There are two types of amenorrhoea, primary and secondary. Primary amenorrhoea is the absence of a menstrual period in a female who has reached reproductive age. Secondary amenorrhoea is the cessation of a menstrual period in a female. A menstrual period is the completion of a woman's menstrual cycle (the body's preparation for pregnancy) signified by a flow of blood out of the vagina. Menstrual cycles vary from woman to woman, on average being 28 days long.
Primary Amenorrhoea Defined
A woman is considered to be experiencing primary amenorrhoea if by age 14 she is showing no sign of breast development and/or growth of public hair along with the absence of menses. Menses is the term for a woman's first menstrual period. Or she is considered to be experiencing primary amenorrhoea if she has not had menses by age 16.
Genetic Causes
Genetic causes of primary amenorrhea stem from fetal development in utero. Genetic primary amenorrhea can be caused by chromosomal disorders such as Turner's syndrome. Structural problems with the uterus such as the lack of one or structural abnormalities with the fallopian tubes could prevent or inhibit the normal development of or the release of eggs into the uterus.
Other genetic causes are inherited disorders of the adrenal glands, heart disease, Cystic fibrosis, true hermaphroditism and Cushing's disease.
Environmental Factors
Rapid weight loss or gain can cause a young woman's menses to be delayed past age 16. Some athletes such as gymnasts and ballet dancers have higher incidences of primary amenorrhea than the general population of woman the same age. Some doctor's suggest that there is a correlation with low body fat and primary amenorrhea in young women. Malnutrition and stress are other environmental factors that can cause the development of primary amenorrhea. In sexually active women, pregnancy can be a cause of primary amenorrhea.
Other Causes
Infections in the reproductive organs, radiation therapy and prescription drugs particularly those prescribed for depression can cause primary amenorrhea. Injuries to or tumors growing on the reproductive organs are also a possible cause.
Treatment Is Based On Cause
The treatment, if there is one for a patient's primary amenorrhea, is based on finding and treating the underlying cause of the patient's condition. A doctor will perform a physical exam, take a detailed patient history and order tests she deems necessary. Tests used to confirm the underlying cause of primary amenorrhea may include measuring hormonal levels, an MRI of the brain to check the pituitary gland, MRI or CT scan of the reproductive organs to check for tumors.
Lifestyle changes, better nutrition, increase in body fat or stress reduction may be recommended depending on the cause. Surgery many also be an option.
Because of the myriad of hormonal and physical factors that are considered in determining the treatment of primary amenorrhea this condition should be discussed with a professional and not self treated.
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