Is Secondary Amenorrhea?
the absence of menstruation. Secondary amenorrhea occurs when you’ve had at
least one menstrual period and you stop menstruating for six months or longer.
Secondary amenorrhea is different from primary amenorrhea, which occurs if you
haven’t had your first menstrual period by age 16.
You must miss at least three to six menstrual periods to be
diagnosed with secondary amenorrhea.
A variety of factors can contribute to this condition, including:
- birth control use
- certain medications that treat cancer, psychosis,
- hormone shots
Missed menstrual periods are usually associated with pregnancy,
breast-feeding, or menopause. However, these conditions don’t cause amenorrhea.
Secondary amenorrhea usually isn’t harmful to your health. It can
be treated effectively in most cases. However, you must address the underlying
conditions that cause amenorrhea to prevent any complications.
Causes Secondary Amenorrhea?
During a normal menstrual cycle, estrogen levels rise. Estrogen is a hormone
that’s responsible for sexual and reproductive development in women. The high
estrogen levels cause the lining of the uterus, or womb, to grow and
thicken. As the lining of the womb thickens, your body releases an egg
into one of the ovaries. When the egg isn’t fertilized by a man’s sperm cell,
it will break apart. This causes estrogen levels to drop. You’ll then shed the
thickened uterine lining and extra blood through the vagina during your
However, this process can be disrupted by certain factors.
A hormonal imbalance is the most common cause of secondary
amenorrhea. A hormonal imbalance can occur as a result of:
- tumors on the pituitary gland
- an overactive thyroid gland
- low estrogen levels
- high testosterone levels
Testosterone is the primary sex hormone in men. However, it also
plays a role in the growth and development of reproductive tissues in women. High
testosterone levels in a woman can result in irregular or absent menstrual
Hormonal birth control can also contribute to secondary
amenorrhea. Depo-Provera, a hormonal birth control shot, and hormonal birth
control pills may cause you to miss menstrual periods. Certain medical
treatments and medications, such as chemotherapy and antipsychotic drugs, can
also trigger amenorrhea.
Conditions such as polycystic
ovary syndrome (PCOS) can cause hormonal imbalances that lead to the growth
of ovarian cysts. Ovarian cysts are benign, or noncancerous, masses that
develop in the ovaries. The hormonal imbalances that result from PCOS can also
Scar tissue that forms due to pelvic infections or multiple dilation
and curettage (D&C) procedures can also prevent menstruation. D&C involves dilating the
cervix and scraping the uterine lining with a spoon-shaped instrument called a
curette. This surgical procedure is often used to remove excess tissue from the
uterus or to diagnose and treat abnormal uterine bleeding.
Body weight can potentially affect regular menstruation as well.
Women who are very overweight or who have less than 15 percent body fat may
stop getting menstrual periods. This is especially true for athletes who train
extensively or excessively.
Emotional stress is another possible cause of secondary
amenorrhea. Your body may respond to extreme stress by temporarily disrupting
your normal menstrual cycle. Your menstrual periods will most likely resume
once you work through your tension and anxiety.
of Secondary Amenorrhea
The primary symptom of secondary amenorrhea is missing several
menstrual periods in a row. Women may also experience:
- vaginal dryness
- deepening of the voice
- excessive or unwanted hair growth on the body
- changes in vision
- nipple discharge
Call your doctor if you have missed more than three consecutive
periods or if any of your symptoms become severe.
Your doctor will first want you to take a pregnancy test to rule
out pregnancy. Your doctor will then run a series of blood tests. These tests
will measure the levels of testosterone, estrogen, and other hormones in your
Your doctor may also use imaging tests to diagnose secondary
amenorrhea. MRI scans, CT scans, and ultrasound tests allow your doctor to view
your internal organs in more detail. Your doctor will be looking for cysts or
other growths on your ovaries or in the uterus.
for Secondary Amenorrhea
The treatment for secondary amenorrhea varies depending on the
underlying cause of your condition. Hormonal imbalances can be treated with
supplemental or synthetic hormones. Your doctor may also want to remove ovarian
cysts, scar tissue, or uterine adhesions that are causing you to miss your
Your doctor may also recommend making certain lifestyle changes
if your weight or exercise routine is contributing to your condition. Ask your
doctor for a referral to a nutritionist or dietitian, if necessary. These
specialists can teach you how to manage your weight and physical activity in a