Wednesday, December 18, 2013

Amenorrhea and infertility

Summary: The commonest cause of amenorrhea is anovulation and Malpani Clinic can help you in making the right diagnosis , so you can get the correct treatment.

Amenorrhea is the absence of periods. It is a symptom which is a result of some underlying disorder of the reproductive system. It may or may not be accompanied by other symptoms like headache, excess facial hair, and abdominal pain depending upon the cause. At Malpani Infertility Clinic, we diagnose the cause of your amenorrhea by taking a careful history and doing a thorough workup. A detailed record of your menstrual periods and any associated symptoms will help us in making the right diagnosis.

Amenorrhea can be either physiological or pathological. Physiological Amenorrhea is the absence of periods before puberty, during pregnancy and after menopause ; while pathological Amenorrhea is a result of some disease. Another way of differentiation is primary and secondary Amenorrhea. When a girl does not get her periods by the age of 16, she is diagnosed as having of primary Amenorrhea. The absence of periods for over 3 months in a woman with a history of having menstrual periods in the past is referred to as secondary Amenorrhea.

Secondary Amenorrhea can be caused by various reasons. The extended list of probable causes includes: polycystic ovarian disorder, drugs, stress, malnutrition, excessive exercise; and chronic illness. Normal menses occur when the uterine lining is shed cyclically under the influence of the reproductive hormones produced by the ovaries – estrogen and progesterone . In simple terms, smenorrhea occurs either due to a disorder affecting the uterus or the reproductive hormones.

Amenorrhea and infertility

The commonest cause of secondary amenorrheaiIn infertile women is anovulation. Anovulation is the failure of ovaries to either produce or release eggs. This is usually easy to treat, if diagnosed properly.

The commonly prescribed tests are : blood tests to check for prolactin; TSH; FSH;LH and AMH; and a vaginal ultrasound scan. The commonest reason for anovulation is usually PCOD (Poly cystic ovarian disorder) . However , it is important to rule out other causes, such as multicystic ovaries ; premature ovarian failure; or a functional ovarian cyst.

Many infertile women naively believe that if the doctor can regularize their period, they will get pregnant. However, do remember that it is the underlying cause of the irregular periods which needs to be treated if you want to have a baby. Thus, if the reason for anovulation is PCOD, you need treatment to induce ovulation in order to get pregnant. Just inducing a period with progesterone hormonal therapy will not help you to achieve a pregnancy.

Not sure your doctor is treating your amenorrhea properly ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !

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