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Adet Görememe (Amenore)

Regular menstrual bleedings is one of the indications of healthy reproductive system. Even though, generally, having periods between 21 to 35 days is viewed as normal, every woman’s menstrual cycle varies.

However, not getting period for 40 to 45 days or two months is identified as amenorrhea. Reasons for amenorrhea vary between age groups of women and their healthy statuses. When women who are in reproductive age and have unprotected sex are not having their periods, possible pregnancy is one of the first things that come to mind.

In these cases, pregnancy tests are taken and if the test’s result is negative, the reason for the problem is investigated. Even though generally examination and test results can find the cause for amenorrhea, there may be rarely no reason for this problem.

What are the reasons for amenorrhea?

For a woman to have a regular menstrual cycle, hormones that are released from pituitary gland and ovaries should be reproduced regularly. Changes in hormone levels and changes in their balances can change menstrual bleedings’ amount and order.

One of the most important factors that affect hormones’ release order is psychological turmoils. So much so that; too stressful, troublesome instances and depressing lives cause hormonal disorder. At the same time, climatic changes, change of the environment due to travel, too intense work outs that tire the body, sudden weight loss or weight gain can also cause amenorrhea.

Having said that, teenagers who are in first couple of years of their puberty and menopausal women through two to three years have menstrual irregularities, sometimes there may be no menstrual bleedings for two to three months. In this context, a women who is in an advanced age doesn’t have menstrual bleeding for six months, all examinations and tests are applied and is diagnosed with entering the menopause.

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How are the reasons for amenorrhea identified?

When a woman in her reproductive age and having unprotected sex goes to a doctor with the complaint of amenorrhea, first there will be a pregnancy test. Having said that, because birth control methods cannot 100% prevent pregnancy, there is the need for pregnancy test for any woman in their reproductive sex.

If the pregnancy is out of question with tests, hormone tests are practiced. This is because some tumours and disorders due to thyroid also may be identified with amenorrhea. In this context, there is also antimüllerian hormone is also controlled through its test to control if a woman is in early menopause.

Since thyroid gland hormones also affect reproductive organs, in case of amenorrhea there is also thyroid hormone test. Beside this, prolactin hormone levels are also analyzed and ovarian cancer and ovarian tumours with ultrasound machine. If there is amenorrhea during puberty, genetic diagnosis is also needed.

What kind of treatment is needed for amenorrhea where the menstrual bleeding never takes place?

Menstrual cycle age is usually between 9 to 13 and sometimes around 14 years of a person. However, if the secondary indications for puberty such as getting bigger breasts, hairing in genital and armpit areas are also identified, it can be wait until a person is 15-16 years old.

If there is no indications for puberty and a teenager who is 15 is still not getting menstrual bleedings, this is called primary amenorrhea and the person should consult to a doctor without wasting time. Not having menstrual cycle in the first place is caused by genetic and hormonal problems. In these cases, it is taken results through hormone treatment.

If a woman doesn’t have a uterus, what kind of treatment is administered?

Some female babies don’t get organs in uterus during pregnancy of their mothers. Even though a girl with no uterus has ovaries and hormone levels are normal, there will be no menstrual bleeding. Because in these cases getting pregnant in normal way, pregnancy is possible with uterus transplantation and surrogate mother system.

What kind of treatment is administered on later amenorrhea cases?

When women are having their usual menstrual bleedings,  sometimes they may not. In these cases, pregnancy and menopause possibilities are taken into account. If a person is not diagnosed with these possibilities, ovarian cysts and tumours and thyroid disorders are questioned. When ovarian problems require surgical intervention; hormone treatment is required in hormonal problems.

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Written by Pepapp

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