Patient's question:
My sister is 34 years old this year. She hasn't had her period for two months. Before that, her periods were also irregular and she had to take medication to induce them. But now, even medication isn't working. She has a history of chronic measles and has been taking medication frequently. I wonder if this could be the reason? Or is there another cause for her cessation of menstruation? If this is a case of amenorrhea, what kind of treatment would be needed?Doctor's answer:
Hello: There are many reasons for amenorrhea:First, diseases. Consumptive diseases, such as severe tuberculosis, severe anemia, or malnutrition; specific endocrine disorders, such as "obesity-related protein-energy malnutrition"; or dysfunction of certain endocrine glands, such as adrenal glands, thyroid glands, or pancreatic glands. Due to these factors, menstruation may not occur. If amenorrhea is caused by any of these conditions, it will naturally return once the disease is treated.
Second, lower genital tract obstruction. For example, congenital or post-traumatic adhesions or obstructions in the cervix, vagina, hymen, or labia. Even if menstruation occurs, the blood cannot flow out, which is known as hidden or pseudo-amenorrhea. Lower genital tract obstruction can be completely cured with medical treatment.
Third, incomplete or underdeveloped reproductive organs. Some individuals may be born without ovaries, or with underdeveloped or damaged ovaries, which cannot produce estrogen and progesterone. As a result, the endometrium does not undergo cyclical changes, leading to no shedding of the endometrium and thus no menstruation. Others may be born without a uterus, or with underdeveloped or damaged endometrium. Even if the ovaries function normally and estrogen and progesterone are secreted properly, menstruation will not occur.
Additionally, tuberculosis endometritis, as well as dysfunction of the pituitary gland and hypothalamus, can also cause amenorrhea. Many factors can lead to hypothalamic dysfunction, such as emotional stress, sadness, anxiety, fear, fatigue, or environmental changes and cold exposure.