menstrual disorders and abnormal vaginal bleeding
women s health issues
Absence of Menstrual Periods
Conditions that can cause amenorrhea include hormonal disorders, birth defects, genetic disorders, medications, and illicit drugs. The most common reason for amenorrhea in women who are not pregnant or breastfeeding is Malfunction of any part of the hormonal system (hypothalamus, pituitary gland, and ovaries) When this system malfunctions, the ovaries do not release an egg. The type of amenorrhea that results is called ovulatory dysfunction. Amenorrhea can also result from conditions that affect the uterus, cervix, or vagina. Less commonly, the hormonal system is functioning normally, but another problem prevents periods from occurring. For example, menstrual bleeding may not occur because the uterus is scarred (Asherman syndrome), because the cervix is narrowed (cervical stenosis), or because a birth defect blocks the flow of menstrual blood out of the vagina. Which causes are most common depends on whether amenorrhea is primary or secondary. The disorders that cause primary amenorrhea are relatively uncommon, but the most common are A genetic disorder A birth defect of the reproductive organs that blocks the flow of menstrual blood (such as an Imperforate hymen ) Genetic disorders include Turner Syndrome None Kallmann syndrome None Overproduction of male hormones by the adrenal glands ( Congenital adrenal hyperplasia ) Genital Birth Defects that result in ambiguous—neither male nor female—genitals (pseudohermaphroditism or true hermaphroditism) Disorders that result in having a Y chromosome (which normally occurs only in males). Genetic disorders and birth defects that cause primary amenorrhea may not be noticed until puberty. These disorders cause only primary amenorrhea, not secondary. Sometimes puberty is delayed in girls who do not have a disorder, and normal periods simply begin at a later age. Such Delayed Puberty may run in families. Themost common causesare Pregnancy Breastfeeding Malfunction of the hypothalamus Polycystic Ovary Syndrome (PCOS) None Premature Menopause (primary ovarian insufficiency) Malfunction of the pituitary gland or the thyroid gland Use of certain medications, such as birth control pills (oral contraceptives), antidepressants, or antipsychotic medications Pregnancy is the most common cause of amenorrhea among women of childbearing age. Thehypothalamusmay malfunction for several reasons: Stress or excessive exercise (as done by competitive athletes, particularly women who participate in sports that involve maintaining a low body weight) Poor nutrition (as may occur in women who have an Overview of Eating Disorders or who have lost a significant amount of weight) Mental disorders (such as Depression or Radiation therapy to the brain or a brain injury Thepituitary glandmay malfunction because It is damaged by a disorder (such as a tumor) or a head injury. Levels of prolactin are high. Antidepressants, antipsychotic medications, oral contraceptives (sometimes), or certain other medications can cause prolactin levels to increase, as can pituitary tumors and some other disorders. may cause amenorrhea if it is underactive (called Hypothyroidism ) or overactive (called Less common causesof secondary amenorrhea include chronic disorders (particularly of the lungs, digestive tract, blood, kidneys, or liver), some autoimmune disorders, cancer, HIV infection, radiation therapy, head injuries, a hydatidiform mole (overgrowth of tissue from the placenta), Cushing syndrome, and malfunction of the adrenal glands. Scarring of the uterus (usually due to an infection or surgery), polyps, and fibroids can also cause secondary amenorrhea. Genetic disorders, such as Fragile X Syndrome , may cause menstrual periods to stop early ( 