Materiały źródłowe

• #1 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Patients who have not reached menarche by 15 years of age (or three years post-thelarche), or who have experienced cessation of regular menses for three months or previously irregular menses for six months, should be evaluated. […] Pregnancy should be excluded in all patients with amenorrhea, and serum follicle-stimulating hormone, luteinizing hormone, prolactin, and thyroid-stimulating hormone levels should be obtained. […] Patients with primary ovarian insufficiency should be treated with hormone therapy until the age of natural menopause (50 to 51 years of age) to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy. […] In patients with functional hypothalamic amenorrhea, treatment should correct the underlying cause to restore ovulatory function through behavior change, nutritional repletion (e.g., caloric intake, vitamin D), stress reduction, and weight gain.

• #2 Amenorrhea Definition, Symptoms, Causes, and Treatment

  https://www.medicinenet.com/amenorrhea/article.htm

  Is it possible to prevent amenorrhea? Amenorrhea is a symptom and not a disease in itself. Therefore, amenorrhea can be prevented only to the extent that the underlying cause can be prevented. For example, amenorrhea that results from genetic or inborn conditions cannot be prevented. On the other hand, amenorrhea that results from self-imposed stringent dieting or intensive exercise is typically preventable. […] The outlook for amenorrhea varies widely and is dependent upon the cause of the amenorrhea. Hypothalamic amenorrhea that is a result of stress, exercise, or weight loss generally can be corrected if the responsible factors can be corrected. Medical and hormonal therapies can be of great benefit in preventing unpleasant side effects or complications of amenorrhea in many women.

• #3 Amenorrhea: Types, Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/3924-amenorrhea

  Maintaining good overall health can help prevent some causes of secondary amenorrhea. Try to: […] Follow a diet and exercise plan that’s healthy for you. […] Be aware of your menstrual cycle (so you’ll know if you miss a period). […] Get regular gynecological appointments, including having a pelvic exam and Pap test. […] Get regular and adequate sleep.

• #4 Amenorrhea: Symptoms, Causes and Treatments – familydoctor.org

  https://familydoctor.org/condition/amenorrhea/

  Can amenorrhea be prevented or avoided? […] It is hard to prevent amenorrhea. Try to maintain a healthy diet and exercise plan. If you are underweight or overweight, talk to your doctor about how to find a balance. Once you begin to menstruate, keep track of your periods each month. This can help identify the condition early on and aid in your diagnosis and treatment. It also is good practice if you try to become pregnant in the future.

• #5 Amenorrhea: Causes, Primary vs. Secondary, Symptoms & Treatment

  https://www.emedicinehealth.com/amenorrhea/article_em.htm

  How to Prevent Amenorrhea […] By maintaining a normal weight, girls can prevent primary amenorrhea caused by excessive weight loss or weight gain. […] […] […] In some women, nutritional deficiencies induced by dieting can cause amenorrhea. Such women should eat a properly balanced diet. […] In some women, excessive body weight can be the cause of amenorrhea. These women should restrict the amount of fat in their diet, and they should exercise moderately to maintain ideal body weight. […] More than 8 hours of vigorous exercise a week may cause amenorrhea. A moderate exercise program may restore normal menstruation. […] In women with anorexia nervosa or excessive weight loss, normal menstrual cycles can often be restored by undergoing treatment to restore and maintain healthy body weight.

• #6 Amenorrhea: Causes, Treatment, and Prevention

  https://www.healthline.com/health/amenorrhea

  To prevent amenorrhea, aim to: […] – maintain a healthy weight […] – eat a well-balanced diet […] – exercise regularly […] – learn to manage stress […] […] […] Talk with your doctor about any concerns you have about your menstrual cycle.

