Causes of amenorrhea are many and many of the causes of amenorrhea are due to normal physiological process of a woman’s life, such as before starting of menstrual cycle or menarche, pregnancy, breast feeding and menopause. However, if amenorrhea is due to other causes, it is an indication of a medical problem and need to consult your doctor for it. Causes of amenorrhea include,
Normal physiological causes of amenorrhea:
- Before menarche or before starting of first menstruation
- Breast feeding. In breastfeeding women menstruation may be delayed by several months after delivery
- Menopause (and pre-menopause)
Contraceptives may cause amenorrhea:
In some women taking oral contraceptives (OCP), menstrual bleeding may not start even after stopping the contraceptive. However, it usually start after delay of few weeks or months and ovulation and menstruation occurs normally.
Medications and amenorrhea:
Some medications may cause menstruation to stop, such as
- Cancer chemotherapy agents
- Antipsychotics, antidepressants
- Some antihypertensive used for lowering BP
- Anti-allergy medications
Hormonal imbalance may cause amenorrhea:
Various hormonal problems may have amenorrhea as a symptoms, they are
- Abnormal thyroid function: hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause menstrual irregularities, including amenorrhea.
- PCOS or polycystic ovary syndrome: PCOS may cause menstrual abnormality and amenorrhea. PCOS lead to sustained high level of hormone instead of fluctuating hormone level in normal females.
- Tumor in pituitary gland lead to abnormal hormone level and may cause amenorrhea.
- Premature menopause for any reason lead to amenorrhea earlier than usual. Menopause starts much before usual age of around 50 years in such women.
Anatomical abnormality as cause of amenorrhea:
Various anatomical abnormality related to reproductive organs lead to amenorrhea. These include,
- Absence of some reproductive organ due to fetal developmental problems. In some girls, uterus, vagina or cervix may be abnormal or absent, leading to amenorrhea.
- Scar tissue may develop in the lining of uterus in some women after some medical procedures such as D & C (dilatation and curettage), cesarean section, removal of uterine fibroid etc. Due to scar tissue in the lining of uterus normal buildup and shedding of uterus lining as occurs in menstrual cycle cannot happen and amenorrhea results.
- Anatomical abnormality in vagina may prevent visible menstrual bleeding. Some membrane or wall may obstruct bleeding outflow.
Lifestyle and amenorrhea:
Certain factors may result in amenorrhea, such as
- Too much severe exercise may cause amenorrhea. Athletes, ballet dancers may not menstrual bleeding due to excess exercise.
- Low bodyweight may cause amenorrhea due to abnormal hormonal functions. Eating disorder anorexia nervosa is associated with underweight and amenorrhea. Bulimia nervosa, another eating disorder may also cause amenorrhea.
- Mental stress may sometime affect normal functioning of hypothalamus and may lead to abnormal hormone levels and amenorrhea.
Image courtesy of [stockimages] at FreeDigitalPhotos.net