Periods can be quite bothersome. The whole unprovoked bleeding from your vagina and having to wear pads and change ever so often. Not to forget the cramps and leg pain and bloating that are associated with that time of the month.
However it is a necessary part of the female reproductive course.
And not seeing your period may be a sign that something is not quite right.
Missing your period for one month may not be something to worry about, but three consecutive missed periods is definitely a reason to see a gynaecologist as soon as possible.
There are a variety of reasons why your period may be absent. In sexually active women, the most common one is pregnancy. A missed period in a sexually active woman should prompt a pregnancy test to be done. When this is negative then other possible causes should be investigated.
The menstrual cycle is hormonally regulated therefore any medical problem that results in a hormonal imbalance can cause periods to cease.
Examples of this include:
- Polycystic ovary syndrome (PCOS). PCOS causes relatively high and sustained 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 changes in the menstrual cycle, including absent periods.
- Pituitary tumor. A noncancerous (benign) tumor in your 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 reduces drastically before age 40, and menstruation stops.
Problems with the sexual organs themselves also can cause amenorrhea. Examples include:
- Uterine scarring. Asherman’s syndrome, a condition in which scar tissue builds up in the lining of the uterus, can sometimes occur after a dilation and curettage (D&C), cesarean section or fibroid surgery. This prevents the normal buildup and shedding of the uterine lining (which is what comes out of the vagina as menstrual blood)
- Structural abnormality of the vagina. An obstruction of the vagina may prevent visible menstrual bleeding. A membrane or wall may be present in the vagina that blocks the outflow of blood from the uterus and cervix. Women with this problem experience regular period symptoms, however they just don’t see the expected bleeding.
Sometimes lifestyle factors contribute to amenorrhea, for instance:
- Low body weight. Excessively low body weight can interrupt many hormonal functions in your body, including ovulation. Women who have an eating disorder, such as anorexia or bulimia, often stop having periods because of these abnormal hormonal changes.
- Excessive exercise. Women who participate in activities that require rigorous training, such as athletes, may find their menstrual cycles interrupted. Several factors combine to contribute to the loss of periods in athletes, including low body fat, stress and high energy expenditure.
- Stress. Mental stress can temporarily alter the functioning of an area of your brain that controls the hormones that regulate your menstrual cycle. Ovulation and menstruation may stop as a result. Regular menstrual periods usually resume after your stress decreases.
Investigations that may be carried out include blood tests to check the hormone levels, ultrasound scan of the pelvis to check the uterus for any structural abnormalities and rule out the possibility of cysts in the ovaries.
Treatment for a missing period would depend on the cause. It is best to report any symptoms to a gynecologist, including an possible changes in lifestyle and current medication as these could also help in finding the root cause.