• #7 Amenorrhea: Absence of Periods | ACOG

  https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

  Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea: Primary amenorrhea is when a girl does not get her first period by age 15. […] Secondary amenorrhea is when a woman who already menstruates does not get her period for 3 months or more. Some medications, such as hormonal birth control, can stop periods while you are taking them. And smoking can increase your risk of amenorrhea. […] Most people with amenorrhea benefit from a healthy diet and exercise. Reducing stress also may help. And it is important to consume enough calcium and vitamin D to help prevent osteoporosis. Aim for 600 international units of vitamin D and between 1,000 and 1,300 milligrams of calcium every day. […] If primary amenorrhea is caused by the ovaries not producing enough estrogen, you can discuss using hormone therapy to start puberty and your periods. Hormone therapy also can help prevent osteoporosis. […] Treatment for secondary amenorrhea depends on the cause: Hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce.

• #8 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  You can prevent hypothalamic amenorrhea by avoiding the common causes of the condition. This includes: […] Eating enough food for your activity level. […] Not restricting your caloric intake. […] Finding ways to reduce and manage your stress levels. […] Limiting extremely vigorous exercise.

• #9 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  In patients with polycystic ovary syndrome and an elevated body mass index, weight loss and regular exercise are recommended and may restore regular menses and improve metabolic comorbidities. […] Hormone replacement therapy (HRT) may reduce associated vasomotor symptoms, bone mineral density loss, and cardiovascular risk and should be continued until the age of natural menopause (50 to 51 years). […] Healthy eating habits and regular exercise should be recommended for all patients with PCOS. Weight loss may restore regular menses and improve metabolic comorbidities in patients with an elevated body mass index.

• #10 Amenorrhea – Types, Causes, Symptoms, Prevention and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Nu

  https://www.pacehospital.com/amenorrhea-causes-symptoms-prevention-and-treatment

  Prevention of amenorrhea is not possible as it can be caused by different factors such as genetics, certain medical conditions, hormonal imbalances or anatomical issues. However, adopting the healthy lifestyle by following the below mentioned can help to reduce the risk of certain types of amenorrhea: […] Body weight significantly affects the menstrual cycle. Being overweight or underweight can disrupt its regularity. Maintaining a healthy weight is essential to balance hormone levels and reestablish a normal cycle. Body weight plays a crucial role in regulating menstrual cycle […] Identify the different aspects of life that are causing stress and take steps to reduce their impact. If you find it challenging to manage stress alone, consider seeking help from family, friends, healthcare provider, or a skilled listener such as a counsellor. […] Adjusting the physical activity level can play a crucial role in restoring the menstrual cycle.

• #11 Amenorrhea – What You Need to Know

  https://www.drugs.com/cg/amenorrhea.html

  Amenorrhea may be a sign of a serious medical problem that needs to be treated. […] Treatment will depend on what is causing your amenorrhea. You may be given birth control pills to restart and regulate your periods. […] Maintain a healthy weight. Low body weight, overweight, or obesity can all affect your period. […] Eat healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. […] Exercise as directed. Exercise can help you build or maintain bone. […] Manage stress. Try new ways to relax, such as deep breathing.

• #12 Amenorrhea Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/amenorrhea

  Maintain a balanced diet and healthy workout routine. Consult your doctor if you are underweight or overweight and achieve a healthy balance. Keep track of your periods each month once you start menstruating. This can help in the early detection of amenorrhea and the diagnosis and treatment of the condition. It’s also a good idea to do it if you want to get pregnant in the future. […] Amenorrhea can be caused by lifestyle factors such as too much exercise or too little food, so strike a balance between work, recreation, and rest. Assess your life for areas of stress and conflict. If you cannot reduce stress on your own, seek assistance from family, friends, or your physician. Changes in your menstrual cycle should be noted, and you should consult your doctor if you have any concerns regarding it. Keep track of the dates of your periods. Keep track of when while noting any troublesome symptoms you experience.

• #13 Amenorrhea – Symptoms, Causes, Diagnosis and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/amenorrhea

  Amenorrhea is the absence of menstruation, typically lasting 3-6 months. […] Amenorrhea can be prevented by consuming a balanced diet that includes all five food groups. […] Engaging in regular physical exercise can also help in the prevention of amenorrhea. […] Ensuring adequate and quality sleep and relaxation is important for amenorrhea prevention. […] Managing stress effectively is crucial for preventing amenorrhea. […] Scheduling regular check-ups with a gynecologist for pelvic examinations and Pap smears can aid in the prevention of amenorrhea. […] Keeping a record of your menstrual cycles to track the onset and duration of your periods and identify any missed periods is beneficial for prevention.

