Cyclical changes in a woman’s body happen every month. However, stress, overwork, poor diet and other adverse external factors, plently of which are present in our everyday life, cause disruptions in the menstrual cycle. But is the menses delay not associated with pregnancy a problem that needs medical attention?
When to Worry?
If menses have not come on time, the usual pregnancy test or a blood test for beta-hCG would confirm or rule out one of the probable reasons for the menses delay in women of reproductive age. Absence of the menstrual cycle should not cause concern in nursing mothers, and its interruptions are not uncommon in women taking contraceptives regularly. In all other cases, the delay of menses can become a cause for concern.
Of course, expectation prolonged for 5-7 extra days is not a reason for running to the doctor. But what if the menses did not come after 2-3 weeks, or even in the next cycle? A rare woman would not ask: “What happened to me?” And would not rush to the doctor to get answers.
She would be surprised to hear that absence of menses for one or even two cycles in a row is not a reason for serious medical examinations.
The doctor might ask about your lifestyle, diet and medications. He would give some recommendations, following which you would be able to normalize menstrual cycle so the follow-up visit to the doctor would not be needed anymore.
Professional medical care is required in all cases, when the menses are absent for three consecutive cycles. Such a long delay in menstruation in women of reproductive age is called secondary amenorrhea. Secondary amenorrhea is not an illnesss, but a symptom that can accompany many diseases and pathological conditions.
Why is There a Delay in Menstruation
Regular menstrual cycle is governed by the efficient work of the hypothalamus, pituitary gland, ovaries and uterus. Hypothalamus stimulates the pituitary gland to release gonadotropins – follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH induce ovaries to produce estrogen and progesterone hormones, which are responsible for the cyclical changes in the endometrium (lining of the uterus), including the onset of menstruation. Besides, there should be no obstacles in the woman’s genital tract for the normal outflow of menstrual blood.
Secondary amenorrhea may indicate a disfunction in the hypothalamo-pituitary-ovarian axis. However, menses can be absent due to other functional reasons.
The most common causes of secondary amenorrhea are:
- hormonal imbalance;
- pituitary tumor;
- excessive body weight;
- weightloss;
- stress, depression;
- bulimia;
- anorexy;
- excessive physical exercises;
- use of some kinds of medication (for instance, corticosteroids);
- chronic disease (for instance, tuberculosis);
- premature menopause (menopause before the age of 40).
How to Identify the Cause of Secondary Amenorrhea
To identify the cause of the long menstruation delay a medical examination is required:
- blood tests to determine levels of hormones prodcued by the pituitary gland (FSH, LH, thyroid-stimulating hormone (TSH) and prolactin) and ovaries (estrogen, progesterone);
- pelvic ultrasound examination to exclude polycystic ovaries;
- computer (CT) or magnetic resonance (MR) imaging of the brain to exclude tumors of the pituitary and hypothalamus;
Additional tests may include:
- tests for thyroid function;
- blood prolactin level evaluation;
- hysterosalpingography — an x-ray examination of the uterus and fallopian tubes;
- hysteroscopy – endoscopic examination of the uterus.
How to Treat a Delayed Menstruation
Depending on the cause of the delayed menstruation, the doctor will choose the necessary treatment method. Most often, hormone medication is prescribed to normalize the menstrual function. In some cases, such as the polycystic ovary syndrome or hyperprolactinemia caused by the pituitary tumor, a surgery might be needed if other treatment proved is ineffective.
However, in all other cases of secondary amenorrhea not related to any of the hypothalamus, pituitary, ovary and uterus diseases, it is sufficient to adjust the way of life and eliminate the root cause of the delay period in order to solve the problem.
If amenorrhea was caused by the extremely intense weight loss due to a diet, it is necessary to normalize your eating by choosing a balanced diet. If you have excessive weight you should limit the amount of fats and easily digested carbohydrates in the diet.
You might need a nutritionist help to normalize your weight.
Excessive fitness and intensive training for more than 8 hours per week are another reason of the delayed menstruation. To restore your normal menstrual cycle it is necessary to reduce physical activities and choose an individual exercise program.
If the secondary amenorrhea was caused by emotional stress or prolonged depression this is a reason to seek a therapist’s help to bring your soul and body into harmony.
Delayed menstruation is a one more reason to get rid of your bad habits.
Avoiding alcohol and smoking will not be superfluous. A healthy diet is necessary even if the delayed menstruation problem is not related to the insufficient or excessive body weight. It is advisable to forgo fried foods and coffee, eat more food rich with unsaturated fats. Whole grain food, vegetables, fish and nuts are healthy eating. A long delay in menses increases the risk of osteoporosis, so it is necessary to make sure you eat adequate amounts of calcium (1000 mg a day) and vitamin D (200-400 IU a day).
Alternative Methods of Amenorrhea Treatment
Alternative methods of treatment for secondary amenorrhea can be offered by the homeopathy and acupuncture specialists. Modern medicine does not deny the effectiveness of homeopathic remedies for delayed menstruation. A professional homeopath will choose the treatment plan, taking into account the patient’s constitutional type, her physical, emotional and intellectual state.
Acupuncture is able to eliminate hormonal imbalances and associated delay in menstrual cycle. Acupuncturists believe that amenorrhea is primarily caused by the lack of the vital qi energy in the liver and kidneys meridians, so the treatment is focused on these areas. Amenorrhea related to the absence of ovulation makes it difficult to become pregnant. Acupuncture shows good results in the restoration of ovulation and reproductive function in women with infertility.
