What to do if you have amenorrhea at the age of 26

What should I do if I have amenorrhea at the age of 26? There are many types of amenorrhea in clinical practice, including primary amenorrhea and secondary amenorrhea, as well as physiological and pathological types. Amenorrhea is a common clinical symptom rather than a disease. If amenorrhea occurs during childbearing age, the patient must go to the hospital for examination in time to confirm the cause so that symptomatic treatment can be given. So, what should I do if I have amenorrhea at the age of 26?

1. Treatment of the cause

Some patients can resume menstruation after the cause is removed. For example, patients with neurological or mental stress should receive effective psychological counseling; patients with low body weight or amenorrhea caused by excessive dieting or weight loss should adjust their diet and strengthen their nutrition; patients with exercise-induced amenorrhea should appropriately reduce the amount of exercise and training intensity; for amenorrhea caused by hypothalamus (craniopharyngeal tumors), pituitary tumors (excluding tumors that secrete PRL) and ovarian tumors, the tumors should be surgically removed; for amenorrhea caused by high Gn containing Y chromosomes, their gonads have malignant potential and should undergo gonadectomy as soon as possible; amenorrhea caused by genital tract malformation and menstrual blood drainage disorder should be corrected surgically to allow menstrual blood to flow smoothly.

2. Estrogen and/or progesterone therapy

Estrogen therapy should be used to treat amenorrhea caused by adolescent sexual immaturity and adult hypoestrogenism.

3. Endocrine therapy for disease pathology and physiological disorders

According to the etiology and pathological and physiological mechanisms of amenorrhea, targeted endocrine drug treatment is used to correct the disordered hormone levels in the body, so as to achieve the treatment goal. For example, CAH patients should be treated with long-term glucocorticoids; PCOS patients with obvious signs of hyperandrogenism can be treated with oral contraceptives combined with estrogen and progesterone; PCOS patients with combined insulin resistance can be treated with insulin sensitizers. The above treatments can restore menstruation in patients, and some patients can resume ovulation.

4. Induce ovulation

For women with low Gn amenorrhea, after estrogen therapy is used to promote the development of reproductive organs and the endometrium has responded to estrogen and progesterone, human gonadotropin (hMG) combined with human chorionic gonadotropin (hCG) can be used to promote follicle development and induce ovulation. Because it may cause ovarian hyperstimulation syndrome (OHSS), the use of Gn to induce ovulation must be performed by an experienced physician under the conditions of B-ultrasound and hormone level monitoring.

For amenorrhea patients with normal FSH and PRL levels, clomiphene citrate can be the first choice as an ovulation-inducing drug because the patients have a certain level of endogenous estrogen in their bodies. For amenorrhea patients with elevated FSH levels, ovulation-inducing drugs are not recommended due to their ovarian failure.