• #14 Patient education: Absent or irregular periods (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/absent-or-irregular-periods-beyond-the-basics

  Menstrual cycle disorders can cause periods to be absent or infrequent. Although some females do not mind missing their menstrual period, these changes should always be discussed with a health care provider because they can signal underlying medical conditions and potentially have long-term health consequences. A female who misses more than three menstrual periods (either consecutively or over the course of a year) should see a health care provider. […] The goal of treatment is to correct the underlying condition. For a female who is trying to become pregnant, restoring fertility may be another goal. […] Polycystic ovary syndrome (PCOS) is a chronic condition that causes infrequent periods and an excess of androgens (male hormones). Most health care providers recommend treating PCOS to re-establish normal menstrual cycles and prevent long-term complications.

• #15 Journal of Women’s Sports Medicine

  https://jwomenssportsmed.org/index.php/jwsm/article/view/43

  In the National Collegiate Athletic Association (NCAA), 9.1% of the injuries reported by womens cross-country athletes between 2014-2019 were fractures. […] Although excessive exercise is a major contributor to the development of amenorrhea, there are currently no studies on the association between amenorrhea and stress fractures in New Jersey (NJ) National NCAA Division III Womens cross country or track athletes. […] This study aims to determine if there is an association between incidence of amenorrhea and subsequent occurrence of stress fractures among this population, and to identify a possible area for increased reproductive health education. […] There is a significant association between having missed at least one menstrual cycle during training or competition and the number of stress fractures experienced by the athlete (p = 0.044).

• #16 Amenorrhea in the Female Athlete: 8 Myths Debunked — Gaudiani Clinic

  https://www.gaudianiclinic.com/gaudiani-clinic-blog/2018/10/10/amenorrhea-in-the-female-athlete-8-myths-debunked

  Amenorrhea should never be considered an acceptable consequence of any level of athletic or fitness training. Amenorrhea is a red flag that the body is not functioning to its full potential. […] All female athletes with amenorrhea for 6 months or more should undergo formal bone density testing by getting a DXA (dual energy x-ray absorptiometry) scan. […] FHA is not one of them. The bleeding caused by OCPs is completely artificial because the hormones in the pills are inducing the bleeding. […] A multidisciplinary team approach is often the most effective to delve into the individual factors at play. […] Amenorrhea can persist for as long as 6 to 12 months, according to some studies, after making the changes to your lifestyle that were felt necessary to resume menstruation.

• #17 Amenorrhea in adolescents: a narrative review – Newbery – Pediatric Medicine

  https://pm.amegroups.org/article/view/4922/html

  Understanding normal menstrual physiology is crucial in recognizing concerns related to amenorrhea in adolescents. […] Provision of appropriate care that is safe and evidence-based can prevent future negative health implications such as infertility and compromised bone health. […] Early detection in adolescent females help prevent potential future adverse health outcomes. […] Weight recovery is a therapeutic goal in ED, but there is no consensus concerning target weight. […] The approach to managing females with amenorrhea is dictated by the underlying cause. […] Similar to the management of functional hypothalamic amenorrhea in females with ED, approach to the female adolescent athlete entails a multidisciplinary team, with emphasis on prevention of future lapses as well as treatment of current dysfunction. […] Understanding the menstrual dysfunction due to common conditions, such as PCOS, ED and FAT, is necessary in providing care that is safe and evidence-based, hence preventing future negative health implications.

• #18 Journal of Women’s Sports Medicine

  https://jwomenssportsmed.org/index.php/jwsm/article/view/43

  Our data also highlights a need for increased education of NJ Division III female athletes regarding the importance of maintaining regular menstruation as a means of stress fracture prevention. […] Further investigation of the role of amenorrhea on the incidence of stress fractures may shine light on an important area for prevention and increased health education.

