- 1 What is amenorrhea?
- 2 Types
- 3 Causes of amenorrhea
- 3.1 Late puberty
- 3.2 Menopause
- 3.3 Pregnancy
- 3.4 Lactation
- 3.5 Dysfunctions or changes in the reproductive system
- 3.6 Endocrine diseases
- 3.7 Chronic diseases
- 3.8 Usual causes
- 3.9 Drug causes
- 3.10 Disorders and conditions
- 4 Groups of risk
- 5 Symptoms of amenorrhea
- 6 How is amenorrhea diagnosed?
- 7 Amenorrhea has a cure? What is the treatment?
- 8 Medications for amenorrhea
- 9 Living together
- 10 Complications
- 11 How to prevent amenorrhea?
What is amenorrhea?
Amenorrhea is the absence of menstruation. It can be primary (when the first menstruation takes long to arrive) or secondary (when a woman has already menstruated and, for some reason, has not menstruated for more than three months). It is a symptom that can be related to several health problems.
The cause of amenorrhea is not always a disease. Some natural phenomena, such as pregnancy, breastfeeding and menopause , can also interrupt menstrual cycles.
In addition, habits such as having a very intense physical exercise routine or restrictive diets can also be the cause of an amenorrhea.
Among the main complications of diseases that cause amenorrhea are infertility (or difficulty getting pregnant) and the development of osteoporosis .
There are basically two types of amenorrhea – one of them affects women who have already menstruated, and the other, girls who have not yet had menarche.
Primary amenorrhea occurs when a teenager has not yet had her first period (also known as menarche), according to the following criteria:
The girl is at least 14 years old, has never menstruated and does not show any body changes typical of puberty (such as the development of a breast bud – that “little ball” that appears near the nipples when the breasts start to develop – or the growth of pubic hair , for example);
The girl has already turned 16 and has never menstruated, even though she already has such bodily changes.
In other words: if you are 14 or 15 years old, you have not yet menstruated, but you already have curves, pubic hair and can observe the growth of your breasts, rest assured. The absence of menarche in these conditions does not necessarily mean that you are presenting with amenorrhea that needs to be investigated.
Secondary amenorrhea is a condition in which women stop menstruating after menarche. In other words, to be diagnosed with secondary amenorrhea, you need to have menstruated at least once in your life and have stopped menstruating for at least 3 months .
It can reach women of any age, within the reproductive age group (from 10 to 49 years old, according to the official classification of the Ministry of Health).
The causes of amenorrhea are diverse. They can be due to natural processes – such as pregnancy and menopause – or serious diseases, such as a range of genetic syndromes, for example.
Some habits can also cause a missed period.
Pictures that can cause amenorrhea are as follows:
Although the “delay” of the first menstruation has the ability to make teenagers a little anxious, in most cases, the “delay” of menarche is perfectly normal.
Each person develops at a different pace, which can vary according to some factors. The biggest influence is genetic. If parents entered puberty shortly after the population average, their children are likely to repeat the pattern.
Babies who are born premature, underweight or under the expected size also tend to become teenagers who postpone entry into puberty a little.
Those who menstruate after the national average (somewhere around 12 years old) for natural reasons have no disadvantage in relation to other girls for this specific reason.
As long as the girl develops normally, with the first signs that she is becoming a woman appearing (changes in voice, thickening of hair, vaginal humidification and breast growth, for example), there is no problem in not menstruating until 16 years old.
Already in girls who do not show the first signs of bodily changes until the age of 14, or who turn 16 and still do not menstruate, some dysfunction may be causing problems. Then, in these situations, a gynecologist will need to be consulted to investigate the source of the delay in puberty.
Problems that can cause late puberty include:
The anemia is a condition in which the body does not absorb enough amounts of iron to function properly. This condition, in turn, affects the functioning of the endocrine system, delaying the arrival of the first menstruation.
To find out if you have anemia, your doctor should order a blood test.
Malnutrition in girls with eating disorders may be directly responsible for delayed puberty. (For more information, read the subsection “Eating disorders”).
Studies show that stress can cause several changes in girls who are about to enter puberty. Among these disorders are late puberty and early puberty – which occurs before the age of 10.
Polycystic Ovary Syndrome (PCOS)
PCOS causes an increase in the size of the ovaries, which have their surfaces covered by small cysts. Although the description is a little frightening, it is a highly recurrent phenomenon among women of reproductive age and one of the most common causes for late puberty. (For more information, read the subsection “Polycystic ovaries”).
