AMENORRHEA (1):

What is amenorrhea, and when should you be concerned about the absence of menstruation?

Dr. Claude Allouche, gynecologistAmenorrhee1 english
Ahuza Clinic, Raanana
058 726 02 64

Amenorrhea is the absence of menstruation (also called periods) in a woman of reproductive age. It is normal during pregnancy, breastfeeding, and menopause.
Otherwise, an evaluation is necessary to determine the cause.

WHAT IS AMENORRHEA?

Amenorrhea is the absence of menstruation in a woman of reproductive age.

There are two types of amenorrhea:

  • PRIMARY when an adolescent has not had her first period by age 16. The normal age for the first period is between 10 and 15 years;

  • SECONDARY when periods have not occurred for more than three months in a woman who previously had regular cycles. This is the more common situation.

Amenorrhea is normal in three cases:
It is a symptom of a dysfunction in the female body except in the following three "natural" or "physiological" situations of secondary amenorrhea:

  • Pregnancy;
  • Breastfeeding;
  • Menopause.

HOW TO EXPLAIN THE REGULARITY OF MENSTRUAL CYCLES AND THE OCCURRENCE OF PERIODS?

Between puberty and menopause (outside of pregnancy), periods are regular.
They occur on average every 28 days (between 26 and 31 days). This regularity indicates that the uterus, ovaries, pituitary gland, and hypothalamus are functioning normally.

Periods mark the beginning of the menstrual cycle, which consists of two phases separated by ovulation.

ABSENCE OF MENSTRUATION: WHEN TO CONSULT?

If you experience a delay in your period or an absence of menstruation, the course of action depends on your personal situation.

  1. You think you are pregnant

The absence of menstruation on the expected date or amenorrhea is the first sign of pregnancy. However, it is not a sufficient sign of pregnancy because some women have irregular cycles. Stress, sports, or travel can also delay periods.

Initially, you can take a pregnancy test, available at pharmacies or large stores. The principle is to detect the presence of pregnancy hormone (human chorionic gonadotropin or HCG) in your morning urine. This hormone appears 10 days after fertilization, and the reliability of these tests is 95%.
If the test is positive or if you have doubts, even after a negative test, consult your doctor. In some cases, they may request a blood test (to measure Beta HCG levels).

  1. You are breastfeeding

If you decide to breastfeed your baby, the return of your periods (known as the “return of menstruation”) is postponed until the end of breastfeeding. Therefore, it is normal not to have your periods while breastfeeding.
Breastfeeding triggers the production of a hormone called prolactin in the mother, which blocks ovulation.

However, beware of the risk of pregnancy! Breastfeeding has a contraceptive effect only under certain conditions. You should still use contraception to avoid becoming pregnant again.

  1. You are approaching menopause

Before menopause, you may experience a period called perimenopause, with the following signs:

  • Irregular periods;
  • Premenstrual syndrome (before your period): breast tenderness and mood swings;
  • The first hot flashes and night sweats appear. These are known as “climacteric” symptoms.

Perimenopausal symptoms typically begin around age 47 and are due to a progesterone deficiency, one of the main female hormones. Estrogen secretion is preserved.

Eventually, your periods stop permanently. Menopause is a natural phenomenon. It occurs when the ovaries stop producing hormones (estrogens and progesterone) and eggs. Climacteric symptoms lessen or persist. Menopause is fully established when periods have been absent for a year.

Talk to your doctor during your next consultation.

What is the Mechanism of Menopause?

Menopause is a natural event in the aging process of a woman. It marks the end of the menstrual cycle and the ability to conceive.

During a woman’s fertile years, hormones such as estrogen and progesterone fluctuate in a continuous cycle to prepare the female body for menstruation, conception, and pregnancy.

When this repeated hormone release decreases, menopause begins. Menopause naturally occurs around the age of 50 or earlier if it results from the removal of the ovaries.

Symptoms vary from woman to woman. Some experience few or no symptoms, while others have various symptoms ranging from mild to severe. Menopausal symptoms include the absence of monthly periods, vaginal dryness, hot flashes, and mood swings.

Due to the decrease in estrogen levels, menopausal women have an increased risk of osteoporosis and heart disease. Patients and their doctors should discuss the risks and benefits of hormone replacement therapy.

If periods have not started by age 16 or have been absent for more than three months, consult your doctor. They will investigate the cause as this situation indicates a dysfunction in the body.

In summary:
Amenorrhea is the absence of menstruation in a woman of reproductive age. It is normal during pregnancy, breastfeeding, and menopause. Otherwise, an evaluation is needed to determine the cause.

Want to know more? Visit my website at https://claude-allouche.com

Source: https://www.ameli.fr