Menstruation has not come for more than 15 days

If menstruation has not come for more than 15 days, you must find ways to improve it. If you still ignore it at this time, your physical condition will become more serious, which will naturally cause more gynecological diseases and even the risk of amenorrhea. In order to avoid this situation, people should take appropriate measures as soon as possible.

1. Hypothalamic amenorrhea

Hypothalamic amenorrhea is amenorrhea caused by various functional and organic diseases of the hypothalamus. This type of amenorrhea is characterized by defective or insufficient synthesis and secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus, which leads to low secretion of pituitary gonadotropin (Gn), namely follicle-stimulating hormone (FSH) and luteinizing hormone (LH), especially LH, so it is a type of hypogonadotropic and hypoestrogenic amenorrhea. Clinically, the disease can be divided into three categories according to its cause: functional, genetic defect or organic, and drug-induced.

1. Functional amenorrhea

This type of amenorrhea is caused by various stress factors inhibiting the secretion of hypothalamic GnRH, which can be reversed with timely treatment.

(1) Stress-induced amenorrhea Mental shock, environmental changes, etc. can cause stress-induced increases in the levels of endogenous opioids, dopamine, and adrenocorticotropic hormone (ACTH)-releasing hormone, thereby inhibiting the secretion of GnRH in the hypothalamus.

(2) Sports-induced amenorrhea Athletes may experience amenorrhea after sustained strenuous exercise. It is related to the psychology, stress response level and body fat loss of amenorrhea patients. Amenorrhea will occur if the body weight is lost by 10% to 15%, or if the body fat is lost by 30%.

(3) Amenorrhea caused by anorexia nervosa is caused by excessive dieting, which leads to a sharp drop in body weight, eventually causing a decrease in the secretion levels of multiple neuroendocrine hormones in the hypothalamus, causing a decrease in the secretion levels of multiple trophic hormones in the anterior pituitary, including LH, FSH, ACTH, etc. The clinical manifestations include anorexia, extreme weight loss, low-Gn amenorrhea, dry skin, hypothermia, hypotension, low blood cell counts and plasma protein levels. Severe cases can be life-threatening.

(4) Nutrition-related amenorrhea Chronic wasting diseases, intestinal diseases, malnutrition, etc. that lead to excessive weight loss and emaciation can all cause amenorrhea.

2. Genetic defects or organic amenorrhea

(1) Genetic defect amenorrhea is a congenital GnRH secretion defect caused by a genetic defect. The main types are Kallmann syndrome with olfactory dysfunction and idiopathic low-Gn amenorrhea without olfactory dysfunction. Kallmann syndrome is caused by a defect in the KAL-1 gene on chromosome Xp22.3, and idiopathic hypogonadism is caused by a mutation in the GnRH receptor 1 gene.