The thyroid has an important hormonal function, and problems with this gland can delay the arrival of the menarche.
The conditions that may be delaying the girl’s entry into puberty are hypothyroidism , when the thyroid produces less hormones than necessary, or hyperthyroidism , if the amount of hormones is greater than ideal. (For more information, read the subsection “Thyroid disorders”).
Some antidepressants, antipsychotics, medicines used in chemotherapy and corticosteroid treatments can cause late puberty. If in doubt, read the package insert carefully or talk to your doctor. (for more information, read the section “Drug causes”).
Hyperprolactinemia is basically the overproduction of the hormone prolactin. The substance, in turn, is responsible for the woman’s milk production during or shortly after pregnancy. Prolactin dysfunctions, however, can cause uterine and hormonal changes, delaying the onset of menstruation.
Every human being has sex chromosomes, which are, roughly speaking, strands of genetic material responsible for attributing different physical, hormonal and reproductive characteristics between the sexes.
Male people have XY chromosomes, while female people have XX chromosomes. It is this configuration that makes each sex have its own reproductive system.
Turner Syndrome is a genetic disease that affects only females. People with this problem have only one X chromosome – and they should have two. The XX chromosomes are responsible for a woman’s sexual characteristics, including, of course, menstruation.
Girls with Turner Syndrome have some characteristics that can be noticed since childhood. In adolescence, they do not usually show the typical signs of puberty.
Kallmann’s syndrome is also a genetic disorder, but unlike Turner’s syndrome, it directly affects hormone production.
The disease causes a drastic reduction in the production of Gonadotropin Releasing Hormone (also known as GnRH), responsible for stimulating the functioning of the ovaries, which prevents the onset of puberty and menstrual cycles.
Menopause is the natural end of a woman’s menstrual cycles, which usually happens between the ages of 45 and 55 . It is one of the most common causes of amenorrhea, along with pregnancy.
In general, one of the first symptoms of the phenomenon is the partial interruption of menstrual cycles, which start to be more widely spaced and do not show up every month. The woman may also notice a decrease in the intensity of the flow.
Early menopause is a rare phenomenon, affecting 1% of women worldwide. It happens when the symptoms of menopause – among them amenorrhea – appear before the age of 40.
If you are under 40 years of age and, in addition to the absence of menstruation, you also experience symptoms of menopause, such as fatigue , hair loss, sudden changes in mood, reduced sexual desire, difficulty concentrating, memory failures, hot flashes and insomnia , it is important to communicate these signs to your gynecologist at the time of the consultation.
Amenorrhea is one of the initial and most popular symptoms of pregnancy. So if you had unprotected sex 14 to 8 days before your menstrual period (assuming your cycle is 28 days and completely regular) and have had your period delayed for at least two weeks , it is important to do a pregnancy test to rule out the hypothesis.
It is recommended to do the test just two weeks after the delay of menstruation because pharmacy tests can only detect the presence of the hormone hCG (which is only produced during pregnancy) about 15 days after conception. The blood test, done in the laboratory, is a little more sensitive and can detect hCG 10 to 12 days after fertilization.
Also known as pseudocyesis or imaginary pregnancy, psychological pregnancy is an emotional condition that can affect both women who really want to have children and those who are terrified of becoming pregnant.
The symptoms are the same as in a real pregnancy: nausea, swelling and tenderness in the breasts, milk production, an enlarged belly and, of course, amenorrhea. The difference is that, in psychological pregnancy, there is no real fetus.
It is not uncommon that, even after ultrasounds show that there is no baby in development, the woman diagnosed with psychological pregnancy remains convinced that she is pregnant. Follow-up for pseudocyesis should be done with psychologists.
Amenorrhea is totally normal in women who are breastfeeding. In general, the absence of menstruation among lactating women usually lasts from 3 to 8 months, but can persist for up to a year.
This happens due to changes in the amount of prolactin – the substance responsible for the production of breast milk – produced by the body. The greater the amount of prolactin in the body, the less likely it is to ovulate. So the more the baby sucks, the less likely the mother is to start menstruating anytime soon.
Dysfunctions or changes in the reproductive system
The most common pathological causes of amenorrhea are those related to the reproductive system.
Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance that is related to the production of excess insulin by the body and also to genetic tendencies. This amount of abnormal hormones causes many cysts and microcysts to appear on the surface of the ovary, completely changing the dimensions of the organ.
