What is the relationship between amenorrhea and estrogen?

Everyone knows that normal women have their periods for a few days every month. Generally, if they don’t have their periods, it means they are pregnant, or there is something wrong with their body. At this time, many people also know that estrogen is also related to menstruation under certain effects. Many people wonder whether amenorrhea is caused by too much or too little estrogen. Let's take a look at the relationship between amenorrhea and estrogen.

Estrogen deficiency and amenorrhea can be coexistent conditions. During amenorrhea, there is insufficient estrogen, and there is amenorrhea at the same time as insufficient estrogen. In women, low estrogen levels are not the sole cause of the disease, but must be the result of some pathological effect.

There are three major physiological reasons for female amenorrhea:

1. Ovarian amenorrhea is a symptom of amenorrhea caused by ovarian disease. If a woman's ovaries become diseased, the secretion of estrogen will be too low, causing the endometrium to stop developing and growing, leading to amenorrhea.

2. Pituitary amenorrhea, which is caused by insufficient pituitary function in women. Understanding the causes of amenorrhea and infertility caused by endocrine disorders can help doctors provide symptomatic treatment and restore patients' health as soon as possible.

3. Uterine amenorrhea, as the name suggests, is caused by the endometrium's failure to respond to hormone secretion. Common causes include endometrial tuberculosis, injury, adhesion and dysplasia.

1. Treatment of the cause

Some patients can resume menstruation after the cause is removed. "For patients with neurological or mental stress causes, effective psychological counseling should be provided; patients with amenorrhea caused by low body weight or 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 the hypothalamus (craniopharyngeal tumors), pituitary tumors (excluding tumors that secrete PRL) and ovarian tumors, the tumors should be surgically removed; for patients with high-Gn amenorrhea containing Y chromosomes, their gonads have malignant potential and should undergo gonadectomy as soon as possible"; amenorrhea caused by reproductive tract malformations and menstrual drainage disorders should be corrected surgically to ensure smooth menstrual blood flow.

2. Estrogen and/or progesterone therapy

Estrogen therapy should be used to treat amenorrhea caused by adolescent sexual immaturity and adult hypoestrogenism. The principles of medication are as follows: for adolescent sexually immature patients, when their height has not yet reached the expected height. Treatment should be started with a small dose, such as 0.5 mg/day of 17β-estradiol or estradiol valerate or 0.3 mg/day of conjugated estrogen; after the height reaches the expected height, the dose can be increased, such as 17β-estradiol or estradiol valerate 1-2 mg/day or 0.625-1.25 mg/day of conjugated estrogen. Promote further development of sexual characteristics after the uterus develops. Depending on the degree of endometrial proliferation, progestogens can be added regularly (see Table 2 for methods) or estrogen and progestogen sequential cyclic therapy can be used. Adults with amenorrhea and hypoestrogenemia should first take 17β-estradiol or estradiol valerate 1-2 mg/day or conjugated estrogen 0.625 mg/day to promote and maintain overall health and sexual development until the uterus develops. It is also necessary to add progestin regularly or adopt estrogen and progestin sequential cycle therapy according to the degree of endometrial proliferation. Natural or near-natural progestins are recommended for cyclical therapy in adolescent women. Such as dydrogesterone and micronized progesterone. It is beneficial to the recovery of reproductive axis function; patients with signs of androgen excess. A progestogen formula containing anti-androgenic effects can be used to treat amenorrhea in patients with a certain level of endogenous estrogen. Progestin therapy should be used regularly (see Table 2 for methods) to allow the endometrium to shed regularly.

3. Endocrine therapy for disease pathology and physiological disorders

According to the causes of amenorrhea and its pathological and physiological mechanisms. Targeted endocrine drug therapy is used to correct the disordered hormone levels in the body 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 combined estrogen and progesterone oral contraceptives; 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 patients 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. Since 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 patient has a certain level of endogenous estrogen in the body; for amenorrhea patients with elevated FSH levels, ovulation-inducing drugs are not recommended due to their ovarian failure.

5. Assisted Reproductive Treatment

Assisted reproductive technology can be used for patients who desire to have children, who have failed to become pregnant after induced ovulation, who have amenorrhea and combined with fallopian tube problems, or who are infertile due to male factors.

Regarding the relationship between amenorrhea and estrogen, everyone knows that there is a certain relationship between the two. At the same time, the above article also introduces to you the other causes of amenorrhea. These are all preventive measures in life. If this situation really occurs, you must go to the hospital for examination and treatment in time to avoid any problems.