Cessation of Menstruation

Definition - What does Cessation of Menstruation mean?

Cessation of menstruation is the disappearance of the monthly menstrual bleeding for 3 consecutive months in females with a regular menses or for 6 consecutive months in females with irregular menses. Because the ovaries in these females also fail to release eggs, pregnancy is not possible.

Cessation of menstruation is also called secondary amenorrhea.

FertilitySmarts explains Cessation of Menstruation

A woman can stop having periods due to hormonal fluctuations under normal circumstances such as:

  • During pregnancy
  • While breastfeeding
  • After menopause - the natural loss of the function of the ovaries that occurs when a woman reaches her 40s or 50s

Additional factors that may cause the menses to cease, include:

  • Polycystic ovary syndrome (PCOS)
  • Premature menopause - menopause occurring before the age of 40 years. This can be induced by ovarian damage secondary to radiation or chemotherapy or surgical removal of the ovaries. Spontaneous causes of premature ovarian failure include an underactive thyroid and rheumatoid arthritis
  • Low body weight
  • High-intensity physical exercise as practiced by athletes. Also known as athletic amenorrhea
  • Eating disorders
  • Psychological stress
  • Elevated prolactin levels
  • Elevated thyroid hormones
  • Certain medications

Factors like low body weight, eating disorders, and extensive exercise cause functional hypothalamic amenorrhea (FHA). These factors are associated with excess energy expenditure relative to the dietary energy intake. This interrupts the gonadotropin-releasing hormone (GnRH) release from the hypothalamic region of the brain. Normally, GnRH stimulates the pituitary gland (a small gland at the base of the brain) to release FSH and LH. This, in turn, signals the ovaries to produce estrogen and progesterone. These hormones cause the ovaries to release eggs and prepare the uterine lining for implantation of an embryo. Withdrawal of these hormones results in shedding and menstruation. A defect in GnRH release halts ovulation and the subsequent steps, including the shedding of the uterine lining during menstruation.

Treatment of cessation of menstruation varies with the underlying cause. Implementing a healthy dietary pattern and psychological counseling are vital to treating eating disorders and athletic amenorrhea.

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