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Amenorrhea Secondary : Types, Symptoms, Causes, Diagnosis, Treatment, Prevention, General Home Care of Amenorrhea Secondary

Amenorrhea is the name given to the condition when a woman fails to have menstrual periods. The condition is known as "primary amenorrhea" when the woman has never menstruated; and "secondary amenorrhea" if her periods cease after having been regular for months or years

Types Of A menorrhea :

PRIMARY AMENORRHEA

SECONDARY AMENORRHEA

Primary Amenorrhea:

It occurs when a woman has not had her first menstrual period (menarche) by age 16. Primary amenorrhea is also called "delayed menarche," it is most often due to late puberty, which is fairly common in teenage girls who are very thin or very athletic. In other girls, the delay of menstruation may be due to Turner's syndrome, a genetic disorder involving the sex chromosomes, or to abnormal female reproductive organs.

Secondary Amenorrhea:

It happens when a woman who has menstruated previously fails to menstruate for three months. This type of amenorrhea can be caused by:

Pregnancy

Breastfeeding

Menopause, the normal age-related end of menstruation

Surgical removal of the uterus

Stopping birth control pills

Tumors of the pituitary gland

Emotional or physical stress

Rapid weight loss

Obesity

Frequent strenuous exercise

Chronic (long-term) illness, such as colitis, kidney failure or cystic fibrosis

Chemotherapy for cancer

Cysts or tumors in the ovaries

Symptoms of Amenorrhea Secondary

Amenorrhea means the absence of or the suppression of menses. It is a condition in which there is suspension or temporary cessation of the discharge after it has been regularly established. This may be sudden in its onset, violent and accidental suppression or it may come on in gradual manner. The more sudden the suppres­sion, the more violent and severe will be the re­sulting symptoms. The consequence of sudden suppression may be severe spasmodic pains in the stomach and bowels, often attended with retching to vomit, fever, headache, flushed face, wild delirium, convulsions, hysteria, palpitation of the heart, difficulty of breathing, etc. When the suspension of the discharge is gradual, or arises from causes operating in the interval, the evil consequences will not appear so suddenly. The lady will become pale, languid and. debili­tated; loses her appetite and ambition; looks sickly and dejected; feet and ankles swell; ner­vous symptoms set in; palpitation of the heart; shortness of breath; and in persons predisposed to consumption that disease is most sure to fol­low.

Causes of Amenorrhea Secondary

There are many causes which may result in the suppression of menses. Exposure to cold and damp, getting feet wet and sitting on damp floor are most common causes of this obstruction. It may also be due to sudden and powerful men­tal emotions and grief. Diseases of the chest, liver and of the organs directly concerned may also give rise to suppression. Besides this there may be other causes like sedentary and indo­lent life of luxury with no exercise, "excessive sexual indulgence, mechanical obstruction, tight clothes obstructing flow of blood, excessive hem­orrhage, catching sudden chill and any acute or chronic disease.

Diagnosis of Amonorrhea

Diagnosis begins with a gynecologist evaluating a female's medical history and a complete physical examination including a pelvic examination. A diagnosis of amenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, a diagnosis of amenorrhea requires that a female has missed at least three consecutive menstrual cycles, without being pregnant. Young women who have not had their first menstrual period by the age of 16 should be evaluated promptly, as making an early diagnosis and starting treatment as soon as possible is very important.

Tests include:
1.Physicalexamination and medical history
2.Urine pregnancy test
3.Progesterone withdrawal
4.Chromosome analysis
5.Serum chemistry (serum gonadotropin)
6.LH and FSH
7.Prolactin
8.TSH and T3 and T4
9.Urine chemistry, 17-ketosteroids
10.Head CT and MRI scan
11.Ultrasound of pelvic region and Laparoscopy

Treatment of Amenorrhea Secondary

Your physician may prescribe various types of hormones to see whether your ovaries are functioning normally.

Provided no underlying disorder is causing the amenorrhea, treatment is generally unnecessary. However, because women who are not menstruating seem susceptible to osteoporosis, your physician may suggest that you take estrogen and a calcium supplement.

If an underlying disorder is to blame for either primary or secondary amenorrhea, the treatment will depend on the nature of the disorder

Prevention of Amenorrhea Secondary

PRIMARY AMENORRHEA

In many cases, teenage girls can help to prevent primary amenorrhea by following a sensible exercise program and by maintaining a normal weight for their height and age. Primary amenorrhea caused by anatomic abnormalities of the reproductive tract cannot be prevented.

SECONDARY AMENORRHEA

Secondary amenorrhea that is related to diet, over-exercise or stress, can be treated by following simple steps:

Eat a low-fat diet that meets your recommended daily nutritional needs.

Exercise moderately, but not excessively, to maintain an ideal body weight and muscle tone.

Find healthy outlets for emotional stress and daily conflicts.

Balance work, recreation and rest.

General Home Care of Amenorrhea Secondary

Amenorrhea in itself causes no problems except that it means a woman cannot get pregnant while it lasts.

If there is some underlying disorder that needs to be treated, periods will usually re­turn with restored health.

If spotting happens at the time when nor­mally menstrual period is expected, patient could possibly be pregnant.

Avoid tea, coffee and alcohol, eat lots of raw vegetables and take moderate exercise regu­larly.

CALL THE DOCTOR

If there is no ill health or pregnancy and periods have not returned after two to three months, consult your doctor.

Unexplained spotting persists for more than three months.

If it is accompanied by fever or pelvic pain.