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Women’s issues – How to handle no periods or Amenorrhea?

• Having no periods is also known as Amenorrhea.
• Amenorrhea is the absence of menstruation.
• Menstruation is a woman’s monthly period.
• Primary amenorrhea is when a girl has not yet started her monthly periods, and she:
– Has gone through other normal changes that occur during puberty.
– Is older than 15.

Causes, incidence, and risk factors

• Most girls begin menstruating between ages 9 and 18.
• An average age for periods is around 12 years old.
• Primary amenorrhea typically occurs when a girl is older than 15.
• She has undergone other normal changes that occur during puberty.

Primary amenorrhea may occur with or without other signs of puberty.
• Being born with poorly formed genital or pelvic organs
• Missing uterus or vagina
• Vaginal septum
• Cervical stenosis
• Imperforate hymen

Hormone problems can occur when:
• Changes occur to the parts of the brain where hormones that help manage the menstrual cycle are produced.
• The ovaries are not working correctly.
These problems may be due to:
• Genetic defects
• Infections that occur in the womb or after birth
• Other birth defects
• Tumors

Conditions associated with primary amenorrhea include:
• Adrenogenital syndrome
• Anorexia
• Chromosomal abnormalities such as Turner syndrome or Sawyer syndrome
• Congenital heart disease (cyanotic)
• Congenital adrenal hyperplasia
• Craniopharyngioma
• Chronic (long-term) illnesses
• Cushing’s disease
• Cystic fibrosis
• Gonadal dysgenesis
• Hypothyroidism and hyperthyroidism
• Hypogonadotropic hypogonadism
• Hyperprolactinemia
• Obesity
• Prader-Willi syndrome
• Polycystic ovarian disease
• Testicular feminization
• True hermaphroditism
• Tumors of the pituitary or adrenal glands
• Tumors of the ovaries

Diagnosis for No periods or Amenorrhea

1. Blood tests may include:
• Estradiol
• LH
• Prolactin
• T3 and T4

2. Other tests that may be done include:
• 17 hydroxyprogesterone
• Chromosome analysis
• Head CT
• Head MRI scan
• Laparoscopy
• Pelvic ultrasound
• Progesterone withdrawal
• Serum progresterone

Treatment for No periods or Amenorrhea

If the amenorrhea is caused by a tumor in the brain (pituitary tumor):
• Medications may shrink certain types of tumors.
• Surgery to remove the tumor may also be necessary.
• Radiation therapy is usually only performed when other treatments have not worked.

Expectations (prognosis)
If the amenorrhea is caused by one of the following conditions, there is a good chance that it can be corrected with medication, lifestyle changes, or surgery:
• Adrenogenital syndrome
• Chronic illness
• Congenital heart disease
• Drastic weight reduction
• Hypogonadotropic hypogonadism
• Imperforate hymen or vaginal septum
• Malnutrition
• Normal delay of onset (up to age 14 or 15)
• Obesity
• Overactive thyroid

Periods are unlikely to start on their own if the amenorrhea was caused by one of the following conditions:
• Congenital abnormalities of the upper genital system
• Craniopharyngioma
• Cystic fibrosis
• Gonadal dysgenesis
• Prader-Willi syndrome
• Testicular feminization syndrome
• True hermaphroditism
• Turner syndrome (XO)

Other Treatments

• If the amenorrhea cannot be corrected, it is sometimes possible to create a menstrual-like situation (pseudomenstruation) with medications.
• Medicines can help you feel more like your friends or family.
• Medications will also protect the bones from becoming too thin (osteoporosis).

Complications of No periods

• Emotional distress
• Osteoporosis and increased risk of fractures

Period. 105 Ways to Celebrate Menstruation The Athletic Woman’s Survival Guide

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