Delay in attainment of puberty and any abnormal rhythm,
alarms every women. Absence of periods in between puberty
and menopause is a clear signal of pregnancy, however
in some cases amenorrhea can indicate an underlying
medical problem. If the problem is present in a young
girl who has not started to menstruate even at of age
16 yrs is medically termed as Primary Amenorrhoea and
the term secondary Amenorrhoea is used to indicate those
who had previously regular menstrual cycles.
Primary Amenorrhoea, that is delay
in puberty or failure may be because of some hormonal
imbalance or developmental problem. There may be a pituitary
dysfunction, ovarian failure or some developmental problems
in Ovaries and Uterus.
Some girls may need more time to mature
and get delayed onset of menses. It may be considered
normal, if the menses start upto 18years. Otherwise
the body changes start appearing like growth spurt,
breast development and genital hair. Sometimes very
low weight or dietary deficiencies are also responsible
for such delay. Just waiting and improvement in general
health status helps in starting the menstruation.
The normal menstrual cycle is under the control of
certain hormones. The pituitary secretes LH and FSH
from the pituitary gland in the brain. A deficiency
in these hormones ovarian stimulation impaired and
causes Primary Amenorrhoea.
Hyperprolactinaemia is a condition where another pituitary
hormone Prolactin is secreted in excess due to the
presence of Tumour.
In some cases ovaries do not develop
properly. This may happen due to some genetic defect,
some environmental influences during development or
due to certain unexplained reasons. Congenital malformations
are also reported in many cases. These may also happen
due to genetic defects or environmental effects.
Other rare causes include general illness like thyroid
disease, diabetes, tuberculosis etc, which may occur
at young age usually and affect the onset of menses.
Treatment of primary disease results in solving menstrual
Secondary amenorrhoea is a very common ailment in
women. Delay in periods for few days would make stressful
in a women, since the most common cause is pregnancy.
A variety of reasons can cause secondary amenorrhoea.
The first cause could be a hormonal
imbalance! Hypothalamus, which is highly associated
with our emotions, has to order pituitary gland to
secrete the Follicular stimulating hormone (FSH) and
Leutinizing hormone (LH). The ovaries releases ovum
and secretes the hormone Oestrogen and Progestrone
. These hormones ripe and grow the inner lining of
the uterus. These hormones control menstruation and
growth of an embryo here.
Any obstruction in this tract,
even our emotions and environmental change could make
some deviation in the hormonal levels, thereby causes
early or delayed periods in women commonly. Now a
days polycystic ovarian disease, hypothyroidism, adrenal
disorders obesity associate themselves in eliciting
a hormonal imbalance very frequently. Anaemia, Tuberculosis
and any illness even fever could results in change