Characteristics of amenorrhea

This article was endorsed by Néstor Zumaya Cárdenas - M.D & Medical Surgeon from the National Autonomous University of Mexico

What is amenorrhea?

Amenorrhea is the temporary or permanent lack of menstruation. It is a disease in which there are delays in the period. The period or menstruation is the bleeding that naturally occurs in women in a cyclical way every month.

The bleeding is a consequence of the detachment of the endometrial tissue, which is the mucosa that covers the walls of the uterus. The lining of the uterus or endometrium had thickened to accommodate and feed a possible fertilized egg.

This tissue comes off because the egg in the ovary has not been fertilized, therefore it is no longer useful and is expelled outside through the vagina.

Menstrual fluid is made up of endometrial tissue, blood, and other vaginal fluids.

Types of amenorrhea

We can consider the following three types of amenorrhea:

  • Physiological amenorrhea: It is a type of amenorrhea that appears in certain periods of the woman in which she does not have a period. In these situations there is no health problem but they are normal periods that any woman can go through. These periods are as follows: before the woman has reached fertility, that is, she is not yet puberty; during pregnancy and lactation and when you get older and lose your period at menopause.
  • Primary amenorrhea: When menstruation does not appear at an age at which it should normally have already appeared. Primary amenorrhea is considered when the period has not yet appeared at age 18.
  • Secondary amenorrhea: Secondary amenorrhea is when more than three missed periods in a row occur in women who have already menstruated or had regular menstruation before.

Amenorrhea symptoms

The symptom that reveals the presence of amenorrhea is the temporary or permanent lack of menstruation.

Causes of amenorrhoea

Why does amenorrhea occur?

Upon reaching menopause, women have a physiological lack of menstruation.

The causes depend on the type of amenorrhea. It is not the same causes that cause the lack of period in a woman who has not yet menstruated, as those that cause the interruption of the period in women who have had it before. Among the main causes we can mention the following:

A- Causes of physiological amenorrhea

Mujeres en estadio de menopausia
Upon reaching menopause, women have a physiological lack of menstruation.

– Lack of sexual development: The sexual organs are not yet ripe for ovulation to occur and the subsequent development of the endometrial walls that should thicken to accommodate and feed the fertilized egg

– Pregnancy

– Lactation

– Menopause

B- Causes of primary amenorrhea

– Imperforate hymen: The blood cannot go outside and is retained in the vagina by the wall that forms the hymen.

– Absence or poor development of the vagina or uterus: Produced for various reasons, including, for example, the following:

– The person does not have a vagina as a consequence of poor formation in embryonic development

– The person is genetically male, but externally has a female phenotype, with the presence of breasts and vagina. May lack a vagina or uterus and present internal testes (androgen insensitivity syndrome)

– The person has hyperdeveloped clitoris, low voice, hirsutism and other secondary male characters (adrenogenital syndrome)

– Presence of a single X chromosome that produces poorly developed sexual characters in girls. (Turner syndrome)

– Hormonal problems: Problems in the FSH or LH hormones produced by the pituitary gland

– Eating problems such as malnutrition or anorexia


– Stress

C- Causes of secondary amenorrhea

– Infections, such as gonorrhea.

– Cysts in the ovary

– Tumors

– Early menopause: A type of menopause that appears before being 40 years old

– Circulatory disorders

– Pituitary abnormalities (Chiari-Frommel syndrome, pituitary adenoma, etc.)

– Thyroid disorders

– Turner syndrome

– Psychiatric problems

– Hormone treatments

– Fatigue

– Exhaustion

– Intense exercise

– Concerns

Preguntas útiles sobre la menstruación

At what age should the first rule occur?

It should normally appear between the ages of 11 and 15, although it may be delayed for another year or two.

When is a woman said to have primary amenorrhea?

Primary amenorrhea is considered when the first period does not occur at age 18.

How often should the rules be produced?

Every 28 days, but the period generally varies between 24 and 36 days in adult women and between 21 and 45 in younger women.

How long should the period last?

The period usually lasts 3 to 5 days. What is the period made of? Endometrial tissue, blood and vaginal fluids

How much blood is lost in the period?

The total amount of blood, endometrial tissue, and other fluids is calculated to be normally about 40 or 50 ml, about four tablespoons.

Diagnosis and treatment of lack of menstruation

The diagnosis of amenorrhea must be carried out by the doctor or specialist.

If menstruation has not yet occurred for the first time and the woman has passed the period considered normal for the first period or menarche, the doctor may need different tests to find out the maturation of the genital tract or check that there are no problems of genetic malformations, hormonal disturbances, imperforate hymen, etc.

For secondary amenorrhea or interruptions of the period, and having ruled out pregnancy, menopause or other mental problems, blood tests are usually requested to check hormone levels and hormone treatments are usually prescribed to check if ovulation is restarted. Otherwise, the tests will focus on studying if there is any problem, mainly in the uterus, or it could be problems in the pituitary or hypothalamus that will require the use of cranial radiographic techniques to check its condition.

punto rojo More information on amenorrhea

Written by Editorial Botanical-online team in charge of content writing

9 July, 2020

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