Absence of menstrual bleeding is called amenorrhea which can be of two forms either primary or secondary
Primary amenorrhea is the absence menstruation in girl by age 14 without secondary sexual characteristics by the age of 14 or absence of menstrual bleeding with normal development of secondary sexual characteristics (brest development and pubic hair) by the age of 16
secondary amenorrhea is the absence of menstruation in women who had been menstruating without reason of pregnancy, lactation or menopause
In normal women the organs that are responsible for the normal menstruation includes hypothalamus,pituitary gland,ovaries and uterus. Hypothalamus stimulate pituitary gland to produce follicle stimulating hormone and luteinizing hormone and the LH cause the ovaries to produce estrogen and progesterone which causes the changes in the lining of the uterine including menstruation
When to consult with a health care professionals
If a girl is 14-year-old her secondary sexual characteristics have not started developing or 16 years old girl has not had her first menstrual period . It is also important to consult a doctor if women missed three consecutive periods who have already begun menstruating
Test to identify the cause of amenorrhea
Blood or urine test are used to identity the common hormonal imbalance in womens body . These imbalance are either caused by pituitary gland or ovaries. Pelvic ultrasound which is painless are used to identify structural problems in the uterus and ovaries. Another test is the progesterone challenge test where you will treated with progesterone to see whether this initiates a menstrual period. An induced menstruation indicates no ovation of eggs
Treatments
In women who have been dieting which caused some nutritional deficiency can be reversed the amenorrhea by eating well balanced diet. Since excessive body weight can cause amenorrhea those who are overweight can restrict the diet containing fats and thereby loosing weight can really improve the conditions. Emotional stress which also a contributing factor for amenorrhea can managed by relieving the stress and conflict by some means. More than 8 hours a day exercise can also a factor that affect the menstruation and a moderate exercise program can reverse the situation. Minimizing alcohol consumption and smoking cessation can also bring the menstruation back to the normal.
Pharmacological treatments
Most of the treatments depends on the cause of amenorrhea. Once the cause is identified the treatments should be focused on that.
Drugs used to treat include dopamine agonist,oral contraceptive , hormone replacement therapy or metformin