• #19 Rowan Digital Works – Rowan-Virtua Research Day: Amenorrhea and Stress Fractures in Female New Jersey Division III Collegiate Runners: An Opportunity for Increased Health Education

  https://rdw.rowan.edu/stratford_research_day/2023/may4/4/

  Of the 68 participants, 58.8% missed their menstrual cycle and 45.6% experienced a stress fracture during training or competition. […] Our data also highlights a need for increased education of NJ Division III female athletes regarding the importance of maintaining regular menstruation as a means of stress fracture prevention. Further investigation of the role of amenorrhea on the incidence of stress fractures may shine light on an important area for prevention and increased health education.

• #20 Hypothalamic Amenorrhea Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hypothalamic-amenorrhea

  To diagnose hypothalamic amenorrhea, healthcare providers must rule out other conditions that can halt menstruation, including benign tumors in the pituitary gland and adrenal gland disorders. […] Recommendations from the guideline include: Hypothalamic amenorrhea is a diagnosis of exclusion, which requires healthcare providers to rule out other conditions that could be interrupting the menstrual cycle. […] In patients with suspected FHA, we recommend obtaining a detailed personal history with a focus on diet; eating disorders; exercise and athletic training; attitudes, such as perfectionism and high need for social approval; ambitions and expectations for self and others; weight fluctuations; sleep patterns; stressors; mood; menstrual pattern; fractures; and substance abuse. […] In adolescents and women with FHA, we recommend correcting the energy imbalance to improve hypothalamic-pituitary-ovarian (HPO) axis function; this often requires behavioral change. Options for improving energy balance include increased caloric consumption, and/or improved nutrition, and/or decreased exercise activity. This often requires weight gain. […] In patients with FHA wishing to conceive, after a complete fertility workup, we suggest: treatment with pulsatile gonadotropin-releasing hormone (GnRH) as a first line, followed by gonadotropin therapy and induction of ovulation when GnRH is not available.

• #21 Endocrine Society experts issue Clinical Practice Guideline on hypothalamic amenorrhea | Endocrine Society

  https://www.endocrine.org/news-and-advocacy/news-room/2017/endocrine-society-experts-issue-clinical-practice-guideline-on-hypothalamic-amenorrhea

  Female athletes and women who have eating disorders are prone to developing a condition called hypothalamic amenorrhea that causes them to stop menstruating. […] This energy imbalance needs to be addressed to effectively treat hypothalamic amenorrhea and typically requires behavioral modifications, said Catherine M. Gordon of Cincinnati Childrens Hospital Medical Center in Cincinnati, Ohio, and the chair of the task force that authored the guideline. Referring patients to a nutritionist for specialized dietary instructions is an extremely important part of their care. Menstrual cycles can often be restored with increased calorie consumption, improved nutrition or decreased exercise activity. […] Recommendations from the guideline include: Hypothalamic amenorrhea is a diagnosis of exclusion, which requires healthcare providers to rule out other conditions that could be interrupting the menstrual cycle.

• #22 Functional Hypothalamic Amenorrhea: What Parents Need To Know

  https://blog.cincinnatichildrens.org/healthy-living/child-development-and-behavior/functional-hypothalamic-amenorrhea-what-parents-need-to-know/

  It is problematic for teenage girls to have irregular or missed periods. […] The reality is that missed and irregular periods can cause a slew of health issues for teenage girls and can be related to a bigger health problem. […] Stress, inadequate nutrition, and over-exercising are common causes of FHA. […] The good news is that FHA is reversible if treated properly. […] Increased calorie consumption, improved nutrition and decreased exercise activity can restore menstrual cycles. […] If your daughter is altering her diet or over-exercising, pay close attention and get your daughter help if you’re concerned. […] The warning signs of functional hypothalamic amenorrhea can be subtle. […] If your daughter is having irregular or missed periods, it is worth a conversation with her and her health care provider.

