Secondary amenorrhea

When the period does not show up, the first thought, if you have a sexual life, is a possible pregnancy, which is easily ruled out with a special test or blood sample. Once it is ascertained that this is not the case, other reasons are then considered.

Secondary amenorrhea: the causes

The causes determining the appearance of secondary amenorrhea can be divided into genital and extragenital.

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The first, irreversible, include conditions which, by causing the destruction (or removal) of one of the organs directly involved in the menstrual function, cause its definitive disappearance. For example, the surgical removal of the ovaries or uterus, the interruption of ovarian function by means of X-rays or the destruction of the endometrium, part of tuberculous endometritis.

The alteration of the functions of the pituitary gland is also among the most common genital causes of secondary amenorrhea, in particular we speak of Simmonds' disease when, following childbirth or the destruction of the pituitary tissue caused by trauma, the stimuli cease caused by the pituitary hormones on the ovary and consequently the activity of the latter. It is a rather serious condition and the solution can only be a transplant of this organ.

Other causes, always of a genital nature, but reversible and therefore treatable, are directly related to the amount and type of hormones present in the body. Since the rhythmic succession of the phases of the menstrual cycle depends on the action of the hormones produced by the ovary (estrogen and progesterone) and, more precisely, on the quantity of each other, an imbalance between the quantities can be the cause of secondary amenorrhea. This condition of imbalance can be observed, for example, in the case of follicular cysts and polycystic ovaries.

Among the extragenital causes, however, the most common are certainly states of severe malnutrition and, therefore, food-related diseases, such as anorexia and bulimia.

To get a general picture of the frequency with which the aforementioned causes occur and cause secondary amenorrhea, here are some data taken from Periodofertile.it:

• Amenorrhea for polycystic ovary syndrome (36.9%)

• Early ovarian failure amenorrhea (23.6%)

• Amenorrhea due to hyperprolactinaemia (16.9%)

• weight-related amenorrhea (9.8%)

• Amenorrhea due to hypogonadotropic hypogonadism (5.9%)

• Amenorrhea due to hypopituitarism (4.4%)

• amenorrhea from excessive physical activity (2.5%)

Secondary amenorrhea and stress

We often wonder if excessive and prolonged stress can also cause secondary amenorrhea.

The studies carried out so far have not shown a certain link between stressful events that are experienced and amenorrhea lasting more than two months.
However, let's not forget that stress can cause psychological problems which can in turn lead to weight loss and consequently to the onset of the disorder.