Amenorrhea is defined as: the absence of a menstrual period in a woman of reproductive age. There can be many causes of amenorrhea and thus diagnosis has to be precise to find the specific underlying cause.
There are two main categories of Amenorrhea: Primary and secondary. Primary amenorrhea is when a patient does not experience a initial menstrual period (due to a developmental disorder). Secondary amenorrhea is when someone’s cycle stops and does not return. The menstrual flow must have ceased for a minimum of 3 months for diagnosis to be made or 9 months if the patient has a history of oligomenorrhea.
This page will primarily discuss secondary amenorrhea as it is very common in today’s practice. Secondary amenorrhea is normally caused by a hormonal disorder involving the Hypothalamic pathway or a blood deficiency pattern.
THE HYPOTHALAMUS DIRECTS THREE PATHWAYS THAT CAN BE INVOLVED IN AMENORRHEA
HYPOTHALAMUS & MENSTRUAL CYCLE
The hypothalamus stimulates the pituitary’s release of follicle stimulating hormone which stimulates the follicles in the ovaries to develop. If for some reason the directive nature of the HPO axis is disrupted, then minimal levels of FSH will be produced. As a result, the ovaries will not be stimulated to produce enough estrogen. Low estrogen levels will not stimulate the uterine lining and amenorrhea will occur. The Hypothalamus also directs the Pituitary to release luteinizing hormone. Luteinizing hormone regulates the second half of the menstrual cycle. If all is normal, at this time progesterone prepares the uterine lining for implantation. When pregnancy does not occur, progesterone levels will drop and thus trigger the menstrual flow. Low estrogen levels, estrogen dominance and low progesterone levels can play a role in amenorrhea. At the Holistic Wellness Center it is our job to find out why the patient may have any of these hormonal imbalances.
OTHER POSSIBLE CAUSES OF AMENORRHEA
- Exercise-hypothalamic related amenorrhea
- Eating disorders
- Weight loss
- Pituitary disorders such as sheehan syndrome, haemochromatosis and hyperprolactinaema
- Adrenal disorders
- Post-pill amenorrhea (birth control pill)
- Polycystic ovarian syndrome (PCOS)
At The Holistic Wellness of the Carolinas, we have the benefit of running complete female hormone panels, which help us to target any hormone imbalances that need to be addressed. Once we have diagnosed the underlying cause, we then implement dietary, lifestyle, herbal, and nutritional protocols to remedy the disorder.