WHAT IS SECENDARY AMENORRHOEA?

Cessation of menstruation for at least 3 consecutive months in a woman who has previously had at least one normal menstrual cycle.

AFFECTS

All women from menarche to menopause.

• Pregnancy is the commonest cause (in sexually active women).
• Breast-feeding an infant.
• Discontinuing use of birth-control pills.
• Menopause (if the woman is over 45 and not pregnant).
• Emotional stress or psychological disorders.
• Surgical removal of the ovaries or uterus.
• Disorders of the endocrine (hormonal) system.
• Diabetes mellitus.
• Tuberculosis.
• Obesity, anorexia nervosa or bulimia.
• Systemic diseases like typhoid, Pneumonia
• Drugs like steroids, anti-depressants,
• Alcoholism.
• Strenuous program of physical exercise, such as long-distance running.

• Stress.
• Poor nutrition.
• Use of certain drugs as above.

• Obtain prompt treatment from your doctor for diseases like tuberculosis.
• Don’t take any drugs without doctor’s advice.

• History and examination by a doctor.
• Laboratory studies, such as a pregnancy test, Pap smear and hormone levels.
• Rarely, surgical diagnostic procedures, such as laparoscopy or hysteroscopy.
• Therapeutic trial of progesterone. If bleeding occurs after progesterone is withdrawn, the reproduction system is functional.

POSSIBLE COMPLICATIONS

None expected if no serious underlying cause can be discovered.

PROBABLE OUTCOME

Amenorrhoea is not a threat to health. Whether it can be corrected depends on the underlying cause:

• If it is due to pregnancy or breast-feeding, menstruation will resume when these conditions cease.
• If it is due to discontinuing use of oral contraceptives, periods should begin in 2 months to 2 years.
• If it is due to impending menopause, periods will become less frequent and gradually stop.
• If it is due to endocrine disorders, hormone replacement usually causes menstruation to resume.
• If it is due to eating disorders, successful treatment of the disorder is necessary for menstruation to resume.
• If it is due to diabetes or tuberculosis, menstruation may never resume.
• If it is due to strenuous exercise, periods usually resume when exercise decreases.

• Reduce stress.
• Dilatation and curettage (D & C).
• Psychotherapy or counseling, if it is stress-related.

MEDICATION

Your doctor may prescribe hormones or hormone replacement therapy, if menopausal.

ACTIVITY

No restrictions.

CONTACT YOUR DOCTOR, IF

• Your periods have ceased for 3 or more months.
• Your periods don't resume in 6 months, despite treatment.
• New, unexplained symptoms develop with hormones used in treatment.