Dr. Kalpana

Amenorrhea is a condition when a woman of childbearing age fails to menstruate. A woman normally menstruates every 23 to 35 days.The part of the brain called the hypothalamus regulates the menstrual cycle. The hypothalamus stimulates the pituitary gland. The pituitary gland lies just below the hypothalamus at the base of the brain.

There are two types of amenorrhea:

1. Primary amenorrhea occurs when a woman has not had her first menstrual period (menarche) by age 15 or 16. This condition is also called delayed menarche. It is most often due to late puberty.This is fairly common in teenage girls who are very thin or very athletic. These young women are typically underweight.
2. Secondary types of amenorrhea occurs when a woman has experienced menstrual periods, but stops menstruating for three or more consecutive months.

Secondary amenorrhea can be caused by:

1. Pregnancy (the most common cause)
2. Breast feeding
3. Menopause, the normal age-related end of menstruation
4. Emotional or physical stress
5. Rapid weight loss
6. Frequent strenuous exercise
7. Hormonal birth control methods, including birth control pills, the patch and long acting progesterone.
8. Polycystic ovary syndrome, a condition is associated with a tendency to be overweight, excessive body and facial hair and hormonal irregularities.
9. Premature ovarian failure (menopause before age 40)
10. Hysterectomy (surgical removal of the uterus)
11. Abnormal production of certain hormones, such as testosterone, thyroid and cortisone.
12. Tumors of the pituitary gland
13. Chemotherapy

Symptoms of Amenorrhea:
Hormone imbalances may cause amenorrhea together with:

1. Excess body and facial hair
2. Acne
3. Lowering of the voice
4. Altered sex drive
5. Breast milk secretions
6. Weight gain

In order to diagnose your condition your doctor will ask you about:

1. The date of your last menstrual period
2. Whether you are sexually active
3. Your birth control methods
4. Your pregnancy history
5. Your eating habits
6. Rapid weight changes
7. Obesity or extreme underweight
8. Your typical monthly menstrual patterns
9. The age when your mother entered menopause(In most cases it has been seen that, both mother and daughter will enter menopause at the same age) 
10. The amount of stress in your life and how you deal with it
11. The types of medications you are taking

Treatment for amenorrhea:
The treatment for secondary amenorrhea varies depending on the underlying cause of your condition. Hormonal imbalances can be treated with supplemental or synthetic hormones. Your doctor may also want to remove ovarian cysts, scar tissue or uterine adhesions that are causing you to miss your menstrual periods. If you wish to discuss about any specific problem, you can consult a sexologist.

Infertility is known to usher a lot of emotional stress in the lives of those who go through it. Often, an overwhelming sense of grief descends upon the couple who try to grapple with the sense of loss. The social and psychological ambience plays a very important role in reconciling one with the harsh reality and prepping one up for a fresh start. 

While IVF has proven to be a boon in the lives of many couples, many still take to IVF as the last resort. Another factor that makes the responses about IVF rather ambiguous is the uncertainty of the results. There are numerous factors like failure in embryo attachment or uterine incompatibility that often results in a failed IVF. Therefore, before opting for this surgery, one must be mindful of the consequences. 

Some of the ways, one can prepare oneself for IVF have been enlisted below: 

1. Informed choice: Considering IVF is a rather stressful surgery, one needs to be well aware of the stakes. Reading up about the potential risks and the details about the process, helps one to be prepared for the consequences and deal better with the trauma.
2. Take good care of your intimate relationships: Since IVF tends to take a toll on not just the mother, but also the close family, it is important to maintain a strong bond of trust and compassion in the course of the surgery. Hostility and discordance adds on the stress and sometimes inflict grave health implications upon the mother. It is important to support your partner through the entire journey. You may consider professional counselling too.
3. Prepare yourself for all possible situations: While the advanced technology aims to minimize any hazard, the results can often be unpredictable. You might want to adequately monitor your cycle in order to anticipate the potential problem areas and the results thereof. You should discuss these with your loved ones to avert excessive stress. It is a good idea to keep oneself productively busy in the due course to avoid anxiety. In case you have a concern or query you can always consult an expert & get answers to your questions!