What are the causes of amenorrhea
The causes that lead to amenorrhea can be both pathological and non-pathological, so let’s distinguish the two types.
Non-pathological causes
The first factor to be taken into account in the absence of menstruation is also the most banal, namely pregnancy , a period in which the disappearance of the menstrual cycle is a completely physiological and natural event and which therefore should not cause concern. Therefore, if you suspect that you may be pregnant, you can carry out a pregnancy test yourself.
The interruption of the menstrual cycle is very frequent as a consequence of strong statesemotional stress , rapid and significant weight loss (especially in women suffering from anorexia), or following intense sports practice
. the correct modalities of assumption indicated by the doctor or that the amenorrhea occurs in the post-pill period .
Another natural cause of amenorrhea is the woman’s entry into menopause, a period that marks the end of her fertile age. Although it is a physiological phenomenon in a woman’s life, it must be kept under medical control since the implications on the cardiovascular system, on the bones, on the state of health and general well-being are numerous.
There are also drugs that can induce a more or less prolonged state of amenorrhea , such as chemotherapy, antidepressants and antihypertensive drugs.
In any case, it is recommended to contact your doctor who will evaluate the need to prescribe clinical tests and to contact medical specialists in gynecology to ascertain or exclude pathological pictures.
Pathological causes
On the other hand, there are pathological causes at the origin of the disorder which are often the consequence of hormonal imbalances, which are of primary clinical importance.
On the basis of hormonal imbalances, different types of amenorrhea are distinguished: normogonadotropic , hypogonadotropic , hypergonadotropic and from excess of androgens .
Let’s define the characteristics of each.
- Hypogonadotropic amenorrhea . The cause of this type of amenorrhea is due to the alteration of the functioning of the hypothalamus-pituitary axis . This alteration may be due to vascular episodes (such as the formation of thrombi in the blood vessels of the pituitary gland following childbirth), which lead to damage to the gland in question. But hormonal imbalance can also be due to severe stressboth physical and emotional, and from severe weight loss (anorexia). This form is found above all in young women who entered the fertile age as obese and then had a significant weight loss which led to a block of the function of the hypothalamus. In a small percentage (about 5%) of women the cause is attributable to a tumor;
- Normogonadotropic amenorrhea : in these cases the levels of gonadotropins (FSH hormone) are normal, therefore the cause is to be attributed to the uterus. The investigations will verify a possible agenesis (therefore lack of formation which takes the name of Rokitansky Syndrome ) of the uterus and uterine tubes, or the presence of signs of scraping or alterations of the anatomical structures following infections (in the case of the Syndrome Asherman ). Any malformations are also evaluated (there are malformations of the vagina that do not allow the outflow of menstrual blood) and if the patient has taken the contraceptive pill for long periods. In the latter case, amenorrheait will be reversible after its interruption;
- Hypergonadotropic amenorrhea: in this case the problem is not borne by the pituitary or hypothalamus , but instead of a genetic nature (as in the case of Turner syndrome for which there is no development of the ovaries). The best known form is the polycystic ovary , which is associated with the excessive presence of hair on the face and body of the woman (hirsutism) and hair thinning;
- Amenorrhea from excess androgens: the levels of hormones called androgens are too high and this determines the absence of a part of the structure of the uterus called endometrium.
How to diagnose amenorrhea
Let’s turn the page to analyze the matter.
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