Amenorrhoea is the absence of menstrual periods. It may be primary or secondary.
Primary Amenorrhoea:
Primary amenorrhoea occurs when a girl has not started menstruating by the age of 16.
Causes
Some common causes include:
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Genetic disorders such as Turner syndrome (one X chromosome is missing)
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Mayer-Rokitansky-Küster-Hauser syndrome, where the uterus is absent
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Hormonal imbalances, for example, hypogonadotropic hypogonadism
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Anatomical abnormalities such asan imperforate hymen or vaginal agenesis
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Chronic illnesses, including thyroid problems, diabetes, or tuberculosis
Secondary Amenorrhoea:
Secondary amenorrhoea occurs when a woman who previously had regular periods stops menstruating for three months or more.
Causes
Secondary amenorrhoea may be due to:
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Chronic diseases such as anaemia or tuberculosis
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Deficiency of vitamin D and calcium, which are needed for ovulation
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Hormonal imbalances like PCOS, thyroid disorders or high prolactin
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Pregnancy or breastfeeding
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Weight changes or extreme exercise
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Athletes may develop amenorrhoea when prolactin increases
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Stress or emotional trauma
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Certain medications, for example:
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proton pump inhibitors (pantoprazole, omeprazole)
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antidepressants and antipsychotics
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Underlying medical conditions such as premature ovarian failure or pituitary gland disorders
Common Symptoms
The main symptom is the absence of periods. However, other symptoms may also occur.
Hormonal changes
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Mood swings
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Weight gain or loss
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Hair loss or excessive hair growth
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Acne
Infertility
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Difficulty conceiving
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Irregular ovulation
Additional symptoms
Depending on the cause, women may experience:
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Hot flashes (menopausal symptoms)
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Galactorrhea (milk discharge without breastfeeding)
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Headaches or vision problems (pituitary issues)
Symptoms from underlying disease
For example, tuberculosis may cause:
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Cough
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Weight loss
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Loss of appetite
Treatment Options:
Treatment depends on the underlying cause. After a proper diagnosis, options may include:
1. Medication
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Correction of anaemia, thyroid disorder or high prolactin
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Treatment of diabetes or raised insulin levels
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Vitamin D and calcium supplements
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Birth control pills or patches to regulate cycles
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Hormone replacement therapy (HRT)
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Medicines to stimulate ovulation for infertility
2. Lifestyle changes
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Maintain a healthy weight with diet and exercise
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Reduce stress using yoga, meditation or relaxation techniques
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Improve sleep habits
3. Surgery
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Correct anatomical problems (such as hymenectomy)
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Remove tumours or cysts causing a hormonal imbalance
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Remove intra-uterine scarring to allow the lining to grow again
Conclusion
Amenorrhoea can have many causes. Fortunately, with correct diagnosis and treatment, most women can regain regular menstrual cycles and improve their overall health. It is always important to consult a healthcare provider for personalised advice.