Amenorrhea is a condition, where absence of menstruation in premenopausal women occurs. In many cases Amenorrhea is not a cause for concern. However, if it persists for more than several months it should be treated, since over time the lack of ovulation and the drop in estrogen levels can increase bone turnover, thus raising the risk of osteoporosis, a systemic and often debilitating skeletal disease. This disease happens when the bones gradually lose their stone of calcium and other minerals. Amenorrhea affects a woman’s fertility.

Usually this condition is most frequently due to delayed puberty, a condition in which maturation is slower than average because of genetic factors or environmental factors such as poor nutrition. Sometimes the first menstrual period is delayed when a girl is undergoing heavy athletic training, stress, or if she has anorexia. At seldom, amenorrhea may result from some anatomical obstructions such as imperforate hymen, which blocks the blow of blood out of the vagina. Another common cause of this disease is a polycystic ovary syndrome, a condition marked by multiple ovarian cysts and excessive production of androgen (male-type hormones). Usually, amenorrhea does not require evaluation or treatment until the age of 18.

However, for girls it is important to see a doctor to rule out the few rare but serious causes of primary amenorrhea. The evaluation includes a pelvic examination, CT scan, or MRI in order to make sure there are no other diseases involved. After the age of 18 these investigations must be done. To prevent complications from amenorrhea, a doctor will prescribe estrogen supplements to help prevent osteoporosis. Supplemental calcium is often suggested as well. Women, who want to bear children, may require medications, such as clomiphene to stimulate ovulation. Various herbal remedies are often recommended. Amenorrhea may be prevented by maintaining normal body weight, reducing stress, and moderate exercise.

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