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Birla Fertility & IVF
Birla Fertility & IVF

Amenorrhea Treatment: Restoring Balance to Your Menstrual Cycle

  • Published on August 10, 2023
Amenorrhea Treatment: Restoring Balance to Your Menstrual Cycle

According to a study conducted in India, Primary Amenorrhea affected 11.1% of adolescent females who sought gynecological care for menstrual abnormalities. However, in the United States, the disease only affects fewer than 1% of women.

What is Amenorrhea?

In women, amenorrhea is a medical disorder marked by the absence of menstrual cycles during their reproductive years. There are different types of amenorrhea:

  • Primary amenorrhea: A woman has not experienced her first period by the age of 16.
  • Secondary amenorrhea: During this condition, a woman who had previously experienced regular menstrual cycles ceases menstruating for three or more consecutive months, are the two categories into which it can be divided.

Causes of Amenorrhea

Amenorrhoea condition can be caused by various factors such as hormonal imbalance, lifestyle factors, chronic medical conditions, congenital defects, structural abnormalities, etc. Additionally, treatment and techniques determined by the expert are typically dependent on the underlying cause and factors of the condition. The various amenorrhea treatments will be covered in this article, along with their efficacy and possible side effects.

Diagnosis of Amenorrhea

To determine the underlying cause of the absence of menstrual cycles, a thorough medical evaluation is required for the diagnosis of amenorrhea. The steps in the amenorrhea diagnosis generally include:

Medical History: The first step in diagnosis involves reviewing the medical record of the patient and getting a thorough medical history from the patient. This will include details like:

  • The patient’s menstrual history,
  • Age at which puberty began,
  • Previous menstrual patterns,
  • Any recent changes to their weight or exercise routines,
  • the presence of any other symptoms or medical conditions

Physical examination: A thorough physical assessment will be performed by an expert to determine the patient’s overall health, including:

  • Body weight,
  • The distribution of body fat,
  • Any abnormal findings in the pelvic area
  • any indicators of androgen excess (such as excessive hair growth)

Evaluation of Hormones: Blood tests will be done to determine hormone levels, including:

  • Elevated follicle-stimulating hormone (FSH) levels may be a sign of menopause or primary ovarian failure.
  • Luteinizing hormone (LH) levels that are out of the ordinary can shed light on ovulation and hormonal abnormalities.
  • Thyroid hormones: Since amenorrhea can be caused by thyroid dysfunction, thyroid hormone levels (TSH, T3, and T4) will be examined.

Prolactin: It will be evaluated since high prolactin levels can cause amenorrhea.

Imaging investigations: Imaging tests may generally be carried out to see the reproductive organs and find any structural abnormalities in the body, specifically in the pelvis region. This may consist of:

  • Ultrasound: To check for any anomalies in the uterus, ovaries, and other pelvic organs.
  • MRI or CT scan: These imaging procedures can offer more in-depth knowledge about the genitalia and the pituitary gland, which is essential in controlling menstruation.

Tests for Ovarian reserve: Diagnostic tests to evaluate ovarian reserve, such as the antral follicle count and anti-Müllerian hormone (AMH) levels, may be performed on women suspected of experiencing premature ovarian failure.

Progestin Challenge Test: A progestin challenge test may be carried out when the reason for amenorrhea is uncertain. This entails taking progestin medicine for a few days and then keeping an eye out for withdrawal bleeding, which can show healthy oestrogen levels and an intact uterus.

Genetic screening: It is usually advised in some circumstances to look for any chromosomal or genetic anomalies connected to amenorrhea.

Amenorrhea Treatments

After a thorough diagnosis of the condition, amenorrhea treatment options can range from hormonal medications to surgical techniques, depending on the underlying cause. The expert will determine the technique for effective results after amenorrhea treatment. Some of the amenorrhea treatment methods include:

Hormonal treatment for amenorrhea: To begin with, an expert may recommend the following hormonal therapies:

  1. Birth control: Combination oral contraceptives are frequently administered to women whose amenorrhea is brought on by hormonal abnormalities, such as polycystic ovary syndrome (PCOS) or dysfunction of the hypothalamus. Oral contraceptives that include oestrogen and progestin can control hormone levels and trigger regular menstrual cycles.
  2. Progestin Therapy: In some situations, women with secondary amenorrhea brought on by anovulation or irregular cycles may be offered progestin-only drugs to encourage uterine lining shedding and initiate monthly flow.