Women with PCOS have, on average, the ovary up to three times larger and wider than normal. This change in the ovarian dimensions causes the patient to ovulate less than normal and, consequently, to have irregular menstrual cycles.
It is not uncommon for people with PCOS to go months without menstruating, menstruating for weeks or even having very intense flows in one month and practically nonexistent in the next.
Despite the discomfort caused by the disease, PCOS is a recurring problem: it is estimated that it affects about 20% of women of reproductive age. The diagnosis is made by a gynecologist or endocrinologist, and the most common treatment is through prescription of contraceptives.
Early Ovarian Failure (FOP) is diagnosed when a woman’s ovaries stop producing healthy eggs sooner than they should. FOP is often the cause of early menopause.
Women with FOP usually do not stop menstruating suddenly, but rather, they notice that their menstrual cycles are increasingly irregular – just like in a normal menopause.
In addition to amenorrhea, other FOP symptoms are hot flashes, night sweat, irritability and vaginal dryness.
You have certainly heard of the hymen – an impermeable film that sits at the entrance to the vagina. Although it is best known for its disruption during after the first sexual intercourse, the hymen has an important function in girls who have not yet entered puberty: to protect them from genital infections.
During childhood, the hymen is a thicker and more resistant structure, which has an opening through which vaginal secretions pass and, from the beginning of adolescence, menstruation.
This is where the problem of carriers of imperforate hymen begins. For these girls, the opening for the passage of menstruation does not exist. With the entrance of the vagina obstructed, it is impossible for menarche to happen.
In addition to amenorrhea, girls with imperforate hymen also experience severe pain in the lower abdomen, a feeling of bloating in the abdomen and discomfort in the stomach and back. Treatment requires surgical intervention.
Amenorrhea is one of the consequences of hysterectomy , surgery to remove the uterus. After this procedure, the woman no longer menstruates. However, patients who undergo partial hysterectomies – in which parts of the uterus are preserved – may eventually experience bleeding similar to menstruation.
Rokitasnky’s syndrome is a rare genetic disease, in which a woman is born without a uterus and vaginal canal. The first symptom of the problem is usually the primary amenorrhea. Most patients discover the situation around the age of 16, when the first menstruation does not arrive.
Scars in the womb
If you have undergone surgical procedures such as curettage or tubal ligation , have had some type of uterine infection or have undergone radiation therapy, it is possible that your uterus has come out of these experiences with some scarring – clinically called uterine synechiae , Asherman’s syndrome or uterine adhesions .
Scarring can affect the diameter of the uterine cavity, causing a blockage that can prevent or decrease the intensity of menstruation.
Tumors in the ovary
Tumors that are located in the ovaries and interfere with the diameter of the organ can cause changes in the ovulation process and menstrual cycles.
The endocrine system is formed by a group of glands that regulate the amount of hormones released into the blood.
Some dysfunctions in this system can cause amenorrhea. Among them are:
The thyroid is one of the most important glands in the body. Located in the throat region, just below the larynx and around the trachea, it is responsible for a series of functions in the human body, including fertility and regular menstrual cycles.
These functions are performed through the production of two hormones, called T3 and T4, which interfere with the functioning of virtually all organs and increase the rate of metabolism. In addition, the thyroid also produces a substance called calcitonin, which regulates the amount of calcium in the body.
Thanks to the hormonal importance of the thyroid, dysfunctions in this gland can directly interfere with menstruation.
Hypothyroidism happens when the thyroid produces less hormones than is necessary for the proper functioning of the body. It is more common after age 35 and much more recurrent in women than men.
For women with hypothyroidism, menstrual cycles become irregular, preventing menstruation from occurring for months and, when it finally comes, much more intense than usual.
In addition to episodes of amenorrhea, hypothyroidism can also cause the following symptoms:
- Difficulty concentrating;
- Weight gain;
- Swelling in the legs;
- Bradycardia (a condition in which the heart beats more slowly than normal);
- Intestine taken;
- Difficulty getting pregnant.
Hyperthyroidism happens when the thyroid produces more hormones than necessary. As in the case of hypothyroidism, hyperthyroidism can cause amenorrhea and difficulty getting pregnant.
In addition, some other symptoms are:
- Feeling of heat;
- Feeling of weakness;
- Tremors in the hands;
- Weight loss;
- Heartbeat faster than normal;
- Excessive sweating.
