Patients can play a key role in restoring their reproductive health. Seek medical care if menstrual periods do not start by the age of 16, or if periods have stopped for 3 months. Also seek medical treatment if there are no signs of puberty by the age of 14.
Ask your physician to refer you to additional medical professionals, as appropriate. For example, if you are overweight or underweight, a nutritionist can determine your ideal calorie intake and teach you to put together nutritionally balanced meals.
If your amenorrhea is due to an eating disorder, you may find that psychological or psychiatric counseling will help resolve the emotional issues at the root of your problem.
Lifestyle changes and stress reduction may restore balance. In some young women, certain lifestyle changes may be sufficient to remedy primary amenorrhea. Treatment for eating disorders may be required. Additionally, changes in nutritional intake may be necessary to correct weight problems. Stress reduction may benefit patients with either primary or secondary amenorrhea. Psychotherapy or counseling also may be helpful for patients with underlying emotional disorders or concerns.
Your doctor is the best source of information on the drug treatment choices available to you.
Nutritional deficiencies should be addressed. Nutritional requirements, particularly in female athletes, should be met. Most patients with underlying nutritional deficiencies will benefit from taking supplements and/or eating foods rich in vitamin B complex (brewer's yeast, wheat germ) and zinc (fish, poultry, and lean meats). To prevent osteoporosis, women with amenorrhea should consume more calcium-rich foods, and also may need to take calcium supplements with vitamin D.
Surgery may be required for some patients with amenorrhea. In some young women with primary amenorrhea, minor surgery may be required to make an opening in an intact hymen so that menstrual fluid can empty out through the vagina. Surgery is also required for removing hormone-producing tumors. Surgical treatment also can be beneficial in women with pituitary disorders or reproductive organ malformations.
Teenage girls who do not show the normal signs of puberty will probably be concerned about their delayed development. Their distress may interfere with their schoolwork and social life. Psychological counseling may help these young women cope with their anxieties.
Amenorrhea seldom generates a short-term health risk. The absence of menstrual periods usually does not pose a health risk. Amenorrhea often can be cured with hormone therapy, or by treating the underlying disorder. Certain causes of amenorrhea, such as Turner's syndrome and premature ovarian failure, however, cannot be cured.
Long-term amenorrhea in a woman who has low circulating estrogen levels can cause a failure of proper bone growth and/or osteoporosis (premature thinning of the bones). For this reason, women who have gone 3-6 months without menstrual periods should seek medical attention and consider using hormones to reduce this health risk.
Women who are not menstruating and who do not want to become pregnant should be cautioned not to discontinue birth control methods. Even though a woman is not menstruating, she could ovulate without warning and possibly become pregnant.
Patients with amenorrhea require ongoing follow-up. Patients receiving hormone therapy for delayed puberty should be examined every three to six months to monitor the progression of puberty. Patients on hormone therapy or who are taking other medications should remain under the care of their physician and be evaluated at regularly scheduled visits.
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