• #23 Amenorrhea: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0415/p1374.html

  A thorough history and physical examination as well as laboratory testing can help narrow the differential diagnosis of amenorrhea. […] The treatment of primary and secondary amenorrhea is based on the causative factor. Treatment goals include prevention of complications such as osteoporosis, endometrial hyperplasia, and heart disease; preservation of fertility; and, in primary amenorrhea, progression of normal pubertal development. […] Women with polycystic ovary syndrome should be tested for glucose intolerance. […] Patients with PCOS have excess unopposed circulating estrogen, increasing their risk of endometrial cancer threefold. […] The primary treatment for PCOS is weight loss through diet and exercise. Modest weight loss can lower androgen levels, improve hirsutism, normalize menses, and decrease insulin resistance. […] In patients with amenorrhea caused by eating disorders or excessive exercise, the use of oral contraceptive pills or menopausal hormone therapy may decrease bone turnover and partially reverse bone loss; however, neither therapy has been shown to significantly increase bone mass.

• #24 Amenorrhea secondary prevention – wikidoc

  https://www.wikidoc.org/index.php/Amenorrhea_secondary_prevention

  Effective measures for the secondary prevention of functional hypothalamic amenorrhea include oral contraceptive pills (OCPs), androgen therapy, recombinant insulin like growth factor 1 (IGF-1), recombinant leptin, bisphosphonates, and increasing calorie intake. […] Different studies have shown that OCP therapy can slow down the bone loss process in patients with exercise- and anorexia-associated amenorrhea. […] Recent studies have shown that androgen therapy in the dose of 50, 100, or 200 mg of micronized DHEA daily may increase bone mineral density (BMD), and prevent osteoporotic fracture. […] Recombinant insulin like growth factor 1 (IGF-1) (30 g/kg1 twice per day) along with OCP (0.035 mg ethinyl estradiol and 0.4 mg norethindrone) prevents fracture in hypothalamic amenorrhea (due to anorexia nervosa) by increasing bone mineral density (BMD).

• #25 General Approaches to Medical Management of Menstrual Suppression | ACOG

  https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2022/09/general-approaches-to-medical-management-of-menstrual-suppression

  Gynecologists should be familiar with the use of hormonal therapy for menstrual suppression (including combined oral contraceptive pills, combined hormonal patches, vaginal rings, progestin-only pills, depot medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine device, and the etonogestrel implant). The choice of method should be individualized based on patient preferences and goals, average treatment effectiveness, and contraindications or risk factors for adverse events. Because complete amenorrhea may be difficult to achieve, gynecologists should counsel patients about realistic expectations. […] Counseling regarding the choice of hormonal medication for menstrual suppression should be approached with the utmost respect for patient autonomy and be free of coercion. Gynecologists should engage in shared decision making with patients, and evidence-based counseling should include menstrual-management options and the benefits and limitations of the different methods, as well as realistic expectations about complete amenorrhea.

• #26 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Treatment is determined by the etiology of the amenorrhea and the desires of the patient. Ideally, treatment should be directed at correcting the underlying pathology. In the case of outflow tract abnormalities (eg, imperforate hymen), surgery may be indicated. In other cases, correcting the underlying pathology should restore normal ovarian endocrine function and prevent the development of osteoporosis. […] Evidence is mounting that loss of menstrual regularity, especially if related to hypogonadotropic hypogonadism, is a risk factor for later development of osteoporosis and hip fractures. Patients and clinicians need to view the ovary as an important endocrine organ that helps to maintain healthy bones. Excessive delay in the evaluation and treatment of disordered menses can contribute to osteoporosis. At some point, failure to promptly evaluate for the presence of ovarian insufficiency could become a medicolegal pitfall.

• #27 Amenorrhea secondary prevention – wikidoc

  https://www.wikidoc.org/index.php/Amenorrhea_secondary_prevention

  Recent studies have shown that administering recombinant leptin (0.08 mg/kg) subcutaneous daily for 23 months can lead to an increase in bone formation markers; and also decrease fracture risk through secondary prevention. […] In adolescent women with anorexia-induced amenorrhea, alendronate (10 mg) with calcium (1200 mg) and vitamin D (400 IU) for a year has been associated with significant improvement in bone loss. Therefore, bisphosphonates can be used as secondary prevention. […] Increasing daily calorie intake and weight gain in women with anorexia or exercise-induced amenorrhea can increase bone mineral density (BMD) and decrease long term complications associated with amenorrhea such as osteoporosis and fracture.

