Pregnancy may be one of the reasons you are not getting your period. However, there are many more causes of secondary amenorrhea.
Girls tend to get the first period right after they notice signs of adolescence such as breast development and pubic hair growth. You probably had it when you were 12, but it can start before and after that. Following the first period, you should get a regular menstrual cycle. However, not all women acquire a regular period throughout the reproductive stage. Sometimes, women who are already menstruating may not obtain a period for more than three months. This is called secondary amenorrhea and can be linked to other factors such as pregnancy, diabetes and weight changes.
What is secondary amenorrhea?
Amenorrhea is the lack of period, and secondary amenorrhea is one of its types. “This refers to the absence of three consecutive cycles or six months of periods that previously had regular periods,” explains obstetrician and gynecologist Dr. Chetna Jain.
It is not the condition itself, but a symptom of underlying health problems that may be related to hormones, structure, or lifestyle-related factors. In order to effectively manage secondary amenorrhea, it is essential to identify and address the reasons behind it.
What causes secondary amenorrhea?
Secondary amenorrhea has many causes. However, according to studies published in Obstetrics and Gynecology, pregnancy is the most common cause. Competency-based 2010 teammate. Other causes of secondary amenorrhea include:
1. Hormonal imbalance
- Polycystic ovarian syndrome: In women with PCOS, ovulation confusion occurs due to excessive androgens. In an analysis published in Statpears in October 2024, approximately 30-40% of all women with secondary amenorrhea suffered from chronic static (lack of ovulation) disorders such as PCOS.
- Thyroid disorders: Hypothyroidism (hypothyroidism) or hyperthyroidism (hyperactive thyroid) are some of the conditions that affect duration.
- Hyperprolactinemia: Increased levels of prolactin (hormones that cause breastfeeding) inhibit ovulation.
- Immature ovarian shortage: Early depletion of ovarian follicles leads to a decrease in estrogen production.
2. Lifestyle factors
- Extreme weight changes: Fast loss of many weight, hypobolic fat, or eating disorders, such as anorexia and bulimia, means there is no period of time. “Obesity can also affect hormonal balance,” experts say.
- Excessive exercise: Intense physical activity can suppress ovulation.
- stress: Psychological or physical stress can destroy the hypothalamus-pituitary-avian axis, the main regulator of the female reproductive system.
3. Problems with reproductive systems
- Ashherman syndrome: This is a condition that often leads to uterine scars due to surgical procedures such as dilation or softness.
- Uterine abnormalities: Uterine fibroids or polyps can lead to absence or irregular periods.
4. Medicines and Treatments
- Contraceptives: Hormonal contraceptives or intrauterine devices can destroy periods. According to the University of US Obstetricians and Gynecology, it can stop the period while taking medications such as hormonal contraception.
- medicine: Antipsychotics, antidepressants, and chemotherapeutics can also affect the menstrual cycle.
- Radiation or surgery: Treatments targeting the pelvic area or the brain can affect reproductive hormones.
5. Chronic medical conditions
- Diabetes: “Chronic conditions like diabetes can affect hormone regulation,” experts say. In a 2006 study published in the Human Reproduction Journal of the Perberbertal Diabetic Group, 7% suffered from secondary amenorrhea. The researchers also found that in the posttracheal diabetes group, 12% of them have this type of amenorrhea.
- Pituitary tumor: These are non-cancerous growth of the pituitary gland that can affect hormone production.
What are the symptoms of secondary amenorrhea?
Apart from having no period of three consecutive months, women may experience the following symptoms:
- Hot springs and night sweats
- Dry vaginal
- Acne or excessive facial or body hair growth
- Breast drainage
- Weight gain or loss
- Reduced breast size
- Pelvic pain
- infertility
- osteoporosis
- Fatigue
- My hair is thin
What is the difference between primary amenorrhea and secondary amenorrhea?
“The main difference is that in primary amenorrhea, in the case of secondary things, it does not occur after the menstrual cycle has already begun,” says Dr. Jain.
Even these two types of causes differ.
- Primary amenorrhea: With regard to primary amenorrhea, the majority of cases are due to gonadal dysfunction or medical conditions affecting the genitals. A study published in Statpearls in 2023 found that 43% of participants with primary amenorrhea had this condition. Delays in growth and adolescence are another cause.
- Secondary amenorrhea: Pregnancy is the most common cause, but behind it is hormones, lifestyle, or medical conditions.
What are the treatment options for secondary amenorrhea?
Like other health conditions, treatment for secondary amenorrhea focuses on addressing the underlying cause.
1. Changes in lifestyle
If secondary amenorrhea is due to lifestyle factors, the following changes can help you recover your menstrual cycle.
- A balanced diet: “Fix malnutrition or obesity by adopting a healthy diet plan,” experts say. Include vegetables, whole grains, fruits, nuts and seeds in your diet.
- Weight control: Loss of weight and increase body fat will increase weight. If obesity is a contributing factor, lose weight.
- Change your exercise routine: If you’re working hard in the gym, reduce excessive physical activity.
2. Medical treatment
- Estrogen or progesterone supplements can help restore hormone balance and protect against bone loss.
- Bound oral contraceptives help balance cycle regulation and hormones.
- Dopamine agonists such as cabergoline and bromocriptine can help reduce prolactin levels.
- Medicines such as clomiphene citrate may be prescribed for fertility.
3. Treatment of fundamental conditions
- Polycystic ovarian syndrome: Lifestyle modifications, insulin-infecting drugs (such as metformin), and hormone therapy may be helpful.
- Ashherman syndrome: Your doctor may suggest that you undergo surgery (hysteroscopy) to remove adhesions in the uterus.
4. Surgical intervention
- Pituitary tumor: Surgery or radiation therapy if the tumor is large or unresponsive to medication.
- Uterine abnormalities: Surgery for structural problems such as uterine fibroids and polyps.
5. Supportive therapy
- If low estrogen levels affect bone density, calcium and vitamin D supplements may be administered.
- For women who want to get pregnant, treatments or assisted reproductive techniques can be considered to stimulate ovulation.
Treatment plans for secondary amenorrhea should be performed according to the cause. Proper treatment can help restore your menstrual cycle and prevent long-term complications such as infertility and osteoporosis.
Related FAQs
Is secondary amenorrhea dangerous?
Secondary amenorrhea is not inherently dangerous, but can be a symptom of underlying health problems that can have serious significance if left untreated. Chronic aovulation (lack of ovulation) can make pregnancy difficult due to conditions such as lack of pregnancy and hypothalamic amenorrhea, and prolong the long-term lack of estrogen.
Can PCOS cause secondary amenorrhea?
Yes, polycystic ovarian syndrome (PCOS) is a common cause of secondary amenorrhea. This is a hormone disorder that prevents regular ovulation, as the ovaries are unable to release eggs regularly. Without ovulation, the menstrual cycle would be destroyed and the period would be missed. Increased androgen levels and unbalanced estrogen and progesterone levels interfere with the menstrual cycle.
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