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Where is my period? pt. 2


¿Has your period not arrived yet? Like, ever? Like we mentioned in the previous post (we really recommend you take a look at it) it is very important that you discard any pregnancy. If that is out of the way than you may be suffering from primary amenorrhea, this type of amenorrhea has its root in the endocrine system (organs that make hormones and release them directly into the blood), so you should check for anatomic, and genetic alterations.



Primary Amenorrhea

You may be wondering, what is primary amenorrhea? It is the absence of a spontaneous menstrual period at the age of 14, with the absence of secondary sexual characteristics, or not presenting the menstrual cycle at 16 years of age, even if there is already the presence of secondary sexual characteristics. In simple words: Primary amenorrhea occurs when a woman has never had her period during the age of puberty.

Amenorrhea is a symptom (a signal perceived by the patients, that something is happening in their body) that can be present in many pathologies; some of these can compromise fertility. Just as secondary amenorrhea, some primary amenorrhea symptoms can be: secretion of milk from the nipple, headache, excessive facial and body hair, acne, heats, and some of them can be particular depending on the etiology like chromosome alteration.

It's not necessary to wait until age 16 to know if you present amenorrhea. Nowadays, physicians have parameters for a previous diagnosis:

  1. Absence of secondary sexual characteristics at 14 years of age.

  2. At 15 years of age, having incomplete or delayed sexual development.

  3. Lack of the period at 16 years of age.

Causes

The causes of primary amenorrhea are rare and have lots of classifications. This is how they are divided:

  • Genetics: it is the most common cause of primary amenorrhea, it occurs due to chromosomal or genetic alterations.

  • Example: Turner syndrome, which is due to the lack of an X chromosome, generating sexual infantilism.

  • Anatomical defects: when their cause is located in the organ (uterus or endometrium) or in the tract (vulva o vagina)

  • Example: the absence of uterus and vagina.


  • Endocrine: functional or organic alteration in the hypothalamic-pituitary- ovary axis

  • Example: malnutrition


Visit your doctor!

Consult your gynecologist and endocrinologist if you feel like you might be experiencing amenorrhea. In many cases, this condition is also handled by a pediatric endocrinologist. As we mentioned initially, pregnancy, the most common physiological cause of amenorrhea, needs to be ruled out first. After ruling that out, it's necessary to know your medical history and your family's, and do the respective tests to get a full diagnosis.


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.

Botero Uribe, J., Henao, G., Londoño Cardona, J. and Júbiz, A., 2010. Obstetricia Y Ginecología. 8th ed. [Medellín]: [Corporación para Investigaciones Biológicas], pp.480-488.


Sepúlveda Agudelo, J., Alarcón Nivia, M., & Jaimes Carvajal, H. (2009). AMENORREA PRIMARIA [Ebook] (1st ed., pp. 1-11). Revista Colombiana de Obstetricia y Ginecología. Retrieved 19 September 2020, from http://www.scielo.org.co/pdf/rcog/v60n1/v60n1a08.pdf.


Richards, J., & Hawley, R. (2020). Secondary Sexual Characteristics - an overview | ScienceDirect Topics. Sciencedirect.com. Retrieved 21 September 2020, from https://www.sciencedirect.com/topics/medicine-and-dentistry/secondary-sexual-characteristics.


Photo by Patrick Kool on Unsplash


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