Amenorrhoea

DEFINITION

Amenorrhoea is the absence of menstruation i.e.,
either a lack of onset or the cessation of normal menstruation.

DESCRIPTION

Absence of menstruation may occur for a variety of
reasons. It is very important for any woman who has stopped
menstruating to consult a medical practitioner immediately for
diagnosis.
Physiological Amenorrhoea
Pregnancy and menopause are two very natural reasons for
menstruation to cease, known as physiologic Amenorrhoea. In other
words, there is an obvious physical reason for the lack of
menstruation which does not involve a disease process. The late
onset of menstruation is often a cause of concern for young girls
and their parents. Providing, however, puberty has progressed
normally, the girl is of normal weight and there are no other
abnormal physical signs, there is usually no cause for concern in
girls under 16 years of age. A Doctor can conduct a number of tests
to check for abnormalities.

Primary Amenorrhoea
Amenorrhoea that is caused by a disease process or changes in
hormonal function is classified as either ‘primary’ or ‘secondary’
Amenorrhoea. Primary Amenorrhoea is usually diagnosed if a woman
has not started menstruation by 16 years of age. This type of
Amenorrhoea is usually the result of one of the following
conditions; a disorder of the pituitary and/or hypothalamus glands,
a chromosomal abnormality (e.g., Turner’s syndrome or testicular
feminisation syndrome) or abnormal development of the ovaries or
uterus.

Secondary
Amenorrhoea
This is a relatively common problem and is seen far more often
than cases of primary Amenorrhoea. Secondary Amenorrhoea is
diagnosed when a woman who is not pregnant and who has been
menstruating normally, skips one or more periods. Unlike primary
Amenorrhoea, there is usually no disease or medical condition
responsible. Secondary Amenorrhoea is more likely to be the result
of stress, rigorous athletic training or an extreme change in
bodyweight (as is seen in anorexia nervosa). Weight-related and
exercise-related Amenorrhoea is common among female athletes, and,
if prolonged, is associated with an increased risk of oestrogen
deficiency and osteoporosis.

Polycystic Ovary
Syndrome
Cysts commonly develop on the ovaries prior to puberty. These are
harmless and usually disappear with the onset of menstruation. A
hormonal imbalance in some women, however, causes these cysts to
continue developing. This abnormal condition is known as polycystic
ovary syndrome (POS). Amenorrhoea (both primary and secondary) is a
symptom of POS. Other symptoms include lack of ovulation and
infertility, acne and excessive body hair. The lack of ovulation
caused by POS along with continuous oestrogen production can
increase a woman’s risk of developing endometrial cancer.
Considering this and the number of possible causes of Amenorrhoea
it is important for a woman who has not begun to menstruate, or
whose normal pattern of menstruation has ceased, to be medically
diagnosed and treated.

TREATMENT
OPTIONS

Always consult your Doctor for diagnosis and
advice. In no way is this information intended to replace the
advice of a medical practitioner.
Treatment for Amenorrhoea includes hormone replacement therapy,
minor surgical procedures and counselling. Treatment depends on the
cause and some women will not require treatment at all. As Athletic
activity and weight fluctuations can cause Amenorrhoea, your Doctor
may refer you to a Dietitian who can devise an eating plan for you.
Your Doctor will explain the causes of Amenorrhoea and answer any
queries that you may have regarding this condition and its
treatment.

DIET HINTS

Amenorrhoea often signals a physical problem which
must be dealt with first. However, a number of nutrients are
required for a regular hormonal cycle. Extreme diet fads can induce
Amenorrhoea. Some dietary suggestions include:

Foods high in vitamin B ( particularly B12, folic acid and B6)
may help the production of hormones. These include brewers’ yeast,
fruits, vegetables, nuts, whole grains, legumes (beans, peas,
lentils etc), seeds and avocados.
Wheatgerm, oats and muesli may help ensure a regular
cycle.
Iron rich foods may help a short or light menstrual cycle.
Sources include oysters, spinach, liver, almonds, hazelnuts, prune
juice, pecans, parsley juice and eggs.
Iodine-rich foods may help regulate an irregular menstrual
cycle due to thyroid dysfunction. Sources include kelp and other
sea vegetables.
Soy bean products, such as tofu and soy milk, may help an
irregular menstrual cycle.
Essential fatty acids, derived from fish, avocados and linseeds
(flaxseed), may help regulate hormones.

VITAMINS/MINERALS/HERBS

Dong quai (Angelica sinensis) may help regulate female
hormones.
False unicorn root (Chamaelirium luteum) may be of benefit for
Amenorrhoea as a uterine and ovarian tonic. It may help to regulate
and normalise ovarian function.
Yarrow (Achillea millefolium) may be beneficial in the
management of Amenorrhoea.
Vitex agnus-castus may help to initiate menstruation in some
types of Amenorrhoea.
Pulsatilla (Anemone pulsatilla) and Bupleurum may be useful for
Amenorrhoea that is a result of nervousness or stress.
Female athletes with exercise-induced Amenorrhoea may be on
diets that limit iron absorption and may be at risk of iron
deficiency.

PHARMACIST’S
ADVICE

Ask your Pharmacist for advice.

If you have skipped a period it is important (if applicable) to
consider the possibility of pregnancy. Ask for advice about the
different home pregnancy
tests available from your Pharmacy or see your
Doctor.
If you are gaining or losing a great deal of weight, ask your
Pharmacist for advice about safe and effective ways to maintain
your ideal weight. Your Doctor may
refer you to a Dietitian.
If your Doctor has diagnosed stress as being the cause of
Amenorrhoea it is important to practise relaxation techniques. Avoiding stressful
situations and people, having adequate exercise, rest, a healthy
diet and doing enjoyable activities all have a role in stress and
anxiety management.

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