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If you are trying to conceive, a regular menstrual cycle can be a sign of a healthy reproductive system and that you are ovulating on time. Amenorrhoea can be a sign that there might be hormonal imbalances, issues with ovulation or other reproductive issues. Understanding the causes and the solutions can help you work through restoring your cycle and improving your chances of getting pregnant.
Types of Amenorrhoea
Primary amenorrhoea: Primary amenorrhoea is when a girl does not start her periods by the age of 15, despite normal growth and development.- Causes: Primary amenorrhoea can be caused by genetic conditions such as Turner’s syndrome and androgen insensitivity syndrome, structural abnormalities in the reproductive tract such as the absence of a uterus or vagina or hormonal imbalances that disrupt puberty.
- Impact on fertility: Primary amenorrhoea often indicates conditions that directly affect fertility and require specialised medical evaluation.
- Causes: This can be caused by underlying health conditions such as polycystic ovary syndrome (PCOS), sudden weight loss or gain, thyroid disorders, extreme stress or premature ovarian insufficiency.
- Impact on fertility: Secondary amenorrhoea is linked to disrupted ovulation, which can make it difficult to conceive naturally.
Impact of Amenorrhoea on Fertility and Conception
- Regular ovulation is crucial for natural conception since it releases an egg for fertilisation to occur.
- If periods stop, ovulation can also stop. This is known as anovulation. However, this is not always the case.
- Even if you are not having periods, you may still be ovulating. But predicting fertile windows can become close to impossible in such cases.
- Amenorrhoea is often a sign that there are other underlying health conditions or hormonal imbalances that can interfere with fertility and conception.
Causes of Amenorrhoea and How They Impact Fertility Issues
Amenorrhoea can be caused by several factors. Here are some of them.- Hormonal imbalances: Conditions like PCOS, thyroid disorders and elevated levels of prolactin can disrupt ovulation. These hormonal shifts can make periods irregular or absent.
- Lifestyle factors: Certain lifestyle factors, such as excessive stress, sudden weight loss or gain, excessive exercise, or a low body fat percentage, can affect your menstrual cycle.
- Medical conditions: Medical conditions like hypothalamic amenorrhoea, where the hypothalamus stops sending signals to the ovaries due to stress, weight loss or illness, premature ovarian insufficiency, where egg supply is depleted early due to genetic factors, autoimmune disorders or chemotherapy, can cause amenorrhoea.
- Medications and birth control: Long-term usage of birth control medications, IUDs and other contraceptive methods can delay the return of periods, once stopped. Additionally, some psychiatric medications and chemotherapy medications can also affect periods.
- Structural or genetic causes: Structural abnormalities like uterine issues caused by Asherman’s syndrome (where scar tissue blocks menstruation) can lead to amenorrhoea. Chromosome abnormalities like Turner’s syndrome can affect ovarian function and, in turn, cause amenorrhoea.
How Amenorrhoea is Diagnosed For Fertility Evaluation
You should consult your doctor if you have missed your periods for three or more months, with previously regular periods. Additionally, if a person has not had periods till the age of 15, they should consult a doctor.Amenorrhoea can make conception challenging, so if you have missed periods and are trying to conceive, consulting your doctor is the best way to move forward.Tests and Evaluations
If you have amenorrhoea, your doctor will conduct tests to evaluate why you have it and then work towards coming up with a solution. Some of these tests include:- Hormone blood tests: This is done to check the levels of thyroid, prolactin, FSH, LH, oestrogen and androgens
- Pelvic ultrasound: This scan is done to evaluate your ovaries and uterus and check for signs of PCOS
- Physical exam: This helps in checking for signs of low oestrogen and excessive male hormones
- AMH test: This is done to check the ovarian reserve
- Progesterone test: This is done to check if ovulation has occurred
- Basal body temperature test: This tracks the basal body temperature to check for ovulation
How To Restore Periods and Improve Fertility
- Lifestyle changes: Lifestyle changes play a huge role in your fertility. Maintain a balanced diet with good, nutritious food, get exercise regularly, manage your stress levels and get adequate sleep.
- Medications: Consult your doctor to ask them if they can prescribe any medications. Additionally, you can also ask them about hormone therapy which is used to restore normal periods.
- Fertility treatments: If natural conception is not possible, your doctor may recommend treatments like IUI (intrauterine insemination) or IVF (in vitro fertilisation). In cases of severe ovarian insufficiency, egg donation may be an option as well.
Can You Get Pregnant If You Have Amenorrhoea?
Getting pregnant with amenorrhoea is largely dependent on the cause. Secondary amenorrhoea is often reversible with proper treatment. Ovulation is the key factor for conception as you do not need to have a period to be able to get pregnant. If your amenorrhoea is caused by conditions like PCOS or hypothalamic amenorrhoea, it is entirely possible to restore ovulation using lifestyle changes or medication, improving the chances of pregnancy.However, primary amenorrhoea linked to genetic or anatomical conditions may require more advanced reproductive treatments.Trying To Conceive With Amenorrhoea
- Early diagnosis is essential. The sooner you know the cause, the quicker you can find a solution and start trying to conceive.
- Even if periods are absent, it is important to track the signs of ovulation.
- If you have been trying to conceive for over six months without any success, consult a fertility specialist and work closely with them.
- Stay patient, calm and positive. Many women successfully conceive despite having amenorrhoea if they have the right support.
FAQs on Understanding Amenorrhoea: What It Means for Your Fertility
- Do missing periods mean I am infertile?No, missing your periods does not necessarily mean that you are infertile. Ovulation determines your fertility and not the presence of periods. However, it is very important to get to the root of what is causing your periods to be missed. Consult your doctor immediately to find out what the cause could be.
- If I miss my periods often, does that mean I can never get pregnant?No, missed periods or amenorrhoea could be caused by a large number of factors. However, with the right medications and treatments, it is possible to get pregnant even if you have amenorrhoea.