Periods are a natural part of life for most women, but for some, the journey begins much later or not at all. Primary Amenorrhea is the absence of periods even after 15 years of age. It is a source of confusion, concern, and social stigma. Due to a lack of awareness, patients with this condition delay treatment and evaluation, which would leave them in isolation and hopelessness.
At Manipal Hospital Bhubaneswar, Dr. Monica Gupta, Consultant – Obstetrics and Gynaecology, came across an interesting case of three sisters from Jharkhand, aged between 33 and 35, who presented with no menstruation. Despite this, they were all married and had no problems in their sexual life. As children, they had been evaluated by local doctors, but they were told that there was no available treatment. This led the sisters to accept their condition silently until one day, when they heard about Dr. Monica Gupta from a local woman who had earlier received successful treatment to become pregnant. This brought a ray of hope to the sisters as they also wanted to explore prospects for pregnancy and childbearing.
At the hospital, Dr. Gupta and her team evaluated them, and it was discovered that the reason for the absence of menses was failure of ovarian function, and the lack of ovarian hormones prevented normal uterine development. Under Dr. Gupta’s medical care, the eldest sister was first started on hormone therapy, which was fruitful as she began to experience regular menstrual cycles. This renewed hope inspired her younger sisters to follow suit, and both also began to have normal periods. With ongoing hormone therapy, their small, underdeveloped uteruses gradually grew to normal size.
With their bodies responding to treatment, the sisters were counselled about assisted reproductive techniques, including IVF (in vitro fertilization), which has revolutionized the treatment of infertility. In women with primary amenorrhea caused by hormonal or uterine issues, IVF allows pregnancy even if natural conception is not possible. Hormonal support prepares their uterus, and IVF enables fertilization and embryo transfer, bypassing obstacles that may prevent traditional conception.
Two of the sisters agreed and went on with IVF treatment cycles and are expecting mothers today, with healthy and ongoing pregnancies – a miracle in their 3 decades of life.
Dr. Monica Gupta noted, “Primary amenorrhea is not a curse; it is a clue, an important point towards medical care, support, and understanding. We are happy that we have the technology today to give women back their choices and, often, the chance to embrace the joy of motherhood through modern hormone therapy and advanced reproductive techniques. Cases like these remind us that what may appear to be a closed chapter can, with the right diagnosis and care, be rewritten.”