12 reasons behind the absence of menstrual period

What is amenorrhea? Amenorrhea refers to the absence of a period, which it is normal in certain circumstances, for example, during pregnancy, lactation or menopause. However, it can also happen that younger women miss their period. So the doctors talk about the call secondary amenorrhea. Primary amenorrhea, on the other hand, refers to the absence of menstrual bleeding until the age of 16.

Mental and physical causes of amenorrhea

The interaction between the hormones FSH (follicle-stimulating hormone), LH (luteinizing hormone), estrogens, GnRH (gonadotropin-releasing hormone), and progesterone is responsible for the process that ends the period. These hormones are produced mainly in the hypothalamus and the pituitary gland (hypophysis). Therefore, a disorder in one or both regions of the brain may be responsible for amenorrhea.

1. Stress

Whether it’s mental stress, serious crises, travel, important decisions or time pressure, physical or mental stress can influence hormone production in such a way that you don’t get your period. The concentration of GnRH in the hypothalamus falls, interrupting the cycle. Women whose cycles are already irregular are at greater risk of missing their periods from this cause.

2. Mental and physical illnesses

Mental and physical illnesses such as depression, psychosis, anorexia, Bipolar disorders or social phobias also put stress on the body. The production of GnRH is reduced, which has a negative effect on the production of hormones, due to which the menstrual period is missed.

3. Competitive sport

Excessive sport with very little regeneration and sleep, it can also cause GnRH production to slow and the menstrual period to stop.

4. Severe weight loss or low body weight

A healthy body weight is important for the cycle to run smoothly. However, if you lose weight quickly in a short period of time, there is a risk of reducing the production of hormones.

This also applies to too low a body weight. If a certain amount of body fat is not available, ovulation will not be triggered because the body cannot sustain a pregnancy if there is a lack of energy.

5. Poorly implanted ovum

If a fertilized egg implants outside the uterus, for example in the fallopian tubes, you may also miss your period. It is an ectopic pregnancy and you have to act quickly, as the risk of damage to the fallopian tube increases as the egg develops.

6. Medications

Hormone preparations, anticancer drugs, psychoactive drugs, cortisone and antihypertensives They are also possible causes and can favor the absence of menstruation.

Hormonal causes of amenorrhea

7. Interruption of hormonal contraceptives

Post-pill amenorrhea can occur after stopping birth control pills or other hormonal contraceptives. First, the body has to learn to make hormones again, which can take a few weeks to months.

8. Thyroid disease

Since thyroid hormones play an important role in the production of sex hormones, Both overactive and underactive thyroid hormones can cause missed periods.

9. Elevated prolactin levels

This hormone is responsible for preventing menstruation during pregnancy and lactation and for stimulating milk production. However, if the prolactin level remains elevated for months or years (Chiari-Frommel syndrome), menstrual bleeding will also stop.

10. Premature menopause

Premature menopause, which begins around age 40, also it can disrupt the cycle, causing irregular and missed periods.

11. Disorder of the ovaries

Ovarian cysts, operations, tumors or medical treatments as radiotherapy can alter the production of hormones and absence of menstruation.

12. Polycystic ovary syndrome

This syndrome disrupts the production of hormones in the ovaries and other hormone-producing tissues. The syndrome is characterized by numerous ovarian cysts, lack of ovulation and lack of menstruation. It is usually accompanied by being overweight, insulin resistance and excess androgens (male hormones).

The period is late, how many days is normal?

Many women assume that a normal cycle lasts around 28 days, but the body is not a Swiss watch, cycle fluctuations are completely normal.

Women who do not use hormonal contraceptives can have a cycle of 24 to 38 days. A study from the University of Pittsburgh School of Medicine and the Magee-Women Research Institute recorded the cycles of 130 women for 30 weeks. It was found that almost half of the cycles can be postponed seven or more days. 20% of the participants had fluctuations of 14 days or more.

To determine amenorrhea, it is important to clinical history (anamnesis). This is followed by gynecological examinations including ultrasound scans. and determination of the hormones prolactin, progesterone, estrogens, androgens, FSH and LH. If thyroid problems are suspected, tests for the three important thyroid hormones TSH, T3, and T4 are added.

Is amenorrhea dangerous?

If you don’t have your period, a visit to the gynecologist is recommended. This applies especially when:

Missed three times in a row Could be pregnant Menstrual period does not come after taking a new medication Missed period for more than six months after stopping hormonal contraceptives Additional symptoms such as abdominal pain, pain during intercourse , chest pain, or milky fluid leaking from the breasts. If polycystic ovaries are suspected, and there is hair loss, a deeper voice, and more body hair (for example, on the beard and chest).

Amenorrhea therapy: what you can do

Missed periods, often due to psychological causes, can be solved by learning relaxation techniques, meditation, or yoga. In the case of mental illnesses such as anorexia or depression, professional help should always be sought.

Moderate exercise can also help. If excessive exercise is the reason for your missed period, you should reduce the intensity and possibly also increase some weight. A diet that provides energy and all essential nutrients is key.