By Dr Joel Enejeta
Cessation of menstruation in a woman who has established a normal and regular menstrual flow previously is one of the major complaints of women in health facilities. It affects a good number of women in their reproductive ages and this affects their day to day living.
In this article, I’m going to highlight on some of the major causes of this condition in women.
The cessation of menses in a woman who had previously menstruated is known as secondary amenorrhoea while primary amenorrhoea is one in which there is failure of menses to occur by age 16 in the presence of normal growth and development of secondary sexual characteristics.
This secondary amenorrhoea is characterized by absence of menstruation for at least six consecutive months or three cycle lengths in women with previously normal and regular menses.
WOMEN WHO ARE AT RISK OF DEVELOPING SECONDARY AMENORRHOEA
The following factors may increase the risk of developing secondary amenorrhoea in women.
- Family history of secondary amenorrhoea- if other women in your family such as mother or female siblings have had secondary amenorrhoea, you may have inherited a predisposition for the problem and as such have an increased chance of developing it sometime in your reproductive years.
- Eating disorders- if you have eating disorders such as anorexia nervosa or bulimia, you are at risk of developing secondary amenorrhoea.
- Athletic training-women who engage in vigorous and strenuous exercises/training also have an increased risk of developing it.
WHAT CAUSES CESSATION OF MENSTRUATION
The following can cause the development of secondary amenorrhoea;
- Pregnancy- this is the most common cause of physiological amenorrhoea, this is so because normal cycle ceases as pregnancy commence. This is normal.
- Lactation- menstruation do not usually occur when you are breastfeeding your baby consistently.
- Menopause- cessation of menstruation naturally occurs in women who have reached menopause maybe from 40yrs and above in some 45-50yrs with an average of 45yrs.
- Intrauterine adhesions- excessive uterine adhesions may occur following extensive pelvic surgery or following dilatation and curettage (D&C){A procedure used in aborting pregnancy or removal of retained placental products} and this causes bands and adhesions in walls of uterus and fallopian tubes, this is a major cause of amenorrhoea and infertility in women.
- Endometritis- this is the inflammation of the endometrium of the uterus which may be due to tuberculous infection and this is one of the major cause of cessation of menses.
- Premature ovarian failure- when the ovary prematurely fails to produce hormones necessary for menstrual cycle to occur.
- Head injury which may affect the pituitary gland.
- Prolactinoma-it is a benign tumour of the pituitary gland and this can also cause your menses to cease.
- Drugs such as contraceptives ( levonorgestrel) otherwise known as postinor, chemotherapy(cancer drugs), radiotherapy, methyldopa, cimetidine (peptic ulcer drug) etc may still cause cessation of menstruation.
- Other causes include; excessive weight loss, eating disorders, excessive exercise, stress, depression, liver and kidney diseases.
COMPLICATIONS IN WHICH CESSATION OF MENSES CAN CAUSE
- Infertility- inability to achieve pregnancy
- Osteoporosis- weakening of your bones if this is caused by low oestrogen levels.
TREATMENT/CONCLUSION
The treatment of cessation of menstruation depends on the cause and patients are advised to visit health facilities for proper investigations and appropriate treatment based on the cause of the problem.
