Can I get pregnant with amenorrhoea? Delving into the world of the female cycle, we come across a term that can arouse uncertainty and curiosity in equal measure: amenorrhoea. This word, which seems to come from an ancient Greek poem, holds a mystery surrounding the absence of a phenomenon that defines femininity: menstruation.
What is amenorrhoea?
Amenorrhoea is the absence of menstruation in women of childbearing age. In other words, when a woman does not have her menstrual period for a considerable period of time, despite not being pregnant, breastfeeding or in the menopause.
What are the symptoms?
The symptoms of amenorrhoea can vary depending on the underlying cause. In addition to a lack of menstruation, some women may experience additional symptoms, such as:
- Changes in hormone levels.
- Abdominal pain.
- Excessive facial hair.
- Milk secretion from the nipple.
- Hair loss.
- Headache.
- Acne.
Types of amenorrhoea
There are several types of amenorrhoea, which are divided into two main categories: primary amenorrhoea and secondary amenorrhoea.
Primary amenorrhoea: This refers to the absence of menstruation in a girl who has reached the age at which she should normally have started her menstrual cycle (around 16 years of age). It can be caused by genetic factors, abnormalities in the development of the reproductive organs, hormonal problems, or disorders such as polycystic ovary syndrome.
Secondary amenorrhoea: This occurs when a woman who previously had regular menstrual cycles stops menstruating for at least three consecutive months. Causes of secondary amenorrhoea can include pregnancy, breastfeeding, extreme stress, excessive weight loss, eating disorders, hormonal problems, thyroid disorders, among others.
What are the causes?
The first thing to do is to find out what is causing the amenorrhoea. To do this, we must again differentiate between primary and secondary amenorrhoea:
Primary Amenorrhoea
Primary amenorrhea can arise from uterine malformations (in the uterus and/or vagina, for example Rokitansky syndrome), imperforate hymen, genetic diseases (such as Turner syndrome or fragile X syndrome) or tumours (for example in the pituitary gland).
Secondary Amenorrhoea
The main causes are weight changes (obesity or anorexia), stress, anxiety, or intense exercise. Other causes may include hormonal disorders (e.g. hypo- or hyperthyroidism, or elevated prolactin secretion), medications (treatments for depression or schizophrenia), or disorders originating in the ovary itself: polycystic ovary syndrome (PCOS), endometriosis, premature ovarian failure, or menopause.
There are times when you should not have your period, such as before puberty, during pregnancy, and after menopause. But if amenorrhoea lasts more than three months, it should be investigated.
If I have amenorrhoea, can I still get pregnant?
Yes, it is possible to get pregnant even if you have amenorrhoea. Amenorrhoea does not automatically guarantee that you cannot conceive. Although a lack of menstruation may indicate problems with ovulation and fertility, there is still a chance of ovulation and pregnancy, especially in cases of mild or intermittent amenorrhoea.
If you are experiencing amenorrhea and are interested in becoming pregnant, it is advisable to speak with a healthcare professional. Tests and examinations can be performed to assess hormonal function, ovulation, and fertility. It is always important to receive proper medical advice to understand your options and make informed decisions about your reproductive health.
Is there a treatment for amenorrhoea?
As we have already mentioned, amenorrhoea does not always mean that the patient cannot become pregnant. Depending on the cause, treatment may be more or less complex.
Treatment in cases of stress, anxiety, extreme sports or weight changes
In this case, correction is easier. When ‘normality’ returns to the patient's life, menstruation usually resumes.
Treatment for hormonal disorders
In the case of hormonal disorders, such as hypothyroidism or hyperprolactinemia, corrective medical treatment is usually carried out prior to attempting to conceive spontaneously or through assisted reproduction treatment.
Treatment in cases of uterine abnormalities
Treatment for uterine abnormalities will depend on their severity:
- In the case of uterine agenesis (disorders in the development of the Müllerian ducts), treatment will be uterine surrogacy.
- In the case of malformations of the uterus (septums, fibroids, etc.), surgical correction may be performed.
- In the case of alterations in the vagina, for example, imperforate hymen, correction is performed through simple surgery.
To do this, treatment to prepare the uterus (specifically endometrial preparation) will be required to ensure adequate embryo receptivity.
Treatment in cases with ovarian problems
When the origin of the pathology is ovarian, the solution may be more complex:
- In the case of polycystic ovaries, weight correction and treatment of associated metabolic disorders can lead to the restoration of amenorrhoea. In some cases, it is necessary to resort to assisted reproduction therapies with ovulation induction, such as timed intercourse or artificial insemination, and in some cases even in vitro fertilisation.
- In the case of ovarian failure, which is the decrease in the number of eggs available for pregnancy at an age when the ovarian reserve should be normal, in addition to a decrease in the number of oocytes, there is also usually a decrease in their quality. Generally, in these cases, in vitro fertilisation is required.
- In the most severe cases of decreased ovarian reserve, including menopause, egg donation treatment may be necessary, using eggs from another woman, who, being younger, has more eggs of better quality.
Treatment in cases of genetic diseases
In the case of genetic diseases, depending on the relevant tests (karyotype, informativeness studies, etc.), it will be up to the geneticist to advise whether to proceed with treatment using the patient's own eggs, in addition to ensuring that the ovarian reserve is sufficient to carry out the treatment.
In conclusion, amenorrhoea is not necessarily indicative of infertility. Depending on the cause, different therapeutic options may be considered to achieve pregnancy.
Book a free consultationDo you have any questions or need more information?
At Fertility Madrid, we specialise in treatments such as egg donation, in vitro fertilisation and artificial insemination, among others.
Please do not hesitate to contact our professionals at our fertility clinic and they will answer all your questions without obligation.
Óscar Oviedo
Director Médico
