AMENORRHEA ISN’T ALWAYS DUE TO ENERGY DEFICIENCY
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There are 2 types: Primary and Secondary. Today, we will be discussing primary amenorrhea which is when no onset of menstruation has occurred by the age of 16 with secondary sexual characteristics, or no onset of menarche by 14 years old without secondary characteristics
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There are usually areas we would want to look at if this were to occur:
1️⃣Ovarian Etiology: This is when an individual has high FSH levels and low estrogen. This could be caused by gonadal dysgenesis which is when there is a congenital developmental disorder of the reproductive system. This can look like Fragile X, Turner’s Mosaic, Swyer’s Syndrome, Turner Syndrome, etc. Another factor could also be autoimmune like unexplained ovarian failure
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2️⃣Receptor abnormalities and enzyme deficiencies: As I have mentioned in past posts, our bodies run off of enzymatic reactions, so if we cannot get those actions to be made, we fail to progress in producing particular functions. Enzymes such as 5-a reductase, 17-a hydroxylase or having an androgen insensitivity could cause one to struggle with having a period
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3️⃣Central issue: A central issue usually has to do with the hypothalamus or the pituitary gland. In many cases, this is very similar to Secondary Amenorrhea where it is caused by a stress (eating disorder, weight loss, illness) or it can be a deficiency of producing gonadotropin releasing hormone. If we were to focus more on the pituitary, it’s possible an absence of menstruation can be a result of a tumor, surgery, radiation, hyperprolactinemia or hypothyroidism
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4️⃣Congenital Outflow tract anomalies: Some outflow tract obstructions may be associated with renal, anorectal, vertebral, cardiac, tracheoesophageal, and limb anomalies. This can come up in varying anatomic locations – vaginal, cervical, or uterine. For those with amenorrhea, it can look like imperforate hymen, cervical stenosis, vaginal agenesis or transverse vaginal septum

SECONDARY AMENORRHEA ISN’T ALWAYS CAUSED BY UNDER EATING OR OVER EXCERCISING
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Missing your period and don’t know why?
Check this out before thinking it is an energy deficiency:⬇️
1️⃣Does it have something to do with the ovaries? Check your FSH levels! If they’re normal, you may have PCOS. If your FSH is high, then look at your situation. Over 35 years, it might be menopause, and under 35 could signal possible autoimmune condition that can be linked to premature ovarian failure
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2️⃣Hypothalamic amenorrhea is the most popular type as this can be induced by any type of stress, whether it be under eating, over exercising, mental stress, weight loss, etc. However, HA can also be brought on by an actual stress on the body like an infection. The difference between the first type and the second type is that FSH would be low in HA
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3️⃣Pituitary issue: This is a small gland in the brain that helps regulate certain functions through the hormones that it produces including growth and sexual development, certain glands (thyroid, adrenals) and organs. Of the many issues that can disrupt menses is high prolactin levels that can coincide as a pituitary adenoma, prolactinoma, damage to the hypothalamic-pituitary stalk, and even hypothyroidism. Other things that can disrupt the pituitary are stressors like an infection, radiation, and Sheehan’s syndrome
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4️⃣Lastly, is there a problem with your ability to even let a flow out? Checking in with your doctor to see if you may be struggling with Asherman’s syndrome or even cervical stenosis can be some clues!
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