In the last post we started a discussion on missing periods, especially for teenagers who have never had a period before which is primary amenorrhea. This time we will be talking about periods that that once were but have seemed to have gone AWOL for one reason or the other. This is known as secondary amenorrhea.
So first thing to rule out for any sexually active female whose period hasn’t shown up for the month is…….Pregnancy of course. So if you’ve been indulging in sexual activity and suddenly your period refuses to show up, first thing to do is pee on a stick. I.e, take a urine pregnancy test. These are typically available at your local pharmacy for as little as 50 bucks and can tell you if you’re pregnant from as early as the first day of your missed period. However a more effective test would be a blood pregnancy test which can be carried out at any diagnostic centre near you.
Now after a pregnancy has been ruled out, it’s time to think about other things that may be causing a delayed or missing period.
Missing one menstrual period is rarely a sign of a serious problem or an underlying medical condition, but amenorrhea of longer duration may signal the presence of a disease or chronic condition
Some women who use certain types of contraception may not have periods. Even after stopping oral contraceptives, it may take some time before regular ovulation and menstruation return. Contraceptives that are injected or implanted also may cause amenorrhea, as can some types of intrauterine devices.
Intensive exercising, extreme weight loss, physical illness, and stress can all result in amenorrhea. Several factors combine to contribute to the loss of periods in athletes, including low body fat, stress and high energy expenditure.
Many types of medical problems can cause hormonal imbalance, including:
- Polycystic ovary syndrome (PCOS). PCOS causes relatively high levels of hormones, rather than the fluctuating levels seen in the normal menstrual cycle.
- Thyroid malfunction. An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) can cause menstrual irregularities, including missing periods.
- Pituitary tumor. A noncancerous (benign) tumor in the pituitary gland can interfere with the hormonal regulation of menstruation.
- Premature menopause. Menopause usually begins around age 50. But, for some women, the ovarian supply of eggs is exhausted before age 40, and menstruation stops.
- Another interesting cause of missed periods is Uterine scarring otherwise known as Asherman’s syndrome, a condition in which scar tissue is formed in the lining of the uterus. It can sometimes occur after a dilation and curettage (D&C), cesarean section or treatment for uterine fibroids. Uterine scarring prevents the normal buildup and shedding of the uterine lining.
As stated earlier, one missed period may just be a case of Aunt Flo being a little shy, but 3 consecutive missed periods is definitely cause to book an appointment with a gynaecologist ASAP so that appropriate investigations can be commenced.
