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Amenorrhea or amenorrhoea is the absence of a menstrual period in a female who has reached reproductive age. [1] Physiological states of amenorrhoea are most commonly seen during pregnancy and lactation ( breastfeeding ).
Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal infertility that occurs when a woman is amenorrheic (not menstruating) and fully breastfeeding. Physiology [ edit ]
It is in fact possible to restore ovulation using appropriate medication, and ovulation is successfully restored in approximately 90% of cases. The first step is the diagnosis of anovulation. The identification of anovulation is not easy; contrary to what is commonly believed, women undergoing anovulation still have (more or less) regular periods.
Patients may present with subclinical menstrual dysfunction, ovulatory amenorrhea, amenorrhea, or have a history of combination of these disturbances. [9] In most cases, there is a gradual loss of ovulation and menses demonstrated as the diseases manifests, followed by the eventual cessation of menstrual cycles altogether. [4]
Amenorrhea, or the absence of menstruation, is subdivided into primary and secondary amenorrhea. In primary amenorrhea, in which there is a failure to menstruate by the age of 16 with normal sexual development or by 14 without normal sexual development, causes can be from developmental abnormalities of the uterus, ovaries, or genital tract, or ...
Suppression of ovulation is more likely when suckling occurs more frequently. [83] The production of prolactin in response to suckling is important to maintaining lactational amenorrhea. [84] On average, women who are fully breastfeeding whose infants suckle frequently experience a return of menstruation at fourteen and a half months postpartum.
While the normal human menstrual cycle typically lasts 4 weeks (28 days, range 24–35 days) and consists of a follicular phase, ovulation, and a luteal phase followed by either menstruation or pregnancy, the anovulatory cycle has cycle lengths of varying degrees.
The rate of amenorrhea after one year of use is in the range of 20 to 50%, although most users of the hormonal IUDs Mirena and Liletta experience a marked decrease in menstrual bleeding, which is beneficial and has led to reported high rates of user satisfaction. Levonorgestrel IUDs have also been used been shown to induce amenorrhea.