Understanding amenorrhoea: Impact on women’s health

Amenorrhoea, the medical term for the absence of menstruation, is a condition that can significantly impact a woman’s reproductive health and overall wellbeing.

Here, Dr Rebecca Scott, renowned consultant endocrinologist, diabetologist and obstetric physician, offers an expert insight into amenorrhoea, explaining the different types, their causes, and the treatment options available.

What is amenorrhoea?

Amenorrhoea is when a woman doesn’t have her menstrual period.

Amenorrhoea can be classified into two main types:

• Primary amenorrhoea: When a woman never has a period at any point (they don’t start in puberty).
• Secondary amenorrhoea: When a woman starts her periods as usual at puberty, but then they stop.

What are the common causes of secondary amenorrhoea?

The most common hormonal causes include:

• polycystic ovary syndrome (PCOS)
• post-contraceptive pill amenorrhoea
• hypothalamic amenorrhoea (where stress or low body weight causes periods to stop)
• primary ovarian insufficiency, also referred to as early menopause
• pituitary gland problems
• pregnancy!

There can also be gynaecological causes (such as adhesions or outflow obstruction), but the majority of cases are due to hormonal issues.

What are the potential long-term health implications of untreated/prolonged secondary amenorrhoea?

These depend partly on the cause of the amenorrhoea. The obvious one is that it may have implications for fertility, but the other areas that can be affected are bone health; mood, anxiety, and sleep disturbances; weight; uterine health.

Can secondary amenorrhoea affect fertility?

Fertility may be compromised in a woman who has secondary amenorrhoea as it often means she is not ovulating.

When should I seek medical attention for secondary amenorrhoea?

If you have not had a period for 6 months (and you are definitely not pregnant), you should seek medical advice.

How is secondary amenorrhoea treated/managed?

This depends on the cause. Often, in women not seeking pregnancy, we use hormone replacement therapy (HRT) or the combined oral contraceptive. If stress or body weight are the underlying issue, we address these. Sometimes, we also treat the consequences of amenorrhoea, such as low bone density.

What lifestyle changes can I also make to support the management of my secondary amenorrhoea?

Again, this depends on the underlying cause. However, in general, ensuring you are at a healthy weight and undertaking regular, but not excessive, exercise can help in the management of secondary amenorrhoea.

If you would like to schedule an appointment with Dr Rebecca Scott, head on over to her Top Doctors profile today.