In order to deal properly with missed periods we need to understand and — if possible — remove the underlying causes and risk factors. We need to ask: "What else is going on inside the body that might allow missed periods to develop?"
Accurate diagnosis of the factors behind missed periods consists of three steps:
|Polycystic Ovary Syndrome||2%||Ruled out|
Have you experienced missed periods that are unrelated to pregnancy, breast feeding, menopause or birth control pill use?
Possible responses:→ No / don't know
→ Yes, but not in the last two years
→ I occasionally miss a period
→ I regularly miss a period or 1 to 2 in a row
→ My periods are infrequent or absent
Amenorrhea also suggests the following possibilities:
Although amenorrhea (abnormal cessation of menstruation) is usually explained by something else, in rare cases it can be caused by a brain tumor.
In many cases, an underactive or overactive thyroid gland is responsible for the absent menstrual cycles.
In many women with polycystic ovaries, menstruation begins at the normal age. After a year or two of regular menstruation, the periods become highly irregular and then infrequent.
Many young female athletes in training experience absent menstrual cycles due to low body fat content. Exercising women with regular menstrual cycles and amenorrheic women who do not exercise excessively demonstrate a clear diurnal rhythm of leptin levels. Exercising women with amenorrhea lose this normal rhythm, which raises the possibility that this cycle is important for the maintenance of reproductive function. Leptin levels normally rise during the afternoon and reach a peak in the early hours of the morning, then decline towards dawn.
For some women, simply explaining the need for adequate calorific intake to match energy expenditure results in increased intake and/or reduced exercise, and their menses resume. For those women in whom no other cause of amenorrhea can be found, but who are unable or unwilling to either increase food intake or decrease the amount of exercise, estrogen replacement therapy is strongly indicated. Appropriate therapy consists of any estrogen replacement regimen that includes endometrial protection.
Women with anorexia and/or bulimia often experience amenorrhea as a result of maintaining a body weight that would be too low to sustain a pregnancy. As a result, as a form of protection for the body, the reproductive system shuts down because it is severely malnourished.
Women who are obese often experience amenorrhea as a result of excess fat cells interfering with the process of ovulation.