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Types of Amenorrhea
At Footsteps To Fertility Centre located in Nairobi, Kenya, we are honored to have helped thousands of couples and single mothers receive the gift of parenthood and being given the opportunity to guide them through their difficult period of infertility.
There are two types of Amenorrhea. They include ;
Primary amenorrhea is when a young woman has not had her first period by the age of 16.
Secondary amenorrhea is when a woman who has had normal menstrual cycles stops getting her monthly period for three or more months.
Diagnosis For Amenorrhea
The commonest reason for missing a period in infertile women is anovulation.
The list of causes looks very intimidating; and you may be completely confused as to what the possible diagnosis in your case is. However, let me try to simplify this, so it’s easier for you to make sense of what the doctor will do.
Let’s start with the basics. In order to get a period, you basically need just two things:
a uterus, which sheds its uterine lining as a period
hormones ( estrogen and progesterone) which act on the uterine lining, and cause it to shed
If you miss a period, this means there are only 2 broad possibilities.
There’s a problem with the uterus. Thus, is may be damaged ( because of intrauterine adhesions)
. There’s a problem with the reproductive hormones . Their levels may be too low; or too high; or out of balance
The first test the doctor may do is a vaginal ultrasound scan to check your uterus; and your uterine lining. If this is normal, then it’s likely the problem is with your hormones.
Sometimes, the doctor may give you hormones as a therapeutic trial to see if this can induce your period. This is called a progesterone challenge test; and consists of 5 days of 20 mg medroxyprogesterone daily. Thus, if you get your periods after taking progesterone, this means your uterus is fine; that you have high estrogen levels; and that you are not producing progesterone on your own (this is the picture classically found in women with PCOD).
If you do not get your periods after taking the progesterone, this means either that your uterus is damaged; or that you are not producing enough estrogen.
The other possibilities include: pregnancy; and the possibility of a functional ovarian cyst ( which can produce estrogen and progesterone and delay the period)
If you miss your periods, your doctor will have to run tests in order to find out what the problem is. If you keep an accurate menstrual diary, this will help the doctor in making the right diagnosis. When was your last period? Was it normal? What were your periods like before this?
Treatment For Absence of Menses
The treatment depends on the cause of your amenorrhea. Options for treatment include:
Medicines that help control abnormal hormone levels
Surgery for tumors of the pituitary, ovaries, or adrenal glands
Counseling about how to eat a balanced diet, keep a healthy weight, and cope with stress.
Your doctor might also prescribe estrogen therapy to relieve hot flashes and vaginal dryness and to protect your bones.Calcium and vitamin D supplements, along with strength training, also help keep your bones strong. If you are trying to get pregnant, other treatments might be needed.