Cushing’s syndrome is a disease characterized by the excessive production of cortisol, a hormone generated by the adrenal glands, located just above the kidneys. Rare, the syndrome can cause amenorrhea, infertility and decreased libido.
In addition to these, its most characteristic symptoms are:
- Fat accumulation in the abdominal region, which occurs suddenly and quickly;
- Appearance of thick, red streaks on the body, especially on the belly.
Tumors in glands
Tumors that are located in the pituitary and adrenal gland can cause menstrual flow to stop.
Some chronic conditions that seem to have nothing to do with the reproductive system can also – oddly enough – have amenorrhea as a symptom.
Colitis is the name given to inflammation of the large intestine, which can be chronic or acute. Amenorrhea can be a symptom of chronic colitis in women.
Patients who are suffering from colitis may also experience:
- Abdominal pain;
- Chills during the night.
To say that a person has kidney failure means that his kidneys are not working as they should. The condition may also be acute or chronic and, in the chronic modality, amenorrhea may be one of its symptoms.
Usually caused by diabetes , autoimmune diseases or hypertension, kidney failure can also cause symptoms such as:
- Dry skin;
- Decreased appetite;
- Bad to be generalized.
The Cystic Fibrosis (CF) is an inherited and incurable disease, which directly affects the cells responsible for producing mucus, sweat and gastric juices. Because of this, these substances are produced in a thicker than normal way, and the body cannot eliminate them. This thick waste, in turn, accumulates and blocks important accesses to the lungs and digestive system.
Amenorrhea is one of the consequences of the development of cystic fibrosis in women, who also often experience difficulties in becoming pregnant.
Certain habits and routines that demand too much of the body can cause the interruption of menstrual cycles.
Excessive physical activity
Do you know that story that everything in excess is bad? This maxim is real when it comes to the relationship between exercise and menstruation.
The practice of physical exercises stimulates the production of prolactin, a hormone that, in turn, decreases the activities of the ovary. For this reason, it is common for high-performance athletes to suffer episodes of amenorrhea.
However, common does not mean normal and much less beneficial. The absence of menstruation in athletes can cause changes in bone density and eventually lead to osteoporosis . This situation favors injuries and may even prevent the patient from continuing to compete.
Athlete Woman Triad
The Female Athlete Triad is a recently cataloged syndrome that is linked to the habits and routines of women and girls who are professional athletes.
The picture of the Female Athlete Triad consists of – as the name suggests – three basic conditions: inadequate nutrition, amenorrhea and osteoporosis. The three problems are directly linked and are caused by the pressure to maintain a certain weight or body mass index that is placed on the athletes.
Despite being more common among high-performance athletes, the Female Athlete Triad can also target women who only exercise too much without adequate supervision or fitness.
Diets that restrict a particular category of food, or recommend that you eat less than three meals a day, are great villains in the regulated menstrual cycle.
Eating little alters metabolic functions. That’s because, when it realizes that you’re eating less than necessary, the brain understands that you’re in a situation where food is lacking and turns on the warning sign. There, it retains the largest possible number of substances necessary for the functioning of the organism.
In the process, some functions of the body are suspended – menstruation among them.
A curiosity is that, it is exactly for this defense mechanism of the brain that restrictive diets do not work: in an attempt to protect the vital functions of the lack of nutrients, the body starts to “ration” the largest amount of fat that it can.
The relationship of sudden weight loss and menstruation is very similar to the case of restrictive diets.
When realizing that there is a low caloric intake and that the body is losing body mass very quickly, the brain interprets that something is wrong and is happening, causing the metabolism to slow down and certain substances to be destined to primary vital functions, suspending the menstruation.
Some drugs and substances can stimulate processes that cause amenorrhea. Among them are the following:
It is not the use of the contraceptive itself that can cause amenorrhea, but the incorrect use of contraceptives.
Contraceptive packs have 21 or 24 tablets in general. The woman should take one pill a day. When the pack is finished, it is necessary to take a break of 4 or 7 days, depending on the directions on the package insert.
It is during this pause that menstruation takes place, when the body is deprived of the hormones contained in the contraceptive pills and thus understands that it is time to menstruate.
If you do not take this break and start a pack the day after the end of the previous one, your body will not stop absorbing these hormones, and you will not menstruate.
Another contraceptive situation that can cause amenorrhea is to stop taking the medicine suddenly. It will take the body a few days to process that it is no longer receiving the substances it used to receive, and some time to adjust the regularity of the menstrual cycle without the influence of the pill.