Hormone Replacement Treatment (HRT): HRT may be advised for women who experience primary or secondary amenorrhea due to menopause or early ovarian failure. In HRT, oestrogen and progesterone are given to imitate the hormonal balance that prevails during the reproductive years.

Medication: The expert may advise a few medications and fertility drugs to stimulate the ovaries for normal function. Some of the common fertility drugs that are generally advised during amenorrhea treatment are:

  1. Clomiphene Citrate, which is frequently prescribed to women with amenorrhea brought on by PCOS or other ovulatory problems, The hormones that cause ovulation are stimulated to release when clomiphene citrate is taken.
  2. Human Chorionic Gonadotropin(hCG): In some instances, women who do not respond to clomiphene citrate or who have other fertility concerns use hCG injections to trigger ovulation.

Surgical procedures: In some cases, an expert may advise surgical intervention based on the severity of the condition. Some of the surgical techniques involve:

  1. Ovarian drilling, is an alternative method for surgical treatment advised to patients with PCOS in order to control insulin resistance. This helps in lowering the levels of androgen (male hormone) production and increases ovulation, tiny holes are created in the ovaries using heat or lasers.
  2. Uterine Surgery: Amenorrhea may be brought on by structural issues with the uterus, such as uterine adhesions or fibroids. Surgery can be used in these situations to resolve these problems and restore menstrual function.

Changes in Lifestyle: During the minor stage, the doctor will recommend some lifestyle modifications in order to increase the quality of life and to improve the symptoms of amenorrhea:

  1. Weight Management: Hormonal balance depends on maintaining a healthy weight. Gaining weight or cutting back on strenuous exercise may help restore regular menstrual periods in women who have amenorrhea as a result of excessive exercise or low body weight.
  2. Stress management: Excessive stress might interfere with the hormonal system that regulates menstruation. For women with amenorrhea brought on by stress-related issues, stress reduction treatments like meditation, yoga, or counselling may be helpful.

Psychological Support: Amenorrhea condition can also be influenced by emotional and psychological factors. Therapy or counselling may be helpful for some women in resolving emotional problems associated with amenorrhea and fostering a positive outlook.

In order to identify the underlying cause and create a suitable treatment plan, it is imperative for women who are experiencing amenorrhea to speak with an expert specialist for effective and suitable treatment.

Conclusion

As a result, amenorrhea requires a diverse approach to therapy because it is a complicated disorder with a variety of underlying causes. The amenorrhea treatments given here aim to treat the specific cause of amenorrhea and help affected patients resume normal menstrual cycles. However,  The efficacy of the aforementioned amenorrhea treatments may vary depending on certain aspects, and your specialist will personalise the treatment strategy in accordance with each woman’s unique demands and medical background. These options range from hormone therapy to lifestyle modifications and surgery. For the best results with any medical problem, early diagnosis and specialised care are crucial. If you have been diagnosed with amenorrhea and are looking for effective treatment in order to conceive a baby, consult our fertility specialist today.

Frequently Asked Questions (FAQs)

  • What are the complications of amenorrhea?

Here are a few major complications of amenorrhea:

  • Infertility
  • Low bone density (if left untreated)
  • Hormonal imbalance
  • Which deficiency can result in amenorrhea?

A deficiency of calcium and vitamin D has the potential to result in amenorrhea.

  • Can amenorrhea be cured through medicines only?

Not really, the treatment for amenorrhea depends on the severity of the condition and the type of factor by which amenorrhea is caused. The technique of amenorrhea is determined by the doctor, and it is difficult to say that it can be treated only through medicines.

Written by:
Dr Rachita Munjal

Dr Rachita Munjal

Consultant – Birla Fertility and IVF
Dr Rachita Munjal completed her MBBS from Dr D. Y. Patil Medical College, Hospital & Research Centre, Pune and MS (Obstetrics and gynaecology) from Dr. D.Y Patil Vidyapeeth Pune. She has also completed her DAGE (Diploma in Advanced Gynae Endoscopy) from Germany and MRCOG-I (Royal College of Obstetricians & Gynaecologists, UK) Membership Examination.

Over 14 years of experience

Gurgaon, Haryana

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