Amenorrhoea

The absence of periods in women is often termed as amenorrhoea. It usually means that no eggs have been produced,
Physiological amenorrhoea is the condition is seen in girls who have not attained puberty or in women who are pregnant or breastfeeding. It also includes women who have attained menopause.

Oligomenorrhoea is a condition that is related to amenorrhea. In this case, periods may be long, irregular and infrequent. Periods in this case usually occur once in three or six months.
.
Another case is primary amenorrhoea in which no menstruation is established in girls. If a girl does not start her physical menstruation by fourteen years or if the girl does not exhibit her normal sexual behaviour by sixteen years, the girl is considered to have some abnormality.

Secondary amenorrhoea is the condition where menstruation is absent in a woman consecutively for six months, who had her periods regularly. This indicates the presence of gynaecological disorder,

Causes

• Due to over exercising in athletes
• If a woman is seriously underweight, due to lack of proper eating.
• High emotional disturbance or stress
• If the ovaries have problems in producing eggs
• Usage of certain medical drugs.
• Use of contraceptive pills without regular pill free intervals.
• Polycystic Ovarian Syndrome.
• Long period of illness
• Hyper or hypo active thyroid glands
• Abnormal functioning of hormones that control ovulation

Some causes of amenorrhoea, which occur very rarely, include:
Absence of womb, vagina, or both at the time of birth
A hymen completely closing vagina

Diagnosis

Even though the diagnosis of amenorrhoea depends of the nature of the basic cause, a pregnancy test may be conducted first after looking into the history and age of the person.

A complete history that covers the family history, activity history, work history, emotional upsets, change in weight of the body, sexual history and any medical history is taken .

In other cases for the purposes of diagnosis a complete gynaecological examining in combination with a number of tests is done. The tests performed can include the blood tests required to determine various hormonal levels. A chance of chromosome examination test being done is very rare, but in case the doctors doubts the sex of the patient.
.
If any abnormalities are present in the genitals, a MRI scan or a CT scan will provide the necessary information on the same.

Treatment

Most of the cases of amenorrhoea can be treated by using the hormone replacement therapy (HRT).

Amenorrhoea which is related to exercise must be treated by modifying the exercise programme. Proper attention on diet must also be given.

If a person is under weight, necessary weight gain under proper supervision must be done.

For improperly developed genitals, surgery is the option.

For Polycystic ovarian syndrome, a weight reduction along with the use of a drug called Metformin, can be used.

Under activity of thyroid gland needs to be treated using thyroxin.

A simple surgery will help to correct a incomplete hymen.