If you take anticonvulsants and contraceptives simultaneously, there is a risk of a drug interaction that can cause amenorrhea, in addition to decreasing the effectiveness of the contraceptive.
In some women, certain antidepressants can cause changes in menstrual cycles. In addition to potentially causing amenorrhea, these medications can interfere with the intensity of menstrual flow.
Some antihistamines can cause hyperprolactinemia, which in turn causes episodes of amenorrhea. (For more information, read the subsection “Hyperprolactinemia”).
As with antihistamines, some antipsychotics also have the potential to increase prolactin production levels, causing amenorrhea.
Medicines used in chemotherapy
Amenorrhea is a direct side effect of drugs used to treat cancer using chemotherapy.
Disorders and conditions
Before talking about how eating disorders affect the menstrual cycle, it is important to talk about two glands located at the base of the brain: the hypothalamus and the pituitary gland.
The hypothalamus and pituitary gland are responsible for ensuring the functioning of the thyroid, which, in turn, emits hormones that stimulate the ovaries. When a woman suffers from anorexia or bulimia, the entire execution of this process is suspended, because, with the low absorption of nutrients, the hypothalamus and pituitary gland fail to function properly.
Thus, with the interruption of this process, the body produces very low amounts of estrogen and progesterone . Without these two hormones, there is no menstrual cycle.
Scientists are still trying to find out the exact reason why women with anxiety disorder can experience attacks of amenorrhea. What is known so far is that the central nervous system directly influences the work of the hypothalamus and pituitary gland.
Therefore, when patients are going through phases in which they are often more anxious, it is possible to have amenorrhea.
Studies show that women with depression have low levels of estradiol, one of the main female sex hormones, responsible for fertility.
Deficiencies in the production of estradiol can be the cause of amenorrhea and delayed menstruation.
When exposed to conditions of extreme stress, women may experience changes in their menstrual cycle, which includes amenorrhea.
A classic case: the woman has sexual intercourse without a condom and takes all possible precautions to avoid becoming pregnant despite this carelessness. But even so, she spends the rest of the month very anxious, imagining that she may have become pregnant. So, on the day that it should come, menstruation doesn’t show up. And not next time. Or the next one. Or the next one.
It is very common for women who are stressed with the possibility of being pregnant to experience menstruation delays. In that case, the way out is to take a deep breath, try to stay calm and take a pregnancy test to clear up the doubt.
Excessive amounts of fat can disrupt the functioning of the pituitary gland, deregulating menstrual cycles and causing amenorrhea.
Women who are obese may also find it difficult to conceive, for the same reason.
People with certain conditions are more likely to develop amenorrhea. These groups include:
Women with other cases of amenorrhea in the family
The tendency to develop amenorrhea is hereditary. Therefore, if irregular cycles that interrupt are recurrent in the lives of two or more women in your family, you can be a strong candidate to deal with the same situation.
High performance athletes
Women with very heavy training routines tend to produce less prolactin, one of the hormones responsible for stimulating the ovaries to function properly.
People with eating disorders
Women who suffer from anorexia or bulimia usually suffer from intense hormonal imbalances, due to the low absorption of nutrients by the body. Therefore, one of the consequences of living with eating disorders is amenorrhea.
Amenorrhea is not a disease , but a symptom. For this reason, it is considered a sign that something is not going well and must have its origin investigated by a doctor.
The most suitable professional to diagnose the cause of amenorrhea is a gynecologist. If a disease is detected that has nothing to do with the reproductive system in the process, the patient will likely be referred to a specialist.
As the causes of amenorrhea are quite varied, the battery of tests that can be done to close the diagnosis also makes up a relatively long list.
Blood tests are the best way to detect the amount of hormones, nutrients and other substances in the body. Therefore, they are basic to arrive at various diagnoses related to amenorrhea.
If you are sexually active, one of the first tests that the doctor should order when he finds a picture of amenorrhea is Beta HCG , which will indicate whether you are pregnant or not.
To check if the origin of your amenorrhea is a thyroid dysfunction, the doctor will indicate tests that measure the production of hormones by the gland, such as TSH , T3 Reverse , T3 Free , T4 Free , TPOAb and TgAB .
Tests for hormones
In the battery of tests to find out the cause of amenorrhea, many tests will probably be included to find out how much hormone production is going on in your body.
