Amenorrhea is a medical condition experienced by women of mature age, which normally should be fitted to procreate, described by the lack of menstruation.
A woman of childbearing age (11-48 up to 50 years) normally experiences a menstrual cycle starting with 23 up to 36 days.
The regularity of the menstruation is governed by the hypothalamus, the same brain portion responsible with fluid electrolyte balance, body temperature, blood pressure and the appetite. It also stimulates the pituitary gland which is located near the brains’ base and governs the reproductive cycle by releasing lutropin, known as the luteinizing hormone a follicle stimulating hormone which thus influences the estrogen and progesterone production, hormones which trigger cyclic changes inside women’s uterus, and one of this changes being the monthly menstruation.
A regular menstrual cycle involves the proper function of woman’s reproductive system: uterus and ovaries and also of the glandular system: hypothalamus, and pituitary gland. Moreover, the anatomy of her vagina and cervix influences the quantity of menstrual blood and offers a normal or abnormal blood flow.
Gynecologists differentiate 2 types of amenorrhea:
Primary amenorrhea also known as delayed menarche, it is a condition triggered by late puberty usually normal for extremely thin or athletic girls, and is characterized by the delay of the first menstrual period or menarche past the age of 16. This condition is normally caused by the abnormal development of the young woman’s body which fails to accumulate puberty-related body-fat which helps the body to start the menstrual cycle; other possible cause of primary amenorrhea is having a dysfunctional reproductive system or moreover, though a rare condition, due to the Turner Syndrome, a genetic abnormality related to women’s sex chromosomes.
Secondary amenorrhea appears in women who have experienced their menarche but they haven’t had their menstruation in a three months period.
The most common cause of secondary amenorrhea is pregnancy but also it can be triggered by a variety of other causes as post-natal lactation, the menopause, the natural end of menstruation after the age of 40-45 years, if menopause starts before the age of 40, it can be caused by premature ovarian failure, the cessation of birth-control pills’ use or the use of birth-control pills with a high concentration of long acting progesterone, can also trigger amenorrhea. The surgical procedure known as hysterectomy (total or partial removal of the uterus) and the existence of pituitary gland tumors (prolactinomas) can also be causes of amenorrhea, along with the polycystic ovary disease which determinates elevated or very low estrogen levels and abnormal levels of luteinizing hormones, Crushing’s syndrome – an endocrine disorder characterized by elevated cortisol and adrenal levels- hyperthyroidism –abnormal high levels of thyroid hormone.
Chemotherapy can also interfere in the regularity of menstrual cycle causing amenorrhea; also ovarian tumors or cysts are likely to trigger this condition, and other causes can be the presence of a chronic condition as cystic fibrosis, kidney failure or colitis.
On the other hand this abnormal condition can be determined by less serious conditions like physical, intellectual of emotional stress, obesity, sudden weight loss or frequent strenuous exercises.
Although amenorrhea affects only a small part of female population, it has to be a concerning problem as it can be the symptom of a much serious medical condition.