Amenorrhea and oligomenorrhea

AMENORRHEA AND OLIGOMENORRHEA

INTRODUCTION & STATISTICS

WHAT ARE AMENORRHEA AND OLIGOMENORRHEA?

Amenorrhea- absence of menstruation.

• Primary: Never started by age 16. Secondary: Stopped for 6+ months.
• Primary: Never started by age 16.
• Secondary: Stopped for 6+ months.

Oligomenorrhea: Infrequent periods (cycles longer than 35 days).

• WHO Data
• WHO Data

• Affects 3–5% of women of reproductive age. Up to 25–30% in athletes and those with eating disorders. PCOS (a major cause) affects 8–13% of women globally.
• Affects 3–5% of women of reproductive age. Up to 25–30% in athletes and those with eating disorders. PCOS (a major cause) affects 8–13% of women globally.
• Affects 3–5% of women of reproductive age.
• Up to 25–30% in athletes and those with eating disorders.
• PCOS (a major cause) affects 8–13% of women globally.

Signs and Associated Symptoms

Amenorrhea - no periods at all.

Oligomenorrhea - periods every 2–4 months or irregularly.

Other symptoms:

Acne

Anovulation (absence of ovulation )

Weight changes (loss or gain)

hair loss (hormonal imbalance)

DIAGNOSIS

• Medical history & physical exam: Cycle history, diet, exercise, stress. Pregnancy test: Always the first step. Blood tests: Hormones (FSH, LH, TSH, prolactin, estrogen, testosterone). Ultrasound: Pelvic ultrasound (ovaries, uterus). MRI/CT: If a pituitary tumor is suspected. Genetic testing: For primary amenorrhea.
• Medical history & physical exam: Cycle history, diet, exercise, stress.
• Pregnancy test: Always the first step.
• Blood tests: Hormones (FSH, LH, TSH, prolactin, estrogen, testosterone).
• Ultrasound: Pelvic ultrasound (ovaries, uterus).
• MRI/CT: If a pituitary tumor is suspected.
• Genetic testing: For primary amenorrhea.

TREATMENT

Treatment depends on the cause:

• Hormonal therapy: Birth control pills, progesterone. Medication: Metformin (for PCOS), dopamine agonists (for hyperprolactinemia). Lifestyle changes: Healthy weight, stress management, balanced exercise. Surgery: For structural issues (e.g., uterine scar tissue). Assisted reproductive technology (ART): For fertility issues.
• Hormonal therapy: Birth control pills, progesterone.
• Medication: Metformin (for PCOS), dopamine agonists (for hyperprolactinemia).
• Lifestyle changes: Healthy weight, stress management, balanced exercise.
• Surgery: For structural issues (e.g., uterine scar tissue).
• Assisted reproductive technology (ART): For fertility issues.

PREVENTION

Can They Be Prevented?

Steps to reduce risk:

• Maintain a healthy weight. Avoid extreme dieting and rapid weight loss. Exercise in moderation. Manage stress (yoga, meditation). Regular check‑ups. Balanced nutrition (calories, vitamins, minerals).
• Maintain a healthy weight.
• Avoid extreme dieting and rapid weight loss.
• Exercise in moderation.
• Manage stress (yoga, meditation).
• Regular check‑ups.
• Balanced nutrition (calories, vitamins, minerals).

GLOBAL ASPECTS

Social and Health Impact (WHO Perspective)

• Infertility: Major long‑term consequence. Bone health: Osteoporosis risk due to low estrogen. Mental health: Anxiety, depression, body image issues. Access to care: Limited in low‑income countries. Awareness: Lack of education about menstrual health. Economic impact: Lost productivity due to untreated conditions.
• Infertility: Major long‑term consequence.
• Bone health: Osteoporosis risk due to low estrogen.
• Mental health: Anxiety, depression, body image issues.
• Access to care: Limited in low‑income countries.
• Awareness: Lack of education about menstrual health.
• Economic impact: Lost productivity due to untreated conditions.

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