Written by Dr.M.D.Mazumdar, MD
Amenorrhoea (loss of periods) can be
Physiological Amenorrhea (Loss of Periods)
Physiological Amenorrhea or the Loss of Periods may be normal at certain periods in a woman's life, for example, during pregnancy, during breastfeeding, before attaining puberty and after the menopause.
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Pathological Amenorrhea (Loss of Periods)
Pathological Amenorrhoea or loss of periods is amenorrhea that occurs as a symptom of an underlying disease. It is not a disease process in itself. There are two types of pathological amenorrhea.
When a girl has never experienced menarche and menses, she is said to be suffering from primary amenorrhoea or primary lack of menses. The cause is usually congenital, i.e. from birth, and can be due to genetic or chromosomal abnormalities or due to a defect in the development of the reproductive tract. Treatment of this condition is very difficult.
When the patient has had at least one episode of spontaneous menses before the loss of her periods, she is said to suffer from secondary amenorrhoea. This is the commonest form of amenorrhoea. The problem may lie in the hypothalamus and the pituitary, or the uterus or the ovary. Other endocrine glands like the thyroid, the pancreas and the adrenal cortex also have a role to play in causing amenorrhoea. There are many causes of secondary amenorrhea:
A. Diseases in the Midbrain
Conditions like encephalitis or meningitis cause inflammaiton in the brain tissue or brain membranes. Tumours can press on the surrounding tissue causing loss of periods.
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C. Pituitary Amenorrhoea
Lack of menses/periods due to a cause in the pituitary gland is very rare. But some of them are:
Sheehan's Syndrome is a condition in which there is necrosis of the anterior pituitary, secondary to severe haemorrhage or bleeding during childbirth. The pituitary thus fails to release hormones necessary to maintain the menstrual cycle and this leads to amenorrhea. Read more...
D. Ovarian Amenorrhoea
The causes of amenorrhea in most cases lie in the ovaries.
E. Uterine Causes
F. Other Causes
Of these, tuberculosis is the most important as the tuberculous toxins appear to have a special affinity for the ovary and the uterine endometrium.
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