20 years old, no menstruation for several months

If your period has not come for a long time, you should first consider whether you have a sexual life. If your period suddenly stops, it may be related to pregnancy. At this time, you need to go to the hospital to have a blood test to check the hcg content. If the possibility of pregnancy is ruled out, you need to consider the possibility of gynecological inflammation. Polycystic ovary syndrome, premature ovarian insufficiency and intrauterine adhesions may all lead to symptoms of amenorrhea and should be checked promptly to prevent the condition from worsening.

Rule out pregnancy first

If menstruation suddenly stops, we must first rule out pregnancy. It's very simple. First, do a urine pregnancy test. If you are still in doubt, you can do a blood test to check hcg. It is possible that urine testing may not reveal pregnancy, but a blood test for hcg will almost certainly reveal it.

However, hCG only proves whether the pregnancy is intrauterine or extrauterine, or the quality of the embryo, it is difficult to determine with a single test. Therefore, it is often necessary to repeat the blood test every 2-3 days. Of course, it is also necessary to combine it with ultrasound examination to make the judgment more intuitive.

1. Polycystic ovary syndrome

This problem has become a common and frequently occurring disease, and is now classified as a chronic disease by our gynecologists. In other words, it is incurable and requires lifelong management.

As for how polycystic ovary syndrome occurs, it is now very clear. Anyway, it is related to metabolic problems. The increase of male hormones and insulin resistance in women's bodies causes immature development of follicles. Ultrasound shows polycystic ovaries, which clinically manifest as anovulation or infrequent ovulation, and then no menstruation.

At least you need to do a B-ultrasound and a blood test. If your period has not come for nearly 3 months or longer, you can directly draw blood to check sex hormones. If it has not been missed for such a long time, you can take medicine and have a blood test on the 3rd to 5th day of your period. In addition to the six routine sex hormone tests, more tests may sometimes be needed to help rule out other diseases.

2. Early-onset ovarian insufficiency

In the early stages of ovarian dysfunction, it is often manifested as infrequent menstruation, which means no menstruation for several months, or a decrease in menstrual volume. Most cases can be diagnosed by combining the tests of sex hormones and AMH.

As ovarian function declines in people in their 20s, they need additional hormone therapy to keep the body at a younger and healthier level. Hormone supplementation can make menstruation regular, but you cannot stop taking the medicine. If you want to get pregnant and have a baby, you also need to go to an IVF center for a comprehensive evaluation.

3. Intrauterine Adhesions

If you have had a curettage, or have had endometritis, pelvic tuberculosis, etc., especially if you have a history of multiple abortions, it is easy to cause endometrial damage, uterine adhesions, and reduced menstrual volume. In severe cases, it may also cause amenorrhea.

In this case, most sex hormones are normal, and adhesions can be detected by B-ultrasound in severe cases. If the condition is mild, it is difficult to judge directly and requires a doctor to make a reverse diagnosis. If it is confirmed, a hysteroscopy is required. During the hysteroscopy, adhesions can be separated, an IUD can be inserted, or estrogen and progesterone can be taken to help improve the uterine environment.

If the woman has no desire to have children, intrauterine adhesions are not a big deal, as long as she does not have dysmenorrhea, she can go. If there is a desire to have children, the treatment is a bit tricky, especially for patients with severe adhesions.

4. Mental Factors

The ovaries are organs that produce estrogen and progesterone. They can regulate the menstruation of the uterus, but they are also regulated by their superior leader - the brain.

When a person suffers a shock, extreme sadness, tension, depression, or a drastic change in environment, the brain may send signals to stop certain organ functions that do not affect life. This is actually a kind of protection for the body, but it may give the ovaries the wrong instructions and stop the production of estrogen and progesterone.

In this case, the doctor needs to patiently inquire about the patient's condition and make a judgment based on the results of hormone testing. The first choice of treatment is to help relieve mental stress and use estrogen and progesterone appropriately.

5. Excessive exercise

People who exercise a lot on a regular basis may also not have their periods. It may be related to reduced fat content, psychological and stress factors. You can reduce the amount of exercise, gain weight appropriately, and take estrogen and progesterone drugs.

6. Excessive weight loss and anorexia

Being too fat can affect menstruation, and so can being too thin. The fat content is too low, and the raw materials provided for the synthesis of sex hormones are insufficient. This raw material is cholesterol, which you probably didn’t expect.

Losing too much weight can also affect the endocrine dysfunction of the brain, and ultimately affect the function of the ovaries, causing amenorrhea.

So, your weight should be moderate, neither fat nor thin is best. Fortunately, there are not many girls who are too thin nowadays. Most of them are slightly plump, and this body shape has little impact.

7. Hyperprolactinemia

This disease has a characteristic, which is that there is often nipple lactation. To rule out problems with the pituitary gland, in addition to sex hormone testing, sometimes a brain MRI is also required.

In addition to lactation, it also affects the maturation of follicles, resulting in no ovulation and no menstruation. Bromocriptine is needed for treatment.

8. Thyroid disease

The endocrine system in the body is a family. Thyroid hormones can indirectly affect ovarian function by affecting the brain. Hyperthyroidism or hyperthyroidism may affect menstruation, so thyroid hormone testing will be added when testing sex hormones.