Here is All You Need to Know About Absent Menstruation(Amenorrhea)

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Absent menstruation or Amenorrhea as it is called in medical terms, is the absence of menstrual bleeding or menstrual periods. Amenorrhea is a condition in which women having regular periods, miss at least three menstrual periods in a row or when girls do not have their first menstrual period by the age of 15.

Many women suffering from amenorrhea deal with a lot of anxiety and stress, even leading to depression in some cases

Types of Amenorrhea

There are two types of amenorrhea – primary and secondary.

Primary amenorrhea
Primary amenorrhea is when periods do not start during puberty. Most girls begin menstruating between ages 9 and 18, with 12 being the average age. If girls do not get periods by the age of 15, then it is considered a case of primary amenorrhea, which may need medical attention.

Secondary amenorrhea
Secondary amenorrhea is when periods have started, but then they cease to occur. Pregnancy and breastfeeding are the most common reasons for this, however, there can be several other reasons for this, that need medical assessment.

Causes

Amenorrhea can occur for a variety of reasons. During the normal course of your life, women may experience amenorrhea for natural reasons, such as –

Pregnancy
Breast-feeding
Menopause

Pregnancy tests, either urine or blood tests, can be done to confirm pregnancy which is considered as the most common reason for absent periods.

Other causes of Amenorrhea include –
Contraceptives – Some women who take birth control pills may not have periods. Even after stopping contraceptives, it may take some time before regular ovulation and menstruation return.

Lifestyle factors – Many a times lifestyle factors contribute to amenorrhea:

Excessive exercise – Women who undergo rigorous physical activity or exercise are highly likely to have interrupted menstrual cycles.
Stress – Mental stress can temporarily alter the functioning of the hypothalamus — an area of your brain that controls the hormones that regulate your menstrual cycle, causing temporary stopping of periods.
Low body weight – Excessively low body weight interrupts many hormonal functions in your body, potentially halting ovulation and causing missed/absent periods.

Hormonal imbalance – Hormonal imbalance can happen due to a number of underlying conditions like:

Polycystic ovary syndrome (PCOS) – PCOS causes relatively high and sustained levels of hormones, rather than the fluctuating levels seen in the normal menstrual cycle.
Thyroid malfunction – An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) can cause menstrual irregularities, including amenorrhea.
Pituitary tumour – A non-cancerous tumour in your pituitary gland can interfere with the hormonal regulation of menstruation.
Premature menopause – Menopause usually begins around age 50. But, for some women, the ovarian supply of eggs diminishes before age 40, and menstruation stops.

Medications – Certain medications, such as antipsychotics, cancer chemotherapy, antidepressants, blood pressure and allergy medications can cause menstrual periods to stop

Structural problems – Problems with sexual organs such as lack of or under-developed or abnormal uterus or vagina can cause amenorrhea

When to see a doctor?

Primary amenorrhea
When a teenage girl hasn’t gotten her first menstrual period by the age of 15, it is advised to see the doctor.

Teenage girls usually show signs of puberty in the following order –

Thelarche (breast bud development)
Pubarche (pubic hair development)
Menarche (onset of menstrual periods)

If a teenage girl is fourteen or older and hasn’t experienced any signs of puberty yet, it is advised to seek medical help.

Secondary amenorrhea
It is advisable for menstruating women and teens to see a doctor if the individual

used to have regular periods and then does not have any for 3 months
used to have irregular periods and then does not have any for 6 months

Do I really need to consult a Doctor?

It is quite likely that you may not experience any discomfort even if you have amenorrhea. But it is still advisable to see the doctor. This is because amenorrhea might be due to an underlying condition that may require review and treatment.

Some other complications due to amenorrhea include –

Infertility – If you don’t ovulate and have menstrual periods, you can't become pregnant.
Osteoporosis – If your amenorrhea is caused by low estrogen levels, you may also be at risk of osteoporosis — a weakening of your bones.
Heart disease – It is suspected that low oestrogen levels also put a woman at risk of heart disease. Also, women having amenorrhea associated with PCOS are more likely to develop risk factors for heart disease, such as high blood pressure, high cholesterol levels, and diabetes.

Treatment

Treatment for amenorrhea varies depending on the underlying cause.
Hormonal imbalances can be treated with supplemental or synthetic hormones, which can help normalize hormone levels

If lifestyle factors are found to be the cause of amenorrhea, the doctor may suggest lifestyle changes.

In the case of weight issues, the doctor may recommend healthier diet options. A consultation with a dietician or nutritionist may be suggested.

In the case of stress-related amenorrhea, the doctor may suggest ways to manage stress, such as yoga, mindfulness, and meditation. A consultation with a therapist may be suggested. A change in exercise routine may also be suggested.

