Waiting for the period: When the menstrual period is absent, this is often a moment of shock. Quickly comes up a question: “Am I pregnant?” But the absence of menstruation can have other causes. We explain what causes the period to go off, when it makes sense to visit the gynecologist and what the absence of the rule (amenorrhea) means. Day counting begins: When the menstrual period stops, many women fall into a slight panic. “Am I pregnant?”, “Did I really prevent it?”, “Did I take the pill properly?” – these questions are swirling around in my head. But pregnancy is not always the reason for the missing period. The female cycle is complex and disorders can have different causes. The absence of menstrual bleeding (amenorrhea) is a normal process during pregnancy, lactation and menopause (climacteric) . If pregnancy is ruled out, the missing menstruation can be attributed to other causes (pregnancy can not be ruled out if the gynecologist is consulted). One speaks of one Primary amenorrhoea if no menstrual bleeding occurred until the age of 16 years. Then usually there is a genetic disease or a morbid change of the genitalia. In most cases, however, the absence of bleeding is a secondary amenorrhoea – several cycles have already taken place before menstruation stops. The article further discusses the most common causes of secondary amenorrhea.
1. Stress affects the cycle
A move, stress in the job or a stressful row in the family: mental and physical stress can have a negative effect on the female cycle. Important appointments, upcoming journeys with a time lag or time pressure also disturb the processes of the body. Thus, in emotionally stressful phases, the menstrual period can be avoided. The best way to counteract stress is to relax. Those who take their time and pay attention to the needs of their own body will quickly return to their usual rhythm. Relaxation methods such as progressive muscle relaxation , autogenic training have a positive effect on the mind and well-beingor meditations. Sport can also help to bring the hormone balance back into balance – by moving stress hormones are reduced in the circulation.
2. Extreme physical stress disturbs the menstruation
Professional athletes will know this: Anyone who pushes his body regularly to the absolute limit of load, risking a disruption of the cycle. After all, extreme competitive sport affects the body like stress. There is too little of the female sex hormone estrogen formed and the period remains off. Here it helps to step down a bit and allow the body more rest periods. Relaxation methods help the body with the regeneration and after some time the usual cycle should be set again.
3. Underweight or overweight prevent the period
Underweight, the menstrual period remains off. If the body registers a “too little” weight, the uterine lining will no longer mature regularly and consequently there will be no rejection. The focus of the organism is on the life-sustaining measures. Thus, the absence of the period is a common symptom of eating disorders anorexia and bulimia . In case of severe overweight or obesity Hormone production gets out of balance and the period can dry up. In both cases, it is important to normalize body weight. After successful weight gain or decrease, the hormone balance levels off again and the menstrual period is as usual. In the case of an eating disorder, treatment by a therapist is also indicated.
4. Disorders of hormone-forming structures
So that it comes at all to a monthly bleeding, the body produces a cocktail of different hormones. The pituitary gland, adrenal cortex, ovaries and thyroid are significantly involved. If a part of the endocrine system is damaged, menstruation may be the result. Growths, tumors or malformations can be a cause of the problem. Here it is necessary to determine the exact cause by a doctor and to initiate a suitable treatment. Thyroid over or under-function sare treated with the administration of hormone preparations. In the case of a tumor on the pituitary gland, surgery may be necessary. If appropriate, growths or cysts in the ovaries can also be surgically removed.
5. Uterine diseases as a cause of cycle disorders
Various diseases of the uterus can cause the period to fail. After curettage (curettage), the lining of the uterus may be damaged, resulting in no monthly build-up and subsequent rejection. Also, adhesions of the uterine lining can lead to a cessation of menstruation. A congenital malformation of the uterus and / or vagina can prevent a withdrawal of the menstrual period. In this case, the attending gynecologist may correct the problem by surgery.
6. Taking a hormonal contraceptive can prevent bleeding
Anyone who uses contraceptive pills over a longer period of time and dispenses the drug must expect that the monthly cycle will initially be disturbed. After stopping the pill, the bleeding may stop until the natural cycle returns. It may take a few weeks or months for the hormone level to return to normal levels.
7. Medications that interfere with the cycle
A whole series of medications can cause the cycle is not regular – the bleeding may be absent. These include primarily hormonal contraceptives such as the three-month injection, the mini-pill, hormone spirals or implants. Androgens (male sex hormones), cancer treatment drugs (on a hormonal basis), cortisone and psychotropic drugs can also help prevent menstruation. Even if there is no bleeding after taking a new medicine, the dose should never be reduced on its own or the drug should be discontinued. In a discussion with the attending physician, the cause of the cycle disorder can be determined and, if necessary, another medication can be prescribed.
8. Early onset of menopause
In some women, menopause occurs already before the age of 40. The ovaries gradually stop production. The result: First, there are irregularities in the cycle until the period is completely dry. In addition, there are the classic symptoms such as hot flashes and sleep disorders.
Diagnosis of amenorrhea: That’s what the doctor does
If there is a missed menstruation for three consecutive months – without a pregnancy – a doctor’s visit is advisable. The gynecologist is the first point of contact. He will first ask the patient about the current life circumstances and possibly underlying illnesses. When examining the abdomen (uterus, ovaries, vagina) possible physical changes can be detected. Ultrasound images can be used. If there is no physical change in the structures, he will take blood and urine samples and examine the hormone levels. If this is the problem, an endocrinologist can be called in.
Treatment of the cycle disorder depends on the cause
Depending on what causes the disturbance of the menstrual cycle, a suitable therapy is started. In most cases, a mental imbalance and stress is the cause. Here is how to bring peace into everyday life and rediscover the inner center. In some cases, therapy can help to get the mood under control. A hormonal disease is usually treated with the administration of hormone preparations, so that the regular cycle takes place again. Physical changes such as tumors are treated surgically.