Dr. Pushpendra Shukla

The absence of periods is medically termed as amenorrhoea. Normally, women do not get their periods prior to puberty, throughout pregnancy and after menopause. If you do not get your periods when you normally should, you might be suffering from amenorrhoea.

Amenorrhoea can be of two types, which include:

1. Primary amenorrhoea: menstruation does not begin till age 16
2. Secondary amenorrhoea: normal menstruation is disrupted when you skip your periods for more than three months

Causes
Amenorrhoea is usually caused by a variety of changes in the hormones, glands and organs responsible for a healthy menstrual cycle.

Primary amenorrhoea is usually caused by:
1. Deterioration in the ovaries
2. The central nervous system (spinal cord and brain) or pituitary gland can get affected, which leads to the malfunctioning of the hormones which are concerned with menstruation.
3. Poorly developed reproductive organs

However, in several cases, what really causes primary amenorrhoea is unknown. The causes of secondary amenorrhoea include:
1. Pregnancy
2. Breast feeding
3. Discontinuation of birth control use
4. Menopause
5. Polycystic ovary syndrome induced hormonal imbalances
6. Removal of ovaries or uterus

Symptoms
Usually, underlying conditions can lead to amenorrhoea. The conditions that lead to amenorrhoea include:
1. A condition called galactorrhoea, in which the glands in the breasts produce milk, even if the woman is not breastfeeding or pregnant; can also cause absent periods.

The surgery options for amenorrhoea include:
1. Surgery or radiation therapy may have to be performed if you have a tumour in your pituitary gland or hypothalamus (part of brain that controls the release of hormones from the pituitary gland).
2. If you have an intrauterine attachment (contraceptive attachments fitted in the uterus), you may need surgery to remove it.

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