In case the doctor’s review reveals that ovarian cysts, scar tissue, or uterine lesions are causing amenorrhea, the doctor may choose to remove these using medications or surgery. Surgery may also be recommended for structural problems with the reproductive organs

Not a disease

Amenorrhea (absent menstruation) is not a disease per say. It is a condition that can be a sign of an underlying health issue that needs attention. In contrast to popular belief, amenorrhea does not indicate that a person is infertile. In most women, amenorrhea is treatable. Treatment of amenorrhea usually involves treating the condition that is causing amenorrhea. Consulting a doctor with your concerns is the key. Following the treatment plan recommended by the doctor can help most people with amenorrhea get their menstrual cycle regular and back on track.

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Today, disposed sanitary pads and tampons have become a biohazard for the planet. This Menstrual Hygiene Day let’s raise awareness about the importance of sustainable menstrual practices and products.

28 May is Menstrual Hygiene Day which aims to break taboos and raise awareness about the importance of good menstrual hygiene management for women and adolescent girls worldwide. It was initiated by the German-based NGO WASH United in 2014. Today, menstruation is a topic slowly making itself into homes and creating awareness about the many taboos surrounding it. Initially, women had been using discarded cloth for absorbing the menstrual blood. This slowly gave way to the sanitary pad revolution. A boon at one time, today sanitary pad has become a biohazard for the planet. Use of non-biodegradable napkins is increasing every day with rising incomes and changing demographics. We produce several hundred million used sanitary pads a month. Plus sanitary workers who pick up these pads, tend to catch infections from them. So on this occasion let us strive and educate ourselves a bit about how we can contribute in lessening towards sanitary waste.

What can we do to reduce our landfills with sanitary waste?

The answer: Use environmentally biodegradable products which are reusable and contribute minimally to the global landfill in the long run.

The options: Many. Right from biodegradable/organic sanitary napkins which decompose over time, to reusable cloth pads to the menstrual cup. The choices are plenty but the awareness is little.

Let’s explore:

1. Organic Sanitary Pads: According to experts, the modern sanitary napkins with odor neutralizers and fragrance use artificial colors, and are 90 per cent plastic, which may cause hormone imbalance, cancer and infertility and take hundreds of years to decompose. But organic and biodegradable sanitary pads can decompose within 6 months. They contain no-added bleach or chemical, and are made with plant-based materials like wood pulp, bamboo or banana fiber and organic cotton, which is ecologically-certified.

2. Cloth Pads or just cloth: These are reusable and a great alternative to disposable sanitary napkins. They are better for your body and the environment provided they are washed and maintained hygienically. They work exactly like a sanitary napkin, except they can be washed and reused for several years. They do not create any disposable waste after each use. It’s also a great save monetary wise. There are many ready-made cloth pad options available in the market ranging from different brands to sizes and colors. Some have a leak-proof layer with wings at the sides that have snap buttons to keep the cloth pad in place. These can also be made at home with hygienic discarded cloth. There are many DIY tutorials available online. However, care should be taken to make sure all these layers are fully exposed to sunlight while drying.

3. Menstrual Cups: Menstrual cups are made of medical grade silicon that collects the blood when kept inserted inside the vagina. This is the same grade that is used in making nipples for baby feeding bottles hence safe to use. Unlike regular pads, there’s no foul smell of the blood, rashes or itchiness and it is much more hygienic than the sanitary napkins. They’re reusable, easy to use with a bit of practice, a one time investment and largely chemical free. Menstrual cups can be a revolution for the lower class of Indian women who have no sanitary options while menstruating and can be a revolution. They come in various sizes and lengths to suit different bodies. This costs 1000-4000 rupees in a lifetime as it can last for years without needing disposal or change. Many brands have emerged in the market.

4. Period Panties: Period panties are designed to provide leak-proof comfort all day long. Period panties have extra absorbent layers to prevent the leakages. You can wash and reuse them multiple times. A loop through which pads can also be slipped in helps keep the pad immobilized. For light bleeding, you can bleed directly into them but for heavy bleeding with chances of leakage, these can be teamed up with your regular menstrual product.

Why are breathable menstrual products important for health?

While the pH of blood is around 7.5 (slightly alkaline), the vaginal pH is typically 3.5 to 4.5 (moderately acidic). The normal vaginal pH is ideal for beneficial bacteria and creates a hostile environment for pathogenic bacteria that cause odor and infection. When the pH of the vagina increases, it favors the growth of pathogenic bacteria and yeast.

During menstruation, vaginal pH becomes elevated by menstrual blood, and chances of contracting infections such as bacterial vaginosis becomes high. Therefore, breathable menstrual products which require to be changed frequently, such as cotton cloth, help to keep the pH levels in check, and prevent vaginal infection, says women’s health activist Sinu Joseph. On the other hand, menstrual products that contain an impermeable plastic layer such as sanitary napkins, and/or are highly absorbent such as tampons, can increase the chances of vaginal infections by increasing the vaginal pH by retaining blood for long periods of time.

Plenty of brands, tutorials, and information is available on the internet and social media regarding sustainable menstrual products and one can easily choose from the wide options available and also order online. It’s time to menstruate responsibly. Let’s switch to sustainable methods of menstruation and join the revolution for a better planet.