• #28 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Many patients are deficient in their body stores of vitamin D, reflected by a serum 25-hydroxy vitamin D level less than 30 nmol/L. If this is the case, patients should be treated for 8-12 weeks with high-dose vitamin D, 50,000 IU/week, for repletion. Once the 25-OH-D level is greater than 30 nmol/L, 1000 IU/d of vitamin D may be instituted.

• #29 Secondary Amenorrhea in Teens: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.secondary-amenorrhea-in-teens-care-instructions.av2844

  Amenorrhea means you do not have menstrual periods. There are two types. Primary amenorrhea means you never start your periods. Secondary amenorrhea means you have had periods, and then they stop, especially for more than 3 months. […] Possible causes include pregnancy, hormonal changes, or losing or gaining a lot of weight quickly. Some medicines and stress could also cause it. […] Being active in endurance sports can also cause you to miss your period or stop menstruating. Losing weight or maintaining a low weight in harmful ways could also stop your period. These include dieting too much or binging and purging. But doing these things can lead to eating disorders, amenorrhea, and osteoporosis. If you exercise less or gain a little weight, your periods will probably start again. […] Your doctor may prescribe hormone therapy to help regulate your cycle. This can also help protect against bone loss.

• #30 Secondary Amenorrhea in Teens: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.secondary-amenorrhea-in-teens-care-instructions.av2844

  Eat a healthy, balanced diet. This includes fruits, vegetables, whole grains, proteins, and low-fat dairy products. […] Try not to overdo it when it comes to exercise, unless your doctor told you not to exercise at all. […] Use birth control if you do not want to get pregnant. […] Tell your doctor about any changes in your menstrual periods.

• #31 Appendix G: Lactational Amenorrhea Method | Contraception | CDC

  https://www.cdc.gov/contraception/hcp/usmec/lactational-amenorrhea-method.html

  The Bellagio Consensus provided the scientific basis for defining the conditions under which breastfeeding can be used safely and effectively for birth-spacing purposes; programmatic guidelines were developed at a meeting of family planning experts for its use as a method of contraception, and the method was then named the lactational amenorrhea method (LAM). These guidelines include the following three criteria, all of which must be met to ensure adequate protection from pregnancy: 1) amenorrhea, 2) fully or nearly fully breastfeeding (intervals between feedings not exceeding 4 hours during the day or 6 hours at night), and 3) 6 months postpartum. […] No medical conditions exist for which use of LAM for contraception is restricted. However, breastfeeding might not be recommended for persons or infants with certain conditions.

• #32

  https://myhealth.alberta.ca/sexual-reproductive-health/birth-control/natural-methods/lactation-amenorrhea

  Lactation amenorrhea method (LAM) is a way for breastfeeding to temporarily help prevent pregnancy. […] With perfect use (you follow the exact directions all the time) LAM is 98% effective against pregnancy for the first 6 months after giving birth. […] LAM does not work if you don’t have all 3 things above. Talk to your healthcare provider to see if LAM is right for you. […] Fertility can return quickly if breastfeeding is reduced. […] Its only effective for up to 6 months after you have your baby.

• #33 Appendix G: Lactational Amenorrhea Method | Contraception | CDC

  https://www.cdc.gov/contraception/hcp/usmec/lactational-amenorrhea-method.html

  LAM does not protect against sexually transmitted infections (STIs), including HIV infection, and patients using LAM should be counseled that consistent and correct use of external (male) latex condoms reduces the risk for STIs, including HIV infection. […] Patients also should be counseled that pre-exposure prophylaxis, when taken as prescribed, is highly effective for preventing HIV infection.

• #34 General Approaches to Medical Management of Menstrual Suppression | ACOG

  https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2022/09/general-approaches-to-medical-management-of-menstrual-suppression

  Gynecologists should conduct a thorough review of a patient’s use of over-the-counter and prescribed medications to address any potential drug interactions with hormonal medications for menstrual suppression. […] One of the most common challenges associated with menstrual suppression is breakthrough bleeding. In a retrospective cohort study of 300 patients, up to 46% cited breakthrough bleeding as the most common reason for discontinuation or considering changing or changing methods. […] Gaps in research include limited studies specifically addressing rates of amenorrhea with hormonal therapy, particularly with nonFDA-approved use such as extended and continuous cycling.

