appointment include the following components:

A survey, during which the nature of the complaints, the symptoms, the reasons that caused them will be understood;
Inspection. With the help of an instrument – a gynecological mirror – the doctor examines the vagina and cervix for the state of the mucous membrane, the presence of erosions, the nature of the discharge, and the presence of the fetus.
Pregnancy test using a urine indicator.
If the reasons for the absence of menstruation remain unclear, the gynecologist will send for additional consultations to other specialists: an endocrinologist, psychotherapist, nutritionist, neurologist, prescribe laboratory tests and instrumental diagnostic methods.

Diagnostic methods

If amenorrhea has arisen due to pathological phenomena, an urgent need to prescribe treatment, otherwise the case will be complicated by infertility or endocrine disorders. First, the cause of the disease is determined, for which an examination is performed. The standard scheme includes:

Ultrasound of the uterus, ovaries, tubes, bladder and ureters to detect structural pathology, inflammatory processes. The examination takes place through the abdominal region, vagina, or rectum. The method is up to 90-95 percent accurate.
Hormonal analysis of venous blood. On the eve of the test, alcohol, nicotine, strong tea, coffee, physical activity are excluded. The accuracy of the method is 80-90 percent. The cost of the service is assigned separately for each type of hormone.
CT scan reveals defects, formations, inflammation in the genitals. Before the session, you need to take a sorbent. Drink about a liter of water an hour before. Do not eat for five hours before the procedure.

Treatment

The main methods of therapy are classical treatment and surgery. If the disease is associated with a lifestyle, the doctor’s recommendations will be as follows:

balance of work and rest;
correct diet and weight normalization;
elimination of stressful situations;
In the presence of infections of the genital organs, the doctor will prescribe treatment, which will include:

broad-spectrum antibiotics or antifungal drugs;
anti-inflammatory therapy;
local antiseptics for treating the vagina.

Many forms of pathology require surgery. For example, if primary amenorrhea has causes such as congenital anomalies in the structure of the genital organs, then reconstructive and plastic interventions are prescribed:

creation of the vagina in its absence;
dissection of too dense hymen;
removal of the vaginal septum.

Indications for surgery are the following acquired diseases and pathologies of the uterus and its appendages:

neoplasms in organs, uterine fibroids;
scars in the genitals;
adhesions in the fallopian tubes.
A serious intervention is manipulation of the brain: the pituitary gland or hypothalamus. In this case, damage to a part of the brain is inevitable, after which the patient is prescribed hormone replacement therapy for life.

Disease classification

Lack of menstruation occurs in adolescence, during pregnancy, breastfeeding, during menopause. In this case, amenorrhea happens:

true and false;
pathological and physiological;
primary and secondary.

False pathology is present when congenital or acquired anomalies in the structure of organs interfere with the discharge. In this case, the secretion can dissolve on its own, and can cause stagnation and inflammation. Also, the pathological process is provoked by:

hormonal imbalance, including endocrine diseases;
violations of the structure of organs: congenital and acquired;
inflammation of the genital organs, neoplasms in them;
psychosomatic and physical reasons;
diseases of the corresponding parts of the brain.

All these items are not included in the classical classification. According to the standard list, depending on the reasons, amenorrhea is divided into primary and secondary. Each of them has its own typology, it can be natural or anomalous.

When is amenorrhea normal?

Every girl or woman needs to know the acceptable measure of the delay in menstruation. Doctors believe that pathology is present if menstruation in a woman of reproductive age after an established cycle is delayed by a week for no reason. Amenorrhea is considered the norm in such cases:

in adolescent girls – after the onset of menarche;
in women of reproductive age – before menopause;
after a strong nervous shock;
after childbirth;
while breastfeeding.

Under the listed circumstances, this is not considered a pathology and passes after the required period has expired. Only before menopause, menstruation can sometimes resume, becoming less and less frequent until they stop completely.

With breastfeeding, the delay in menstruation varies individually for each nursing mother, which is affected by the amount of prolactin produced. The more active lactation, the more hormone is produced, the longer the pause. This is due to the fact that the body puts a protective barrier against a new pregnancy, maintaining the strength for feeding and giving time to recover all processes after childbirth.

Amenorrhea and menopause: what are the differences?

A common symptom of both phenomena is the lack of bleeding in due time, as well as the inability to get pregnant https://en.wikipedia.org/wiki/Amenorrhea. But how to distinguish menopause, which began to “grow younger” sharply, from amenorrhea? Postmenopause is a natural process, which consists in a decrease in the production of female sex hormones and the gradual extinction of a woman’s sexual function. Based on this, it has a number of symptoms:

hot flashes, especially at night, sweating;
irregularity of the cycle;
the amount of blood secreted ranges from abundant to scanty;
heartache;
neurological abnormalities: tearfulness, low mood, irritability.

Gradually, the duration of the pauses between periods increases until they completely stop, which occurs at 52-55 years. But the early menopause can overtake women from 35 years old. The body begins to age rapidly, the skin withers, various formations can appear in the mammary glands. If there are signs of menopause after 30 years, you need to urgently consult a specialist and be examined. Competent hormone therapy will prolong a woman’s youth for many more years, allowing her to remain healthy and active.