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Where is my period?

What's the first thing that comes to mind the minute you don't get your period? If you thought the same thing I did, it's okay, because when a woman doesn't present her period, the first thing a physician will do is take a pregnancy test. Why a pregnancy test, you ask? Because it’s the most common cause for not receiving our periods and the doctor will ALWAYS dismiss a physiological reason like, breastfeeding, puerperium (the period of adjustment after childbirth during which the mother’s reproductive system returns to its normal state) and menopause.

Amenorrhea who?

But these may not be the only reasons for not having your period, this gynecological symptom is called amenorrhea, in medical terms, and it is classified in two ways, primary amenorrhea, and secondary amenorrhea. To keep it simple for today we will be focusing on secondary amenorrhea, but I'll give you an introduction first.

Primary amenorrhea

It's when teenagers' bodies fail to present spontaneous menstrual bleeding around the age of 14 along with the absence of secondary characteristics like the development of their breasts and pubic hair growth or when they don't present their menstruation at around the age of 16, even though their secondary characteristics have been developing. In, shorter terms, it's when the woman has never gotten her menstruation even though having an adequate age for it.


Secondary amenorrhea

Is defined as the absence of menstruation between 3 to 6 months in women that receive their periods regularly, and that is what we will be talking about today.


Why?

First, let's clarify why these alterations take place. We have to keep in mind that in order to menstruate, there is a cycle through which hormones circulate. This cycle begins on the hypothalamus (functional anatomic structure located in the brain) and concludes on the ovaries (located in the womb or uterus). These pathologies can occur at different points on the axis that affect the normal hormonal cycle, and in addition to hormonal alteration, there may also be anatomical altercations due to surgical procedures in women.


So, what could be the symptoms manifesting that I have amenorrhea? (symptoms depend on the type of amenorrhea you're experiencing)

  • Secretion of milk from the nipple

  • Headache

  • Excessive facial and body hair

  • Acne

  • Infertility

  • Changes in vision

  • Dry skin

  • Heats

  • Recurrent abortions


The main pathologies that cause it are:

  • Functional hypothalamic amenorrhea due to excessive physical exercise and/or mental disorders

  • Hyperprolactinemia: due to tumors, trauma, or secondary to other pathologies.

  • Ovarian causes such as polycystic ovary syndrome (PCOS).

  • Alterations acquired from the uterus and vagina by surgical procedures, like curettage (cutting of tissue) and surgical resections.


Consult your doctor!

We can't stress this enough, but, it is always important to consult your gynecologist and/or endocrinologist if experiencing any weird symptoms you may not have before, or if your period hasn't been present in a long time. As the protocol indicates, physiological causes such as pregnancy will always be ruled out. Additionally, the physician will ask for personal, familiar, and OB/GYN history. Remember that menstruation can stop for many different reasons, it does not necessarily mean that a person is infertile and can never conceive and treatment in many cases are available!


Camila Quintero

Adira advisor, last year medicine student interested in women’s wellness and promoter of a healthy lifestyle. You can find more of her content on @karantina_col where you'll find recipes and tips to a better wellbeing.


Weatherspoon, D. (2018). Amenorrhea: Types, causes, and treatment. Medicalnewstoday.com. Retrieved 26 August 2020, from https://www.medicalnewstoday.com/articles/215776#takeaway.


Botero Uribe, J., Henao, G., Londoño Cardona, J. and Júbiz, A., 2010. Obstetricia Y Ginecología. 8th ed. [Medellín]: [Corporación para Investigaciones Biológicas], pp.480-482.


Foto de Polina Zimmerman en Pexels

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