Amenorrhea is the absence of menstrual cycles.
Amenorrhea is called primary when a woman has not started to menstruate by the age of 16 years, while secondary amenorrhea refers to the abnormal cessation of menstruation in a woman who previously has had menstrual cycles.1 In amenorrheic women, the levels of female reproductive hormones are not sufficient to stimulate menstruation. This condition is sometimes associated with malnutrition, such as that which occurs in anorexia nervosa, or with extreme exercise, which puts excessive nutritional and other demands on the body.2 3 An association between stress and amenorrhea has also been demonstrated.4 Amenorrhea may also result from potentially serious disorders of the ovaries, the hypothalamus, or the pituitary gland; therefore, a physician should always evaluate chronic absence of menstrual cycles. Prolonged amenorrhea can result in early bone loss and increased risk of osteoporosis.5 Amenorrhea occurs naturally in women who are breast-feeding,6 but in these circumstances it does not put the bones at risk.7
What are the symptoms?:
Women with amenorrhea may have symptoms of absent periods, increased facial hair, decreased pubic and armpit hair, deeper voice, decreased breast size, and secretions from the breast.
Depression is a condition characterized by unhappy, hopeless feelings. It can be a response to stressful events, hormonal imbalances, biochemical abnormalities, or other causes.
Mild depression that passes quickly may not require any diagnosis or treatment. However, when depression becomes recurrent, constant, or severe, it should be diagnosed by a licensed counselor, psychologist, social worker, or doctor. Diagnosis may be crucial for determining appropriate treatment. For example, depression caused by low thyroid function can be successfully treated with prescription thyroid medication. Suicidal depression often requires prescription antidepressants. Persistent mild to moderate depression triggered by stressful events is often best treated with counseling and not necessarily with medications.
When depression is not a function of external events, it is called endogenous. Endogenous depression can be due to biochemical abnormalities. Lifestyle changes, nutritional supplements, and herbs may be used with people whose depression results from a variety of causes, but these natural interventions are usually best geared to endogenous depression.
What are the symptoms?
A diagnosis of depression requires at least five of the following symptoms.
* Depressed mood.
* Diminished interest or pleasure in all or most activities, most of the day, nearly every day.
* Significant weight loss or gain when not dieting (e.g., more than 5% of body weight in a month).
* Insomnia or excessive sleeping nearly every day.
* Agitation or depression in voluntary muscle movements nearly every day.
* Fatigue or loss of energy nearly every day.
* Feelings of worthlessness or excessive and inappropriate guilt nearly every day.
* Diminished ability to think or concentrate, or indecisiveness nearly every day.
* Recurrent thoughts of death (not just fear of death), recurrent suicidal ideation without a plan, or a suicide attempt or specific plan to commit suicide.
Menopause is the cessation of the monthly female menstrual cycle. Women who have not had a menstrual period for a year are considered postmenopausal.
Most commonly, menopause takes place when a woman is in her late forties or early fifties. Women who have gone through menopause are no longer fertile. Menopause is not a disease and cannot be prevented. Many hormonal changes occur during menopause. Postmenopausal women are at higher risk of heart disease and osteoporosis, presumably because of a decrease in the production of estrogen or other hormones.
What are the symptoms?
Several unpleasant symptoms may accompany menopause. Some, such as vaginal dryness, result from the lack of estrogen. Others, such as hot flashes and decreased sex drive, are caused by more complex hormonal changes. Some women experience depression, anxiety, or insomnia during menopause.
About weight loss and obesity
About two-thirds of the adult U.S. population is overweight.1 Almost one-third not only exceeds ideal weight, but also meets the clinical criteria for obesity. In the 1990s, rates of obesity more than doubled, and are currently rising by over 5% per year.2 3 Excess body weight is implicated as a risk factor for many different disorders, including heart disease, diabetes, several cancers (such as breast cancer in postmenopausal women, and cancers of the uterus, colon, and kidney), prostate enlargement (BPH), female infertility, uterine fibroids, and gallstones, as well as several disorders of pregnancy, including gestational diabetes, preeclampsia, and gestational hypertension.4 The location of excess body fat may affect the amount of health risk associated with overweight. Increased abdominal fat, which can be estimated by waist size, may be especially hazardous to long-term health.5 6
For overweight women, weight loss can significantly improve physical health. A four-year study of over 40,000 women found that weight loss in overweight women was associated with improved physical function and vitality as well as decreased bodily pain.7 The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases in overweight men and women in all age groups.8 Losing weight and keeping it off is, unfortunately, very difficult for most people.9 10 However, repeated weight loss followed by weight regain may be unhealthy, as it has been associated with increased heart disease risk factors and bone loss in some studies.11 12 Rather than focusing on weight loss as the most important health outcome of a change in diet or lifestyle, some doctors advocate paying more attention to overall fitness and reduction in known risk factors for heart disease and other health hazards.13
Excess body mass has the one advantage of increasing bone mass—a protection against osteoporosis. Probably because of this, researchers have been able to show that people who successfully lose weight have greater loss of bone compared with those who do not lose weight.14 People who lose weight should, therefore, pay more attention to preventing osteoporosis