Secondary amenorrhea occurs when a woman stops having her period for six or more months. A woman is suspected to have this medical condition if she is not pregnant, breastfeeding or going through menopause. Obesity, hypothyroidism, premature ovarian failure and high prolactin levels are among the causes of secondary amenorrhea.
Treatment for secondary amenorrhea depends on the cause. That is why to effectively treat this medical condition, diagnosis of the cause must be done to target the root of the disorder. Side effects and risks are common with each medication; that is why a patient must carefully discuss with her health care provider any past or present health conditions that might be risk factors while she is on medication.
Hypothyroidism as a Cause of Secondary Amenorrhea
If the patient is diagnosed to have secondary amenorrhea as the result of hypothyroidism, she may be prescribed to take medication to replace the hormone that she is lacking. The most commonly used medication for hypothyroidism is Levothyroxine. It is a thyroid hormone that reverses the symptoms caused by a deficiency in this hormone.
Levothyroxine comes in tablet form, and is administered orally an hour before breakfast. This medication does not cure hypothyroidism, but merely controls it. It may take several weeks before a change in symptoms may be observed, but it is recommended that the patient adheres strictly to the doctor's prescription and advice in taking this medication.
Risks and Side Effects
Some side effects may arise when taking this medication, and a doctor should be notified if these symptoms persist or worsen:
- weight loss
- excessive sweating
- irregular heartbeat or pulse
- chest pains
Those who are taking other medications such as antacids, diabetes medications, oral contraceptives, beta-blockers and aspirin should notify their doctors to prevent serious side effects from Levothyroxine.
Premature Ovarian Failure as a Cause of Secondary Amenorrhea
Secondary amenorrhea may be caused by premature ovarian failure. Hormone replacement therapy (HRT) is the most common treatment option to help resume the normal functioning of the ovaries, as well as to regulate the menstrual cycle. In HRT, hormone supplements (estrogen-only or progestin and estrogen combination) are given to a woman in order to replace the hormones that her body fails to make.
Risks and Side Effects
The Women's Health Initiative (WHI), a program established in 1991 by the National Institutes of Health, conducted a clinical trial and observational study on 161,808 healthy postmenopausal women. One of the goals in their study was to identify the effects of hormone replacement therapy on these women. These were the risks of HRT as stated in the results of their study:
- invasive breast cancer
- coronary heart disease
- blood clots
Elevated Prolactin Levels as a Cause of Secondary Amenorrhea
Prolactin is a protein hormone that is closely linked to the growth hormone. An increased level of prolactin may be caused by pituitary tumors, breast stimulation or as a result of certain drugs such as trifluoperazine and haloperidol. Some medications can help reduce elevated prolactin levels, such as bromocriptine, a dopamine antagonist medication. Bromocriptine is administered orally, once or twice daily, and must not be taken on an empty stomach. After the first dose, this medication usually causes dizziness, and the patient is advised to lie down to relieve this condition. However, one should not stop medication without consulting a doctor first. It usually takes six to eight weeks for prolactin levels to decrease, and twelve months of medication is necessary to gain the full benefits of treatment.
Risks and Side Effects
The most common side effects of this medication are the following:
- loss of appetite
Those who have coronary heart disease, low blood pressure, gastrointestinal bleeding, kidney disease, liver disease, breathing problems and those who smoke and drink alcohol are at risk of developing serious side effects and are not advised to take this medication.
In treating secondary amenorrhea, diagnosis of the medical condition that causes it must be done first. Elimination of the cause is the most effective way to treat secondary amenorrhea. Though each treatment option has its effectiveness, there are also risks and side effects that the patient must be aware of.
Secondary Amenorrhea, https://www.nlm.nih.gov/medlineplus/ency/article/001219.htm
Premature Ovarian Failure, https://www.nichd.nih.gov/health/topics/premature_ovarian_failure.cfm