What is Secondary Amenorrhea?
Amenorrhea is a condition characterized by complete stoppage or missing of menstrual periods (1). Secondary Amenorrhea develops when a female with normal menstrual cycle stops having her periods for more than six months (2). However, it must be noted that women who are pregnant, breastfeeding or those who are in menopause are not considered to have secondary amenorrhea. More about the condition, its causes, symptoms and also treatments could be known from the following array of the article.
Absence of menstruation is known to be Amenorrhea. Secondary amenorrhea occurs when you have had at least one menstrual cycle and you stop menstruating for few months. It must be noted that secondary amenorrhea is different from primary amenorrhea. Secondary amenorrhea generally occurs in case you have not had your first menstrual period by the age of 16. This is not usually harmful to your health and in most cases secondary amenorrhea can be effectively treated. However, in order to avoid complications, you must address the underlying conditions that might cause secondary amenorrhea in you.
Causes of Secondary Amenorrhea
Hormonal Imbalance as a Cause of Secondary Amenorrhea(2):
The most common cause of Secondary Amenorrhea is believed to be hormonal imbalance(2). This normally occurs as a result of certain medical conditions to include: pituitary gland tumor, depleted estrogen levels, overactive thyroid and elevated levels of testosterone.
Additionally, birth control by way of hormones can also cause secondary amenorrhea. Depo-Provera, which is a common birth control shot and certain other birth control pills which alter the levels of certain hormones are also believed to cause missed menstrual periods(3).
Certain other classes of medications like antipsychotics and use of chemotherapy drugs to treat some forms of cancer also contribute towards development of Secondary Amenorrhea (3).
Structural Issues Can Cause Secondary Amenorrhea(2, 3):
There are some structural issues that can cause secondary amenorrhea. Polycystic Ovary Syndrome also called PCOS is a medical condition that is known to cause hormonal imbalances, which can lead to the development of secondary amenorrhea due to growth of cysts in the ovaries(3). Ovarian cysts are noncancerous lumps or masses which develop in the ovaries. It is a benign condition although requires treatment to get rid of the symptoms of PCOS.
Scar tissue as a result of pelvic infections or multiple D&C procedures also are believed to inhibit normal menstrual periods. This procedure is done by first dilating the cervix and using a curette to scrape off the linings of the uterus. It is often used for removing excess tissue from the uterus. It is also used in diagnosing and treating abnormal uterine bleeding.
Secondary Amenorrhea Caused Due To Lifestyle Factors:
Body weight can actually affect menstruation. Women who are overweight or who have less than 15% body fat may stop getting their menstruation periods. This is especially true for athletes who train their body extensively or excessively(3).
Emotional stress is one more cause for secondary amenorrhea(3). Disruption of menstrual periods is one of the ways that the body responds to excessive stress. However, normalcy is restored with regard to periods when the cause of the stress is identified and successfully addressed.
Symptoms of Secondary Amenorrhea
Missing several menstrual periods in a row is the primary symptom of secondary amenorrhea. However, women with secondary amenorrhea may also experience the following symptoms:
- Changes in breast size.
- Vaginal dryness.
- Acne formation.
- Deepening of the voice.
- Changes in vision (This generally occurs if the amenorrhea is caused by a pituitary tumor).
- Unwanted or excessive growth of hair on the body.
- Discharge from nipples.
- Weight loss or weight gain.
Diagnosis of Secondary Amenorrhea
Your doctor will first require you to take a pregnancy test so as to rule out pregnancy(4). He or she may then run a series of blood tests, which can measure the levels of testosterone, estrogen and other hormones present in your blood for diagnosing secondary amenorrhea(4). These blood tests may be done to known about the hormone levels like the prolactin level, Estradiol levels, Luteinizing Hormone LH levels, Follicle Stimulating Hormone levels of FSH levels, Thyroid Stimulating Hormone or TSH levels, etc(4).
There may also be some other diagnosis and tests, especially the imaging tests for diagnosing secondary amenorrhea. To take a close look at the internal structures the physician may do radiographic studies like MRI and CT scan or an ultrasound of the pelvis. The doctor will be looking for cysts or any other growths on your ovaries or in the uterus.
Biopsy of the lining uterus may also be done and also genetic testing may also be required in some cases to arrive at the right diagnosis.
Treatment of Secondary Amenorrhea
Treating secondary amenorrhea generally varies depending on the underlying cause of your condition. For instance, hormonal imbalances causing secondary amenorrhea can be successfully treated with supplemental hormone therapy(5).
In some cases, your medical professional may also treat ovarian cysts, uterine adhesions, or scar tissues by surgically removing them, as they may be the reason behind missing periods(5).
You may also be asked to make certain lifestyle changes, by your doctor. For example, if your weight and exercise routine is contributing to the condition then you might require some effective lifestyle changes(5). Ask your doctor for a referral to a dietician or a nutritionist, in case required. These specialists can actually help you manage your weight and physical activity in a healthy and effective manner.
The outlook of secondary amenorrhea for getting treated depends on its cause. Many conditions causing secondary amenorrhea, will fairly respond to treatments.
We are now aware of some of the causes, symptoms and treatment methods for secondary amenorrhea. It is essential for you to call your health care provider in case you have missed more than one period, so as to get properly diagnosed about secondary amenorrhea and get treated in case required.