In the guide for exams, you will possibly read names like FSH , LH , estradiol , progesterone , inhibin B and anti-Mullerian hormone (AMH) .
Diagnostic imaging exams
Diagnostic imaging exams are ideal for investigating the inside of the uterus and diagnosing some other problems with the endocrine system. Tests that can be ordered include:
Through a pelvic ultrasound , the doctor will be able to assess whether there are uterine changes such as cysts, tumors and ectopic pregnancy – in which the fetus grows outside the uterus. Ultrasound is also used to diagnose Polycystic Ovary Syndrome.
Magnetic Resonance and / or Tomography
A CT scan or MRI may be ordered to ensure that there is no tumor pressing on the pituitary gland, thereby causing the absence of menstruation.
As in the case of magnetic resonance imaging and tomography, a radiograph of the sella turcica can show whether there is a tumor affecting the pituitary gland.
The hysteroscopy is an examination done by inserting an instrument called a hysteroscope into the uterus. It can show a series of diseases and anomalies that are affecting the region.
Amenorrhea is a symptom, not a disease in itself. Therefore, treatment will be directed to the cause of the problem.
Roughly speaking, amenorrhea can be said to be curable in most cases . However, this statement will depend exclusively on the disease or condition that is causing the absence of menstruation.
Some types of treatment, depending on the case, are:
Psychotherapy can be a good way to treat various causes of amenorrhea, including depression, eating disorders, anxiety, stress and psychological pregnancy.
In cases of imperforate hymen and uterine scars, surgical interventions are usually the most recommended treatment modality.
Women who have removed the uterus or been born without it will not have menstrual cycles, even with surgery.
Hormone replacement therapy can be recommended for women who have menopause.
For early menopause, treatment is highly recommended. For natural menopause, hormone replacement therapy will only be administered if the patient is suffering a lot from side effects such as hot flashes and mood swings, for example.
Hormone therapy is also indicated for women who undergo hysterectomy surgery – not to continue the menstrual cycle, but only, to prevent osteoporosis.
There are some alternative and natural treatments that can be good solutions for treating amenorrhea. But beware! These therapies have no scientifically proven efficacy and should in no way replace the treatment recommended by the doctor.
Also known as angola rosemary , agnocasto is a plant that stimulates the production of the hormones LH and FSH, which are responsible for the ovulation process.
In addition to being used as a complementary treatment for amenorrhea, agnocasto is also recommended to treat menstrual cramps, acne and premenstrual tension (PMS).
Angelica is a European plant with several medicinal properties. Teas made with it are known to have positive effects in the treatment of gastrointestinal problems, menstrual cramps and, of course, amenorrhea.
However, Angelica needs to be used with care. Still little studied by the medical community, the plant has a toxic oil that, in excess, can damage the nervous system and cause severe paralysis.
In addition, in contact with the skin, Angelica can also cause allergies and serious dermatitis.
Many patients claim to notice improvements in amenorrhea linked to emotional issues (such as anxiety, stress and trauma, for example) through homeopathic treatment.
The professional responsible for prescribing the best homeopathic compound for your case is a homeopath .
Medications are usually indicated when the cause of amenorrhea is some hormonal imbalance, such as hyperprolactinemia (for which drugs such as Dostinex , for example) or excess estrogen (a condition for which the doctor may, for example, prescribe drugs such as Acetoflux ).
Medicines can also be prescribed to treat thyroid disorders. Therapy may include substances such as beta-blockers and radioactive iodine, depending on the case.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Recurring delays, skipping cycles (which normally happen in a month and then go on for months) and absence of menstruation are not normal conditions. It is important to visit a doctor and find out the cause of this condition to avoid complications.
To notice changes more easily, it is essential to pay attention to your cycle and get to know your body. Keep notes about your menstrual cycle and don’t be afraid or ashamed of noticing significant changes in your menstrual flow, let alone communicating them to a professional – no matter how silly they seem.
Some smartphone apps can help you in this endeavor. Suggested apps for tracking, notes and information about your menstrual cycle are:
- Clue (free for Android and iOS);
- Menstrual Calendar (free for Android and iOS);
- Sai Cólica (free for Android and iOS);
- My Monthly Diary (free for iOS);
- Ladytimer ($ 2.99 for Android and iOS).
In addition, changing some habits that are harmful to your menstrual cycle can also be a good way to live with the situation throughout the treatment in the best possible way. Eating properly and exercising in moderation are great ways to alleviate the symptom (for more information, read the section “How to prevent amenorrhea?”).
