Causes of Missed Periods
Jul 14, 2022
Source: Cainiu Health
Dr. Chen Zhe
Introduction
The persistent absence of menstruation may indicate a congenital developmental anomaly, such as congenital absence of the uterus or uterine hypoplasia, both of which clinically present as amenorrhea. Menstruation reflects normal function of the hypothalamic–pituitary–gonadal (HPG) axis; therefore, irregular menstruation suggests dysfunction at some level of this axis. Conditions such as excessive weight loss, premature ovarian insufficiency, polycystic ovary syndrome (PCOS), intrauterine adhesions, and endometritis can all lead to amenorrhea.
Many women undergoing menopause experience delayed menstrual cycles and worry about premature ovarian insufficiency (POI) or underlying gynecological disorders. So, what are the possible causes of prolonged amenorrhea?
Causes of Prolonged Amenorrhea
Prolonged amenorrhea may stem from congenital developmental abnormalities—such as congenital absence of the uterus or uterine hypoplasia—which clinically manifest as primary amenorrhea. Menstruation reflects normal hypothalamic–pituitary–ovarian (HPO) axis function; irregular menstruation often indicates dysfunction at some level of this axis. Secondary amenorrhea can result from multiple factors, including excessive weight loss, certain medications, pituitary tumors, premature ovarian insufficiency, polycystic ovary syndrome (PCOS), endometrial injury, intrauterine adhesions (Asherman’s syndrome), endometritis, hyperthyroidism, or hypothyroidism.
In women of reproductive age with regular menstrual cycles and a history of sexual activity, a delay of more than 10 days warrants suspicion of early pregnancy. Pregnancy can be confirmed via urinalysis or serum measurement of human chorionic gonadotropin (hCG). Aside from pregnancy-related nausea, occasional menstrual delays may be attributable to emotional stress or environmental changes—close observation is recommended initially.
If endocrine dysfunction is suspected, appropriate diagnostic evaluation and targeted treatment are essential. Polycystic ovary syndrome (PCOS) is one of the most common causes of secondary amenorrhea and may present with symptoms such as amenorrhea, obesity, infertility, acne, and hirsutism. Affected individuals should seek medical evaluation at a hospital for comprehensive assessment—including hormonal profiling, pelvic ultrasound, and other relevant tests—to guide necessary clinical interventions and management. We hope this information proves helpful!
