Disorder proves common in women

By Morgan Conklin
Summer Reporter

Every day women are diagnosed with common health disorders; however, one that is less known may be more common than women expect.

Amenorrhea, the absence of a menstrual period, affects most women at some point in their life.

"Anybody is at risk (for amenorrhea) because it can randomly happen; every once in a while someone can skip a period," said Kelly Murray, a nurse practitioner at the Student Health Center.

It is not abnormal to skip your period a few times each year, Murray said. However, if you have less than four periods a year, that is not healthy. "Women who don’t have periods at least four times a year are at higher risk for uterine cancer," she said. "That is why it is important to have a period every 12 weeks."

"There are a lot of reasons (why women could be amenorrheic). Pregnancy, obviously, but there are so many hormones that go into play in making a woman’s body function the way that it is supposed to that it is hard to say that there is one reason why women don’t have their period," Murray said.

Women who are obese, as well as women who are underweight are at the most risk for the disorder, although it can occur in any woman. "There is so much that goes into (making a woman’s body function regularly), and it is such a fine balance that if one of the hormones is even a little bit out of whack it could cause a change in someone’s menstrual cycle."

Women who are thin may not be getting enough of the hormone estrogen, thus preventing the endometrial lining to shed itself in a normal cycle. Murray said estrogen is stored in body fat so when a person is thin, they don’t have much fat on reserve to store the estrogen, thus making it potentially difficult to maintain a period.

However, women who are obese have different issues that may cause amenorrhea. Murray said those women have a lot more estrogen stored up because they have a lot of body fat. Amenorrhea in an obese woman may be part of a larger underlying disorder.

Even though amenorrhea is the most common in women who are extremely thin or overweight, stress can cause the disorder in anyone. "Stress and the hormones that respond to stress are made in the same place in your brain so it makes sense that if someone is stressed out about something that their periods may be affected," Murray said.

She said that before making an appointment with the gynecologist, a woman who thinks she has amenorrhea should wait a couple months to see if her period returns. "Examine what is going on in your life — if you have skipped periods before in your life and they return without any intervention and you don’t feel that you are at risk for pregnancy then certainly waiting it out is not going to do you any harm," Murray said.

Women who are diagnosed with amenorrhea are given a variety of options to correct the problem. The most common way is to go on a birth control pill. The pill has a balance of estrogen and other hormones that let the body have a period, Murray said.

Another option is to do what Murray calls the provera challenge. An amenorrheic woman will take a set of pills — lasting about a week — every few months that feed some progesterone into the body. The uterine lining forms a matrix with the endometrium and when the provera is taken away, the uterine lining will shed, which is the same thing that happens when a woman is on the pill.

The provera challenge ultimately tests the end organ response. Murray said, "The uterus is an organ that responds to those hormones (in the provera challenge), and we are testing it to make sure it is doing what it needs to do."

Provera is available by prescription, and Murray recommends this treatment for women who are not a good candidate for the pill.

Also, women should always take a multivitamin, along with getting an adequate diet and exercise. An adequate diet includes limiting the amount of carbohydrates and red meats a woman consumes and eating plenty of leafy vegetables.

As for taking estrogen supplements, Murray said, "There is so little research on those products because the products that are sold at GNC are usually dietary supplements so they don’t get regulated by the FDA so there isn’t a lot of strong research on those products."

Although some people may think that estrogen may increase the risk of cancer, Gina Shepard, clinical support staff regulator at the Women’s Clinic, said, "There is no greater risk of cancer (with taking estrogen). All birth control pills have estrogen in them."

Murray said the one thing amenorrheic women need to be aware of, however, is that even if they aren’t getting a period they may still be able to have children. "Women think that if they are not having their periods then they can’t get pregnant and that is not the case, anything is possible," she said.