Doctors define secondary amenorrhea as the absence of a menstrual period for three or more months in someone who previously experienced regular menstrual cycles. In other words, if your periods were regular and your cycles were normal, but you’ve missed your last three periods and you aren’t pregnant, you may have secondary amenorrhea.
Women who experience irregular periods may also suffer from secondary amenorrhea. Doctors typically wait for six months with no period before diagnosing secondary amenorrhea in the case of women with irregular cycles. There is a condition called primary amenorrhea in which a woman hasn’t ever had a period. If you’ve had at least one period and your cycle stops, it’s considered secondary.
Causes of Secondary Amenorrhea
There are several conditions linked to secondary amenorrhea, including hormonal imbalances brought on by an underlying condition, weight changes, chronic stress, certain medical conditions, and their treatment that cause your periods to cease. But no matter the cause, secondary amenorrhea often indicates that ovulation isn’t occurring and that can have an impact on your fertility.
Hormonal Imbalances
A normal menstrual cycle, as well as fertility, depends on hormones. Estrogen, the primary female hormone, rises, which signals the lining of the uterus to thicken and grow in anticipation of the implantation of an embryo. While your uterine lining thickens, one of your ovaries prepares to release an egg. Unfertilized eggs disintegrate and, along with your menstrual lining, pass out of your body via your period.
Imbalanced hormones are a big reason women experience secondary amenorrhea. While it isn’t uncommon for your hormones to be a bit out of whack sometimes, three months or more without a period is much more concerning. Causes of your hormonal imbalance may be:
- Pituitary gland tumors
- Overactive thyroid (hyperthyroidism)
- Higher than normal testosterone
- Lower than normal estrogen
Structural Complications
Certain conditions can cause what’s known as structural complications, which may cause your periods to halt. PCOS, the most common endocrine disorder in women of reproductive age, disrupts the hormonal balance and causes non-cancerous masses, or cysts, to grow in your ovaries, preventing ovulation and resulting in secondary amenorrhea.
Sexually transmitted infections and other pelvic inflammatory conditions cause scar tissue to develop, as do surgeries in the pelvic region. The scar tissue may prevent ovulation, causing secondary amenorrhea.
Treatment for Certain Medical Conditions
Some medical conditions require treatment that may cause secondary amenorrhea. They are:
- Chemotherapy and radiation may cause secondary amenorrhea. If you’ve had cancer treatment that involved chemo or radiation, let your doctor know.
- D&C to treat abnormal bleeding or remove tissue from your uterus may cause scarring that causes secondary amenorrhea.
- Hormone therapy to treat diabetes, early menopause, a thyroid condition, a growth disorder, or cancer.
Certain Lifestyle Factors
Lifestyle factors such as being extremely overweight, may result in your periods ceasing. Women who have less than 15% body fat may also suffer secondary amenorrhea. This can be common among female athletes who train excessively. Also, those who are severely underweight due to an eating disorder may experience secondary amenorrhea.
In today’s high-stress environment, it isn’t uncommon for individuals suffering from chronic stress to develop secondary amenorrhea. If you suffer from unrelenting stress and need ways to cope, please let your doctor know. In many cases, once you healthily manage your stress, your periods resume.
The Symptoms of Secondary Amenorrhea
While the obvious symptom of this condition is the absence of your monthly period, there are other signs too. If you suspect secondary amenorrhea, you may experience:
- Vaginal dryness
- Excessive hair growth on areas of your body where you previously had very little to no hair.
- Headaches
- Vision problems or noticeable changes in vision
- Raspy or deep voice
- Discharge from your nipples
- Acne
If you experience any of the above symptoms, along with no period for three or more months, please alert your doctor.
How is Secondary Amenorrhea Treated?
Treatment depends on the cause and diagnosis of your secondary amenorrhea. Doctors treat most hormonal issues through hormone therapy or medications. Scar tissue, adhesions, and ovarian cysts may be surgically removed. If you are overweight or underweight so severely that it impacts your menstrual cycle, your doctor may refer you to a nutritionist, dietitian, or therapist so you may address diet and fitness in a healthy way.
Secondary Amenorrhea and Fertility Treatment
Although doctors don’t consider the condition itself a direct form of infertility, it’s necessary to ovulate for natural conception. If you’re trying to conceive without success and feel it’s related to secondary amenorrhea, there are ways to overcome your infertility.
Treatment for infertility because of your secondary amenorrhea depends wholly on your diagnosis. There may be multiple causes, and your doctor addresses each before determining the correct treatment plan.
Let’s Find Answers Together
For more information on secondary amenorrhea, or if you suspect you may have infertility for any other reason, please contact LA IVF today. Schedule a consultation, and together we will find answers.
