If a woman of childbearing age has already established regular menstruation, and then disappeared for a period of more than 6 months - this is secondary amenorrhea. In adolescents, whose monthly did not appear at all, they speak of primary amenorrhea.
Secondary amenorrhea - causes
The main causes of secondary amenorrhea:
- intrauterine synechia (adhesions), during which during the monthly discharge can not leave the uterine cavity because of its obliteration after severe inflammatory processes (including tuberculosis), operations on the uterus, and its scraping;
- polycystic ovary ;
- syndrome of ovarian malnutrition or premature menopause (with the ovaries do not form estrogens with an elevated level of gonadotropic hormones - LH and FSH);
- syndrome of hypertrophy of the ovaries (due to uncontrolled long-term use of contraceptives, especially monophasic, the level of gonadotropic hormones is decreased with an increased level of prolactin);
- physical exhaustion of the body (with increased physical exertion, especially in athletes, with fasting and anorexia);
- psychogenic amenorrhea (with psychological trauma, chronic stress).
Diagnosis of secondary amenorrhea
For the diagnosis of secondary amenorrhea, anamnesis is primarily important: to know about the possible cause of the disease, a doctor can, by asking about the regime of stress in a woman, about taking contraceptives, about secretions from the mammary glands (with an increased level of prolactin in the body).
It is possible to suspect the appearance of secondary amenorrhea according to the symptoms: in polycystic women, there is increased hairiness, a violation of fat metabolism, problematic skin. With premature menopause, the symptoms of disturbance of the autonomic nervous system come to the forefront, and other types of amenorrhea may even be asymptomatic.
But the best way to diagnose the disease can be by checking the woman's blood levels of gonadotropic hormones, prolactin , ovarian hormones and thyroid gland. Ultrasound can help diagnose the adhesions inside the uterus, polycystic ovary, the absence of ovulation. To answer the question whether pregnancy is possible, if secondary amenorrhea has occurred, it should be remembered that there is no ovulation, so pregnancy will not come.
Secondary amenorrhea - treatment
To understand how to treat a secondary amenorrhea, first of all, you need to find out the reasons that caused it. Without a comprehensive examination of a woman diagnosed with secondary amenorrhea, neither medication nor folk remedies can be prescribed. With synechia in the uterus, they are removed, and then within 4 months, hormone estrogens and progestins are prescribed (for example, Dufaston).
With the secondary amenorrhea, because of premature menopause, estrogens are prescribed, and with hypertrophy of the ovaries, they usually recover themselves. In polycystic ovaries, after determining the level of sex hormones, contraceptive preparations are selected that are best suited for hormonal purposes.
The reason for the increased level of prolactin is not completely clear, and if there are no problems with the pituitary (for example, pituitary tumors) and the woman does not breast-feed (and lactational amenorrhea does not require treatment), then dopamine antagonists are recommended.
When physical exhaustion or prolonged starvation recommend a gentle regime of stress and nutrition. A woman with psychogenic amenorrhea should be examined by a psychotherapist and hormone therapy is not recommended.