Vaginitis
What is vaginitis? Vaginitis is an inflammation of the vagina. Vaginitis may cause itching, burning, a bad odor, or a large amount of discharge. It is one of the most common reasons for visiting an obstetrician–gynecologist (ob-gyn).
What is Amenorrhea?
Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea:
- Primary amenorrhea—This is when a girl does not get her first period by age 15.
- Secondary amenorrhea—This is when a woman who already menstruates does not get her period for 3 months or more.
Some causes of amenorrhea are normal, including pregnancy, breastfeeding, and menopause. Amenorrhea also may be caused by medical conditions or medications.
What is Amenorrhea?
Candida overgrowth can stem from a number of factors. But, if you’re under stress for a prolonged period of time like many of us during the holidays, the body may begin to produce increased levels of cortisol, a hormone that can weaken the immune system, and simultaneously cause elevated levels of blood sugar. And, since yeast feeds off of sugar, candida is able to grow faster than normal. While Mrs. Claus means well, stress gets the best of us and we get carried away baking one batch of cookies too many.
What Causes Primary Amenorrhea?
When periods do not start in girls, there may be medical reasons, including:
- Genetic conditions, such as Turner syndrome and androgen insensitivity
- Problems with the brain (with the hypothalamus or pituitary gland)
- Problems with development of the uterus, vagina, or hymen
- A delay in puberty
What Causes Secondary Amenorrhea?
When periods stop in women who were menstruating and who are not pregnant, the reasons may include:
- Low body weight (about 10 percent under normal weight)
- Rapid weight loss
- Eating disorders (such as anorexia nervosa)
- Problems with the brain (with the hypothalamus or pituitary gland)
- Polycystic ovary syndrome (PCOS)
- Problems with the thyroid gland
- Primary ovary insufficiency (also called premature ovarian failure)
- Stress
- Other chronic medical conditions, such as kidney failure or inflammatory bowel disease (IBD)
Some medications, such as hormonal birth control, can stop periods while you are taking them. And smoking can increase your risk of amenorrhea.
Who Should Be Evaluated for Amenorrhea?
Teens should be evaluated for primary amenorrhea if they have not had their period by age 15. Teens also should be evaluated if there is no sign of breast development by age 13.
No matter your age, you should be evaluated for amenorrhea if your period stops for more than 3 months without explanation. You can talk with an obstetrician–gynecologist (ob-gyn) about diagnosis and treatment.
What Should I Do If I Think I Have Amenorrhea?
Talk with your ob-gyn about your symptoms. Amenorrhea may be a sign of an underlying medical issue. If left untreated, it can also lead to other problems, such as low bone density and osteoporosis. Your ob-gyn can help find the cause of your amenorrhea and discuss treatment options.
How Is Amenorrhea Diagnosed?
Your ob-gyn should review your medical history and discuss whether you need a physical exam. This may include a breast exam and a pelvic exam. He or she may ask you the following questions:
- How long has it been since your last period?
- What was your menstrual cycle like before this?
- Have you had any recent illnesses?
- Do you have a family history of amenorrhea?
- What medications, drugs, or herbal remedies are you taking?
- What is your diet like?
- What are your exercise habits?
- Do you have any medical conditions or physical abnormalities, such as a single kidney or a heart condition?
You also may need certain tests to help find a diagnosis. This could include blood tests to check your hormone levels or an ultrasound exam. Depending on your age and sexual activity, you also may be asked to take a pregnancy test to rule out pregnancy.
How Is Primary Amenorrhea Treated?
If a teen is going through puberty normally, but a little later than usual, then typically no treatment is needed. You, your parent or caregiver, and your ob-gyn should monitor your health. If there is another cause for the delay in puberty, then you may need to see a specialist for treatment.
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.
Some girls are born with a physical difference that prevents them from having vaginal bleeding, such as an imperforate hymen, vaginal septum, or absence of the uterus. Surgery may be needed in these cases.
How Is Secondary Amenorrhea Treated?
Treatment for secondary amenorrhea depends on the cause:
- Primary ovarian insufficiency—Hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce.
- PCOS—Treatment may involve weight loss and hormone therapy.
- Other causes—Your ob-gyn may suggest you see an expert in treating eating disorders, thyroid issues, or other medical problems.
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. (Recommended daily calcium intake depends on your age.) Good sources of calcium include dark, leafy greens; dairy foods; and canned salmon and sardines. Good sources of vitamin D include fortified milk, fatty fish like salmon, and sun exposure (15 minutes a few days a week).
Screening for Hepatitis B and Hepatitis C During Pregnancy
Hepatitis. It’s one of those medical words you may have heard, but never understood. And if you’re pregnant, it’s a word you might hear at your first prenatal visit. Screening for Hepatitis B and Hepatitis
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