2 Amenorrhoea Types & 10 Reasons You Should Not Ignore Missed Periods
January 16, 2023
Amenorrhoea (missed periods) is one of the commonest reasons women attend the clinic. For simple classification, we organise amenorrhea into two main types, which you will learn about below.
Primary amenorrhoea describes a woman who has never had periods (from birth).
Secondary amenorrhoea is absent (missed) periods when you previously had periods.
When a woman goes without her period for 3-6 months, having previously had normal periods, that is known as secondary amenorrhoea.
If she initially had irregular or infrequent bleeding and the period stops for 6-12 months, that is secondary amenorrhoea.
Having missed periods is a medical condition that needs investigating. It has a wide variety of causes.
Using Contraceptives (extended-cycle combined oral contraceptives, injectable progesterone, implantable etonogestrel [Nexplanon®], and levonorgestrel intrauterine system [Mirena®] may cause amenorrhea).
Natural menopause or Early menopause (symptoms include: Hot flashes and vaginal dryness) lead to the end of your periods. Before it sets in, there are missed periods as the cycle becomes irregular until the periods eventually stop.
Some types of brain tumour – specifically a pituitary tumour can lead to amenorrhea. Some symptoms include: headaches, visual disturbances, or galactorrhoea – producing breast milk in the absence of pregnancy and breastfeeding.
Problems that affect the brain’s and reproductive hormones’ normal functioning, e.g. high prolactin and abnormal FSH/LH levels: Stress, depression, weight loss, disturbance of perception of weight or shape, level of exercise, and chronic (long-term illness) like kidney or heart failure).
Other hormone conditions like Thyroid and other endocrine diseases.
Previous surgery or obstetric procedures may lead to womb adhesions and scarring – for example, surgical termination of pregnancy.
Your periods may stop after having chemotherapy or radiotherapy to the pelvic area – for conditions like cervical cancer. Any of these can lead to early menopause from premature ovarian failure.
Other conditions that can lead to early menopause relate to the brain and damage the organs in the brain which produce reproductive hormones. Examples are head injury, radiotherapy for brain tumours, and a condition known as Sheehan’s Syndrome. In Sheehan’s syndrome, a woman who just delivered a baby and experienced heavy blood loss suffers damage to her pituitary gland in the brain from lack of oxygen. It is a potentially life-threatening condition, but other symptoms are problem breastfeeding and the absence of menstruation.
Apart from contraception, some other drugs can affect and stop menstruation. Examples are antipsychotics, which can cause increased prolactin levels) and illicit drug use (primarily cocaine and opiates, which can cause your sex glands to produce little or no sex hormones, i.e. hypogonadism).
Finally, a condition known as Primary Ovarian Insufficiency can happen. In POI, the ovaries do not work as they should. It is different to premature menopause, and it causes women to stop having their periods before the age of 40 years.
It can also run in families, so if a woman has a close relative with POI, she is at a higher risk of developing this condition.
These are some conditions that could affect you and lead to delayed periods. It’s important to keep track of your menstrual cycle. You can do so with an app or a simple diary. Including other events or symptoms that happen around the time of your menstrual cycle can provide a clue for the cause and a quicker diagnosis.
Editing by AskAwayHealth Team
All AskAwayHealth articles are written by practising Medical Practitioners on various healthcare conditions to promote quality healthcare. The advice in our material is not meant to replace a qualified healthcare practitioner’s management of your specific condition.
Please contact a health practitioner to discuss your condition, or reach us directly here.
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