• #35 Preventing Secondary Amenorrhea: Tips and Tricks – Doctronic, Your Trusted AI Doctor

  https://www.doctronic.ai/sexual-reproductive-health/preventing-secondary-amenorrhea-tips-and-tricks-6zmrZL

  Prevention is better than cure! Learn how to reduce the risk of secondary amenorrhea with simple lifestyle changes. […] One of the best prevention strategies is maintaining a balanced lifestyle. Ensure a healthy diet, regular moderate exercise, and manage stress effectively. These habits promote hormonal balance and support overall menstrual health. […] Some medications can affect menstrual cycles, so it’s essential to discuss any new drugs with your doctor. If you experience changes in your cycle after starting a medication, consult a healthcare provider to explore alternatives. […] Regular check-ups can help catch issues before they become serious. Keep an eye on conditions like thyroid imbalances or PCOS that can lead to amenorrhea. Early detection and management are key to prevention.

• #36 Endocrine Society experts issue Clinical Practice Guideline on hypothalamic amenorrhea | Endocrine Society

  https://www.endocrine.org/news-and-advocacy/news-room/2017/endocrine-society-experts-issue-clinical-practice-guideline-on-hypothalamic-amenorrhea

  As part of their initial evaluation, women diagnosed with hypothalamic amenorrhea should have a series of laboratory tests to check levels of hormones including estrogen, thyroid hormones and prolactin. The workup can help identify factors preventing menstruation. […] Hypothalamic amenorrhea patients should be evaluated for inpatient treatment if they have an abnormally slow heart rate, low blood pressure, or an electrolyte imbalance. Careful monitoring is needed in these cases because there is a high mortality rate associated with hypothalamic amenorrhea in the setting of eating disorders, particularly anorexia nervosa.

• #37 What Is Amenorrhea? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/amenorrhea/guide/

  To best regulate your menstrual cycle, maintain a healthy body weight and do a proper amount of exercise. […] Going without a period may not signal a health problem. When there is no natural explanation, though, it can be a sign that your hormonal or reproductive system is not working properly. The risks of having amenorrhea vary, depending on a womans estrogen state. For example, infertility or osteoporosis can occur from low estrogen, while endometrial cancer is related to high estrogen levels. […] Several underlying conditions that include amenorrhea as a symptom may cause significant complications. […] Unintended pregnancy can be a result of amenorrhea if you are not carefully using birth control. It is still possible to get pregnant even when you are not having regular periods.

• #38 Quick Facts About Amenorrhea — 3W Medical for Women

  https://www.3wmedical.org/medical-blog/quick-facts-about-amenorrhea

  Amenorrhea means the absence of menstruation. […] Knowing the underlying cause of amenorrhea allows effective treatment. Treatment may include medication, surgery, lifestyle changes in diet and activity, or stress reduction counseling. […] Amenorrhea is associated with infertility and long-term consequences of untreated abnormal amenorrhea can include endometrial cancer, osteoporosis, and cardiovascular disease.

• #39 Amenorrhea: symptoms, diagnosis, prices for treatment at the Universum Clinic

  https://universum.clinic/en/service/zagalni-napryamki/ginekologiya/amenoreya/

  We recommend not to wait months and years, but to contact the clinic as soon as signs of any gynecological pathology appear. […] The general recommendations for the prevention of amenorrhea are related to maintaining health: active lifestyle, starting from adolescence, balanced nutrition, controlling body weight throughout life, giving up bad habits, balanced sexual life, use of barrier methods of contraception, annual check-ups by a qualified gynecologist from the first period, a balanced approach to the choice of oral contraceptives and intrauterine devices. […] It will be useful to show a newborn girl to a pediatric gynecologist at Universum clinic: a doctor’s consultation will help identify various prerequisites for the development of primary amenorrhea and treat them in a timely manner.

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