Complications related to amenorrhea can vary depending on the cause of the symptom.
In general, the complications that are directly related to the absence of menstruation are:
The sex hormone estrogen plays an important role in bone calcification. Therefore, changes in the menstrual cycle – especially the complete absence of menstruation – can interfere in this process and favor the appearance of a disease called osteoporosis.
Osteoporosis is a problem caused by the low absorption of minerals by the bones of the body. This phenomenon causes the loss of bone mass, which, in turn, leaves the bones very fragile.
This condition can facilitate fractures, cause severe chronic pain and discomfort, cause shrinkage and deformities, and also cause the development of respiratory and gastrointestinal problems.
Your ovulation process is directly linked to your menstrual cycle. Certain hormonal changes that happen during your cycle are responsible for the production, maturation and release of your eggs, as soon as they are ready to be fertilized.
If you don’t menstruate, your ovulation process is probably not going as it should (or it just isn’t ).
Therefore, women who have not had their periods for months and do not seek treatment are at risk of not being able to get pregnant at all.
Can women with amenorrhea get pregnant?
It depends. The possibility of women with amenorrhea being able to get pregnant is directly linked to the cause of the problem.
Women with amenorrhea caused by the breastfeeding period or with an imperforate hymen, for example, can perfectly produce a child, despite the absence of menstruation.
However, it is important to note that, in most cases, amenorrhea is a symptom of diseases that affect the ovulation cycle. Therefore, it is not uncommon for women with amenorrhea, especially secondary, to have difficulty conceiving.
It is difficult to talk about ways to prevent amenorrhea. However, some changes in the routine can already prevent the problem from appearing:
The lack of nutrients can be linked both to the absence of menstruation and to very intense flows. In order to regulate and eliminate this type of problem, it is important to ingest adequate iron levels.
According to data from the World Health Organization, the recommended daily amount of iron for women of reproductive age is 15mg. Pregnant women should take a little more care and take, on average, 30mg per day.
Some iron-rich foods that can be included in your diet are:
- Soy, with 15.7mg of iron per 100g of food;
- Sesame, with 14.5mg of iron 100g of food;
- Liver steak, with 10mg of iron per 100g of food;
- Oysters, with 9.2mg of iron per 100g of food;
- Parsley, with 6.5mg of iron per 100g of food;
- Beans, with 3.7mg of iron per 100g of food;
- Lentils, also with 3.7mg of iron per 100g of food;
- Spinach, with 2.7mg of iron per 100g of food;
- Tofu, with 2.5mg of iron per 100g of food;
- Chard, with 1.8mg of iron per 100g of food.
Exercise in moderation
Exercising is very good for your health, however, it is very important to respect the limits of your body. Training hard without being prepared for this load of physical stress can lead to serious health problems.
Always follow the recommendations of your personal or trainer and be faithful to the training regime that has been indicated to you by the professional. If you can, follow up with a nutritionist and ensure that adequate amounts of nutrients are ingested, according to the load of physical exercises practiced.
If you feel that the training is too heavy for you, talk to the professionals who accompany you. There is nothing wrong with pulling the brake to take care of your health.
Now, if you are a professional and / or high-performance athlete, and you cannot decrease the intensity of your training, it is essential to exercise your diet carefully, ensuring that your body has the necessary gas to keep up with your pace.
Go to the doctor regularly and report to your trainer if you experience any atypical symptoms – such as amenorrhea.
See a gynecologist regularly
It is essential that women of reproductive age (especially those who are sexually active!) Set aside time for the gynecologist at least once a year.
There is no need to be ashamed of going to the doctor, especially if you are feeling that something is not going well. Remember: this is the job of that professional and, before you, he has possibly seen many other girls and women with similar problems. What is new to you is just routine for him. Try to relax.
If you are uncomfortable, ask a friend or relative to accompany you and wait for you outside the office, but be sure to go.
Write down your doubts and symptoms and take them to the doctor. When it comes to your body, there is no silly question.
Despite social taboos, taking care of your sexual and reproductive health is extremely important. Do not hesitate to treat yourself well.
Amenorrhea is a symptom that needs to be investigated by a specialist. If you notice significant changes in your menstrual cycle, visit a gynecologist as soon as possible.
Do you have any questions about menstruation? Leave it to us here in the comments! We will respond as soon as possible.