When a girl turns a “young lady” her body changes its physical appearance as well as the chemical makeup.  A woman does not experience her period or menstruation during three phases in her lifetime; puberty, pregnancy and menopause unless she had her ovaries or uterus removed. The medical term for missed periods is amenorrhea (pronounced a-men-or-re-a) and is classified as primary or secondary. Primary amenorrhea occurs when the first period takes long to come, like after the age of 16. Note that it is not normal if you are 16 and still did not experience your first menstrual cycle.

Secondary amenorrhea is very common and occurs when there is an absence of your period for three (3) months or more.

We all know that when you are pregnant you will not menstruate. However if you are not pregnant and you still don’t see you menstruation then one of the reasons could be stress. For example; it could be something that you may not even consider “stress” such as changing jobs, sudden increase in workload, bereavement or depression.

Other lifestyle changes which can cause you to have an absent menstrual cycle are a rapid weight change (whether a significant increase or decrease in weight) due to an eating disorder, over exercising or smoking.

Also if you were placed on hormonal treatment for example contraceptives and then you suddenly stopped you may not see your period for months to a year. On the other hand there is some birth control like Depo-Provera which can cause you to miss your period.

Breast feeding could be another reason why some mothers do not see their cycle.

Sexually transmitted diseases especially Chlamydia (which shows no symptoms) can also cause not only amenorrhea but if untreated can cause infertility.

However some more serious and complicated reasons for primary amenorrhea are poorly formed reproductive organs, failure of the ovaries (the organ which releases the eggs) or a problem with either the brain, spinal cord or pituitary gland (the gland for which one of the functions is menstruation).

What to do if you have missed your cycle?
•    The first thing you should do is a pregnancy test. Using the first morning urine, just about 14 days after your expected period in the second or third month. Two or three confirmatory tests can be done using a blood sample if possible.
•    If you are not pregnant then please know that amenorrhea is not a disease and can be treated.

It would be a good thing to have certain facts at hand like the pattern of your cycle or at least the date of your last period. Also from conversations with the other female family members will give you an indication if there is any possible genetic predisposition.

Generally it would be recommended that you maintain a healthy weight, avoid excessive alcohol consumption and smoking. Controlling  your stress levels is also be recommended.

The treatment for amenorrhea starts 8 weeks after the last period to induce a menstruation-like bleeding using Progynon Depo 10mg just before Primolut N, having ruled out any pituitary tumor. The treatment on day 1 is 2 x 10mg Progynon Depo i.m. and 1 x 10mg Progynon Depo i.m. on day 14. Primolut N is commenced on day 19 and continued to day 26 at a dose one tablet 2 -3 times daily. At the end of the treatment or on day 28 there will be a withdrawal bleeding, mimicking the menstruation.

This can be continued for 2 to 3 cycles. Using the first day of the “artificial” menstruation as day 1 now, the Progynon Depo is given on days 6 and 16 followed by the same Primolut N on day 19 to 26 but this time only to be taken 2 times daily.

Additionally, the same Primolut N can be used for premenstrual  syndrome where the persons gets all the signs like the period is about to come like headaches, water retention, depressive moods or tension in the breasts. The dosage to used to give relieve is one tablet 2-3 times daily on day 19 to day 26.

Hence the missed period phenomena can be dealt with in a very systematic manner if it is uncomplicated but it boils down to knowing your body, dates and family history so that you can make the necessary lifestyle decisions to enhance a better reproductive health.

For further information please call the pharmacist at Medicine Express located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.