Let us say your periods have stopped and you are NOT pregnant (your urine test has been negative for HCG) and it's been more than 3 months since you last got your period you have what is called amenorrhea, or secondary amenorrhea to be precise.
“Women complain about premenstrual syndrome, but I think of it as the only time of the month that I can be myself.”
― Roseanne Barr
Primary Amenorrhea, in contrast, means the absence or delay in the onset of regular periods in young girls, say after age 13.
In case regular periods are missed or absent an evaluation as to find out the cause is indicated.
Natural causes for Missed Periods:
Just like pregnancy is a natural cause of secondary amenorrhea, so breastfeeding and menopause are another two natural causes of cessation of regular periods.
Apart from these natural causes, other causes if missed periods are Obesity and Polycystic Ovarian Syndrome.
Birth control pills or hormone shots such as Depo-Provera may cause absent monthly bleeding. Even after you stop taking these hormones, periods may not return for more than 6 months.
If you exercise too much and for long periods of time; if you have very low body fat (less than 15 to 17%) or if you lose a lot of weight suddenly due to extreme dieting or gastric stapling surgery.
Whenever you are undergoing severe anxiety or emotional distress for any reason you could very well develop secondary amenorrhea.
Other reasons for missed periods could be
- Tumours in the brain (pituitary tumours)
- Hormonal disorders such as reduced oestrogen or raised testosterone
- Certain medications to treat schizophrenia
- Psychosis or cancer
If you have undergone certain procedures like dilatation and curettage (D&C), or if you have had severe pelvic infections, there may be scar tissue in the uterus causing menstruation to stop.
Along with cessation of periods, you could have a variety of other symptoms such as
- Weight gain or loss
- Changes in the size of your breasts
- Increased hair growth overly body
- Vaginal dryness
- Hoarseness of voice
- Vision loss or headaches
These symptoms will help point towards the cause of the amenorrhea.
Tests to confirm the cause for Missed Periods:
Certain tests can then be carried out to confirm the cause. Blood tests can be done for hormone levels of estradiol, follicle stimulating hormone (FSH level), luteinizing hormone(LH level), prolactin. Serum hormone levels such as testosterone levels, thyroid stimulating hormone (TSH).
To rule out any tumours, CT scan or MRI scan of the head are the other tests that may require.
Biopsy of the lining of the uterus might be required to check for scarring, genetic testing and ultrasound of the pelvis or hystero-sonogram (pelvic ultrasound that involves putting saline solution inside the uterus) might also be carried out.
Treatment for Missed Periods:
Treatment depends on the cause of amenorrhea. Amenorrhea is usually not difficult to treat. Normal monthly periods usually return and established once again after hormone therapy is given or after underlying condition is treated. Lifestyle changes such as losing weight, altering one's exercise routine or proper nourishment can also normalise the menstrual cycle.
The outlook naturally depends on the cause of amenorrhea. Most of the conditions that cause secondary amenorrhea will respond to treatment.
If you have missed more than one period then make an appointment with your doctor for treatment of your problem.