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Oligomenorrhea: Understanding the role of genetics in menstruation.

SamanOligomenorrhea: Understanding the Role of Genetics in Menstruation.

Background: As research on menstrual disorders continues, there is particular focus in understanding the role of genetics in menstruation and the relationship between low body fat and hormonal regulation. Medical dictionaries define oligomenorrhea as infrequent or very light menstruation. But physicians describe it as follows: Women who regularly go more than 35 days without a period, with only four to nine periods per year, may have oligomenorrhea. The condition itself isn’t serious, but may be indicative of other underlying conditions. Amenorrhea refers to the absence of menstrual period in a woman while she is in her reproductive years. It may further be classified as either primary or secondary. In primary amenorrhea, menstruation does not start during puberty. If a young woman who is undergoing normal growth and development does not start her periods by the age of 15 years, it is recommended that she should see a physician. Secondary amenorrhea is the absence of menstrual bleeding in a woman who had been menstruating but stopped menstruating later in life for three or more months in the absence of pregnancy, lactation (production of breast milk), cycle suppression with systemic hormonal contraceptive (birth control) pills, or menopause.

– It is important to rule out pregnancy as a cause of delayed menstrual cycle at the outset before further investigation. Some of the common causes of oligomenorrhea are as follows:
Hormonal imbalances in the body.
Use of hormonal birth control pills could lead to oligomenorrhea as a side effect. Some women, after they start taking birth control pills, have lighter and lighter periods for about three to six months while in some others, periods may even stop completely.
It can develop in young women who participate in heavy exercise or sports.
Eating disorders, such as bulimia and anorexia nervosa could be causative factors.
Other preexisting conditions such as thyroid problems or diabetes.
It is also common in adolescent girls and peri-menopausal women because of their fluctuating hormone levels.
Consumption of certain medications, such as anti-epileptics and antipsychotics.
Women having increased levels of prolactin in their blood may also suffer from oligomenorrhea.

Symptoms:

Going more than 35 days without having a period without the consumption of birth control medication is the primary symptom of oligomenorrhea.
Other symptoms consist of pain, discomfort, heavy menstrual bleeding, infertility and a feeling of heaviness in between menstrual cycles.

Diagnosis:

Review of a patient’s menstrual history gives a clear indication of oligomenorrhea.
Pap test, pelvic examination, blood tests and imaging tests may also be done to confirm the diagnosis and to rule out various illnesses.

Treatment:

Oligomenorrhea is not exactly a serious condition on its own and its treatment consists of balancing hormone levels in a woman’s body by through medication.
After the hormone levels have balanced out, the patient’s menstrual cycle returns to normal in a couple of months.
Birth control pills, which contain synthetic hormones, can also be prescribed for treatment.
Women with PCOS are treated with hormones. The hormones prescribed are those that are deficient in the body or out of balance.
If the cause of oligomenorrhea is obesity, being underweight or some eating disorder, then correcting these issues is the resolution.
Specialized treatment or surgery may be needed in rare cases if the cause is the malfunctioning of some gland which is throwing off the balance of hormones in the patient’s body.

Prevention:

Oligomenorrhea is preventable in women whose “low body fat to weight ratio” is keeping them from maintaining a regular menstrual cycle.
Adequate nutrition and less vigorous training schedules for female athletes.
When causative factors are hormonal, the condition is not preventable, but usually treatable.

Conclusion:

Problems related to menstruation are quite frequent and often result in the interruption of daily routines of adolescent girls and women. The effects are not just physical but could also be emotional. Therefore, it is important that healthcare programs be organized to address such issues and counseling of patients be done on a regular basis. Further studies should be performed to determine the exact causes for the frequent occurrence of oligomenorrhea among women, and newer strategies need to be employed to tackle it.

 

Dr. Saman, Ph.D ( Clinical Biochemistry), J.N. Medical College, Aligarh Muslim University, India.

October 22, 2017

Reference:

Int J Gynaecol Obstet. 1994 Jun;45(3):247-52.

Endocrine profile of women with amenorrhea and oligomenorrhea.

https://www.ncbi.nlm.nih.gov/pubmed/7926244

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