Absence of Periods even after 15

The menstrual period occurs between 11-15 years. Primary Amenorrhea can be stated as the:

  • absence of period by the age of 15 in the presence of other secondary sexual characteristics in a girl
  • when no secondary sexual characteristics like breast development has occurred by the age of 13 years in a girl.

It is not the same as missing the periods for a long duration. Causes for Primary Amenorrhea include:

  • Chromosomal or Genetic problems like Turner syndrome (absence of one of the 2X chromosomes), Gonadal dysgenesis.
  • Any medical issues that may have affected the ovaries.
  • Structural problem with the reproductive organs, i.e. like an obstruction in the vagina or the absence or failure of proper development of certain reproductive organs by birth (Müllerian defects).
  • Very low or high body weight.
  • Eating disorder: anorexiabulimia
  • Malnutrition
  • PCOS – Polycystic Ovary Syndrome
  • Any heart diseases
  • Hormonal causes

 Diagnosis for Primary Amenorrhea

  • MRI – for identifying if there are any issues with the pituitary gland.
  • Lab tests – Thyroid function test, Ovary function test, Prolactin test, Male hormone test.
  • Ultrasound or CT scans to identify any abnormalities in the reproductive organs.

Treatment for Primary Amenorrhea

The treatment is based on the cause for primary amenorrhea. This is not a disease instead is displaying an underlying issue that needs to be corrected. The main goal will be to start menstruation.

  • For genetic issues or any abnormalities in anatomy or presence of a tumor, surgery is usually suggested.
  • Hormone therapy consisting of estrogen and progestin.

What are the effects of Primary Amenorrhea?

Infertility is a complication of Primary Amenorrhea. Another risk is developing osteoporosis later in life. Always keep a track of the changes that occur in a girl after she has crossed 11 years. Any delay in the attainment of mensuration or development of secondary sexual characteristics must be noted and must be diagnosed as we need to determine the underlying cause and work to rectify it as early as possible.

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