[25F] Experiencing absence of menstruation

Patient Description

A 25-year-old female presents with an absence of menstruation. The patient is not currently pregnant and denies any unusual milk production from the breasts or changes in vision. There are no reported headaches or changes in weight. The patient has been breastfeeding but did not specify if she is still currently doing so. No other symptoms or health changes were reported.

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Arora's Assessment

What might be happening

Based on the information you provided, the following are possible explanations for your lack of menstruation 16 months postpartum:

  • Lactational Amenorrhea: This is a natural form of birth control that occurs when a woman is breastfeeding. Prolactin, the hormone responsible for milk production, also suppresses the hormones that cause ovulation and menstruation. If you are breastfeeding frequently, it's normal not to have your period.

    • Treatment: No treatment is necessary. Your period will return once breastfeeding decreases or stops.
  • Postpartum Thyroiditis: This is a condition in which a woman's thyroid gland becomes inflamed after giving birth. It can cause symptoms like fatigue, weight changes, and irregular periods.

    • Treatment: Treatment may include medications to regulate thyroid hormone levels.
  • Pituitary Issues: The pituitary gland, located in the brain, regulates the hormones necessary for menstruation. Certain conditions, such as a benign pituitary tumor or Sheehan's syndrome (a condition that can occur in women who lose a life-threatening amount of blood in childbirth), can disrupt this process.

    • Treatment: Treatment depends on the specific condition and may include medication or surgery.

What you can do

While it's common for menstruation to be delayed while breastfeeding, it's important to consult with a healthcare provider to rule out other potential causes. Here are some steps you can take:

  1. Schedule an appointment with your healthcare provider: They can provide a formal assessment and order relevant tests if necessary.
  2. Keep track of any other changes: Note any changes in your body or symptoms that may occur. This information can be helpful during your medical consultation.
  3. Maintain a healthy lifestyle: Eating a balanced diet and getting regular exercise can help regulate your menstrual cycle.

What you should look out for

Contact your healthcare provider if you experience any of the following:

  • Unexpected weight changes
  • Excessive fatigue or changes in energy levels
  • Any signs of pregnancy (e.g., nausea, breast tenderness, frequent urination)
  • Any other symptoms that concern you

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

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People Also Ask


What is lactational amenorrhea and how does it affect menstruation?

Lactational amenorrhea is a natural form of birth control that occurs when a woman is breastfeeding. The hormone prolactin, which is responsible for milk production, also suppresses the hormones that cause ovulation and menstruation, leading to an absence of periods.


Can breastfeeding really delay the return of my menstrual cycle?

Yes, breastfeeding can delay the return of your menstrual cycle. Frequent breastfeeding increases prolactin levels, which suppress ovulation and menstruation. This is a normal physiological response.


What are the symptoms of postpartum thyroiditis?

Symptoms of postpartum thyroiditis can include fatigue, weight changes, and irregular periods. It occurs when the thyroid gland becomes inflamed after childbirth.


How can pituitary issues affect menstruation?

Pituitary issues, such as a benign tumor or Sheehan's syndrome, can disrupt the regulation of hormones necessary for menstruation. This can lead to an absence of periods or other menstrual irregularities.


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