Amenorrhoea

What is menorrhoea?

Menorrhoea is the medical word for a period. This usually lasts between 3-10 days, and happens on average, every 28 days. However, it’s normal to have a slightly longer or shorter cycle. Getting to know your menstrual cycle can be a great way to get to better understand your general health too.

What is amenorrhoea?

This is when your period doesn’t happen. There are two main types of amenorrhoea:

1. Primary amenorrhea

Primary amenorrhoea can be either:

• Where you don’t have a period before the age of 15, despite developing features linked with puberty, like breasts and pubic hair.

• Where you don’t have a period by the age of 13 and you don’t develop features linked with puberty.

2. Secondary amenorrhea

Secondary amenorrhoea is where you don't have a period for 3 months when you have previously had normal periods. However, exact definitions vary.

If your cycles are not normally regular and vary in length, amenorrhoea can be defined as up to 12 months after your last period.

What are the causes of amenorrhoea?

Lifestyle factors

In some cases, lifestyle factors can be linked to missing your period. Factors like increased levels of stress, excessive levels of exercise, sudden weight loss or being overweight can all impact your period.

Pregnancy

If you conceive, your periods will stop. Once you have had your baby, your periods can return as early as 5-6 weeks after birth.

Menopause

A common reason for your periods stopping can be because you are going through the perimenopause. This is a natural process and you might notice changes such as:

• Your periods getting lighter or heavier

• Changes to your period pattern, so that it becomes longer or shorter

• Your periods stopping completely

• Other symptoms such as hot flushes, dry skin, irritability and mood changes

Sometimes, some women go through a premature menopause, which happens when you are under the age of 40, or an early menopause, which happens between the ages of 40-45.

PCOS

Another cause for you potentially missing your periods is PCOS. You might have other symptoms such as acne or an increased growth of body hair. This can cause your periods to become irregular, meaning you might go several months without having your period.

Thyroid issues

An overactive or underactive thyroid gland can also affect your periods.

Some medications

Some medications such as antipsychotics, drugs for cancer chemotherapy, allergy medications and antidepressants can also be linked to amenorrhoea. Sometimes, after stopping contraception, it takes some time for your periods to return to a regular pattern or cycle.

Genetic conditions

Turner syndrome is a genetic condition that some females have, which can mean that you might never have a period. Sometimes, this is tricky to diagnose until you reach puberty, as it mainly affects height and sexual development. This is an example of primary amenorrhoea and is one reason why girls don’t start their period.

What are the symptoms of amenorrhoea?

The most obvious sign that people notice is that their periods stop.

Any of the other symptoms depend on the underlying cause for the absence of your periods.

Common accompanying symptoms include:

• Headache and vision changes

• Milky discharge from your nipples

• Acne

• Excess facial and body hair

• Hair loss

• Pain in the pelvic area

How is amenorrhoea diagnosed?

If your periods suddenly stop, speak to a doctor in the first instance. They will ask you to perform a pregnancy test, just to rule out pregnancy as the cause of your amenorrhoea.

Depending on how long you’ve gone without a period, they might advise you to wait a little longer for your periods to see if they return on their own.

If your period still does not arrive, your doctor may advise having some blood tests to look for some of the most common causes.

Depending on the results of these tests, your symptoms can either be managed by your GP or you may be referred to a specialist for further advice.

How is amenorrhoea treated?

Your treatment will depend on the underlying cause. If your periods have stopped due to early menopause or menopause, they may suggest hormone replacement therapy (HRT) to help manage accompanying symptoms.

If your thyroid gland is producing too much, or too little, hormones, you might be given medication to help resolve any symptoms.

If a doctor finds that the cause of your amenorrhoea is because of something like PCOS, they might advise you to start on a hormonal contraceptive to help regulate your periods.

When should I speak to a doctor about amenorrhoea?

If you’re concerned about your periods stopping, or you’re experiencing heavy or irregular periods, talk to a doctor. Similarly, if you have accompanying symptoms like acne or hair loss, speak to a doctor who will help to investigate the cause.

How can Livi help?

A Livi doctor can talk to you about your symptoms and give you advice on the next steps and possible treatment.