Written by EniOluwa Ojewunmi

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Main Points

• Menstrual Period is the monthly shedding of the uterine wall.
• Amenorrhea is the stoppage of a regular menstrual period.
• Primary and secondary amenorrhea are the two types of amenorrhea.
• To determine the cause of the amenorrhea, it is best to consult a Gynaenocologist

What is a Menstrual Period?

Menstrual period refers to the shedding of the wall of the uterus. It is a sign that the egg released by the ovaries has not been fertilized therefore, pregnancy cannot occur.

Mechanism of Action

Luteinizing hormone and Follicle stimulating hormone work together for ovulation to occur.  Ovulation refers to the release of an egg from the ovaries. When the egg is released, it travels along the fallopian tubes waiting to be fertilised. Oestrogen and progesterone are released and this amps up the sex drive of the woman. If intercourse happensand the egg is fertilised, then the fertilised egg travels to the uterus, implants and the foetus begins to grow.

However, in the case where the egg is not fertilised, Oestrogen and progesterone levels drop and this drop leads to the shedding of the wallls of the uterus. This shedding is known as the menstrual flow. The period from ovulation to the menstrual flow is known as the menstrual cycle.

In healthy females, the menstrual period is regular and many ladies often know when their period comes. So what happens when the menstrual period suddenly disappears?

The disappearance of the menstrual period is known as amenorrhea. While this may mean the lady is pregnant, a pregnancy test is the definitive way of knowing. There are other things that can cause the absence of the monthly period.

What Causes Amenorrhea?

Amenorrhea is cased by several factors depending on the type that the person is affected by.

What are Types of Amenorrhea?

There are two types of amenorrhea.

Primary Amenorrhea

This refers to the failure of menses to appear by the age of sixteen (16). It is caused by two main factors.

1. Genetic Factors: Abnormalities in the chromosomal make up of the individual can lead to the ovaries not performing as they should. For example, in a female affected by Turner’s syndrome, instead of the normal XX chromosomes, she could have one X totally or partially missing. This could alter the ovaries and prevent the commencement of menses.
2. Neural Abnormalities: If there are problems with the Hypothalamus or the Pituitary gland, there would be hormonal imbalance which could prevent menstruation. If the hormone involved are not secreted in their right concentrations, then this would lead to abnormalities in the menstrual cycle.

Secondary Amenorrhea

In this case, meses have started and they are regular. However, there is an absence of menstruation for three months. It is caused by different factor.

1. Natural Causes: As we earlier mentioned, in the case where the egg is fertilised, there would be absence of menstruation. Menstruation is also absent when the woman is breastfeeding or when menopause (the permanent end of menstruation) has set in. During pregnancy, oestrogen prodction is
2. Medications: Certain birth control pills can interfere with the menstrual cycle. This also applies to drugs sch as antidepressants, and blood pressure medications.
3. Hypothalamic Amenorrhea: This occurs when the Hypothalamus stops releasing the hormone responsible for menstruation. This could be caused by low calorie intake, low body fat percentage and low body weight. It cold also be caused by emotional distress and some illnesses.
4. Gynenological Conditions: In cases where a woman is suffering from hormonal imbalances, secondary amenorrhea may set in as a result. For example,  in Polycystic Ovary Syndrome, testosterone and androstadiene are produced in excess amounts and this causes irregular menstrual cycles which progresses to amenorrhea.

How do I Know Which is the Issue?

The best way to know what is causing the absence of your period is to consult a doctor or more specifically a Gynaecologist. They will examine your symptoms and then give you an accurate diagnosis.

Here is the best part. Right now, DoctorOnTap is running a promo where you can consult a Gynaenologist for as low as 1,500 Naira. You can book your consultation, speak to a qualified professional and get an accurate diagnosis.

So why wear yourself out with worry when you can book your consultation and know exactly what your issue is. You can also skip long lines at the hospitals as well.

Wrap Up

Amenorrhea is not always caused by pregnancy and it is best to seek medical counsel rather than jump to premature conclusions. So, if you are experiencing the symptoms of amenorrhea, get medical counsel.

Further Reading

Breast Cancer is the most common cancer and it affects majorly women. If you would like to know more about it, this article is the best place to start. Read Breast Cancer: Awareness, Risks, and Prevention

Frequently Asked Questions

What is amenorrhea?

Amenorrhea is the absence of menstrual periods. It can be primary (when periods never start) or secondary (when periods stop after they had been regular).

Does missing my period always mean I am pregnant?

No. Pregnancy is one possible cause, but amenorrhea can also result from hormonal imbalance, stress, medications, low body weight, or conditions like PCOS.

When should I see a doctor for missed periods?

If you miss your period for more than three months (and are not pregnant, breastfeeding, or menopausal), you should consult a gynecologist. You can speak to a qualified Gynaecologist for as low as 1,500 Naira if you book a consultation on DoctorOnTap

What medications can affect menstruation?

Birth control pills, antidepressants, and blood pressure medications can sometimes interfere with regular periods.

References

1. Rodriguez Paris V, Bertoldo MJ. The Mechanism of Androgen Actions in PCOS Etiology. Med Sci (Basel). 2019 Aug 28;7(9):89. doi: 10.3390/medsci7090089. PMID: 31466345; PMCID: PMC6780983.
2. National Institute of Child Health and Human Development. 2017. “What Causes Amenorrhea?” January 31. https://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/causes. NICHD
3. Philibert P, Leprieur E, Zenaty D, Thibaud E, Polak M, Frances AM, Lespinasse J, Raingeard I, Servant N, Audran F, Paris F, Sultan C. Steroidogenic factor-1 (SF-1) gene mutation as a frequent cause of primary amenorrhea in 46,XY female adolescents with low testosterone concentration. Reprod Biol Endocrinol. 2010 Mar 19;8:28. doi: 10.1186/1477-7827-8-28. PMID: 20302644; PMCID: PMC2848664.
4. Thiyagarajan DK, Basit H, Jeanmonod R. Physiology, Menstrual Cycle. [Updated 2024 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500020/