Treatment of Amenorrhea by Obstetrician-Gynecologist Irina Ivanovna Kulbach in Dnipro

Patients often come with symptoms such as absence of menstruation, irregular cycles, lower abdominal pain, or sudden changes in well-being. The doctor conducts a thorough examination, analyzes complaints and medical history, and, if necessary, prescribes additional tests to identify possible causes.

Patients receive a clear and understandable action plan — what to do now, which examinations to undergo, and how to monitor their condition over time.

Irina Ivanovna Kulbach pays special attention to the differential diagnosis of the causes of amenorrhea and manages follow-up care with a focus on the patient’s comfort and safety.

When to See a Doctor

Missed periods can be concerning for different reasons: sometimes they are accompanied by unpleasant symptoms, sometimes they appear suddenly or alongside other changes in the body. It is advisable to consult an obstetrician-gynecologist to understand the causes and receive necessary recommendations. You should make an appointment with a doctor if, when missing your period, you notice:

• Constant feelings of fatigue and weakness
• Pain or discomfort in the lower abdomen
• Sudden, unexplained weight changes
• Sleep disturbances or a general decline in well-being
• Occasional headaches or dizziness
• The symptom repeats or worsens over time
• Missed periods have lasted for several menstrual cycles in a row
• No improvement despite attempts to regulate the cycle on your own
• Missed periods interfere with work or daily activities
• Symptoms first appeared after stress or lifestyle changes
• Therapy adjustment is needed if you have other diagnoses
• Symptoms recur or appear regularly

Even if the cause cannot be quickly identified, it is important not to ignore these symptoms. Monitoring and timely medical consultation can help prevent possible complications and find the most appropriate solution together with your doctor.

Emergencies or When You Need to See a Doctor Immediately

• Sudden and heavy bleeding from the genital area
• Sharp, increasing pain in the lower abdomen
• Combination of severe weakness, dizziness, and fainting
• Sudden worsening of overall condition with a high fever
• Acute pain following trauma or surgical intervention in the pelvic area

If you experience any of these symptoms, do not wait for a scheduled appointment—seek urgent medical care. Our clinic offers a doctor-at-home service for prompt assessment and support.

Causes and Risk Factors for Absence of Menstruation

It is important to understand that the absence of menstruation can occur for various reasons, and an accurate diagnosis requires evaluation by a doctor and examinations. In this section, we will discuss the most common mechanisms and factors that may influence the development of this problem.

Main Causes / Mechanisms (Briefly)

• Hormonal imbalances affecting the function of the ovaries and hypothalamus
• Stressful situations or sudden lifestyle changes
• Diseases and inflammatory processes in the reproductive organs
• Side effects from certain medications or therapies
• Some chronic diseases affecting metabolism and the endocrine system

Risk Factors

• Significant weight changes — rapid weight loss or gain
• Frequent and severe emotional stress
• Age-related changes associated with the reproductive period
• History of thyroid diseases
• Family history of reproductive organ disorders
• Frequent dieting and physical overexertion
• Smoking and harmful habits
• Chronic inflammation and irregular sexual activity

Reversible Causes That Are Important to Rule Out

• Temporary hormonal disturbances related to the menstrual cycle
• Cycle disruption after stress or heavy physical exertion
• Effects of medication intake, which can be managed by a doctor
• Recovery after infections in the pelvic area

The absence of menstruation requires a careful and step-by-step approach to identify the actual causes and exclude reversible conditions. Only a doctor can assess the situation and select the necessary examinations.

Diagnosis

The diagnosis of amenorrhea requires a comprehensive and step-by-step approach to identify possible causes and prescribe the appropriate treatment. This process helps to rule out serious issues and develop a plan for further management.

Diagnostic Approach

• Taking a detailed medical history including complaints, menstrual cycle, and overall condition
• Physical examination and assessment of the pelvic organs
• Ordering basic laboratory tests to evaluate hormonal balance
• Conducting additional investigations as indicated (ultrasound examination, blood tests, etc.)
• Interpreting results and discussing subsequent management strategies

Typical Investigations as Indicated

May include:

• Blood tests for hormones (pituitary, ovarian, thyroid)
• Ultrasound examination of the pelvic organs
• General clinical and biochemical blood tests
• If necessary — additional imaging techniques and examinations

What to Bring to the Appointment

• Results of previous examinations and tests
• List of current medications
• Menstrual cycle and symptom diary
• Information about comorbidities and past surgeries

Diagnosis of amenorrhea is an important step towards understanding your health status, and your doctor will help determine the necessary investigations for an accurate assessment of the situation.

Treatment

Treatment for the absence of menstruation is aimed at identifying the causes and improving the overall condition of the patient. The therapy plan is tailored individually, taking into account the patient’s specific characteristics and examination results.

Therapy Goals

• Reduce and alleviate symptoms associated with menstrual cycle disturbances
• Correct possible hormonal imbalances and causes of amenorrhea
• Restore normal reproductive system function when indicated
• Prevent potential complications and support overall health

Main Treatment Approaches

• May include medications that help normalize hormonal levels as indicated
• Lifestyle and dietary adjustments, as well as stress reduction, are important
• Non-drug methods such as physiotherapy and supportive procedures may be used
• Additional interventions may be prescribed by the doctor if necessary
• Therapy is individualized and requires regular monitoring

What the Doctor Does

• Develops and adjusts the treatment plan based on the patient’s condition
• Takes into account comorbidities and individual patient characteristics
• Monitors for possible side effects and treatment effectiveness
• Explains criteria for evaluating results and the sequence of monitoring
• Coordinates care with other specialists if needed

What to Expect: Plan and Monitoring

• Regular assessment of symptom dynamics and patient condition, depending on the situation
• Treatment plan is adjusted if expected changes do not occur or side effects appear
• Follow-up visits help adapt therapy and maintain stability
• An individual approach allows flexible modification of tactics as necessary

To develop an individualized plan, schedule a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention in the absence of menstruation helps reduce the risk of complications and maintain the health of the female reproductive system. The prevention plan is tailored individually, taking into account the characteristics of the body and the doctor's recommendations.

Main primary prevention measures

• Weight control and maintaining a healthy nutritional balance
• Reducing stress levels and adequate recovery after physical exertion
• Quitting smoking and limiting harmful habits
• Regular physical activity within the limits allowed by health status
• Managing chronic diseases and timely treatment

Screening and secondary prevention / regular monitoring

• Regular gynecological examinations according to the doctor's recommendations
• Monitoring hormonal balance as indicated
• Screening for possible inflammatory processes and pelvic infections
• Controlling comorbid conditions and adjusting therapy if necessary

Practical advice

• Discuss possible changes in diet and lifestyle with your doctor
• Keep a diary of cycles and symptoms for easier monitoring
• Ask your doctor to evaluate the need for additional examinations if your condition changes
• Follow the recommended visits and tests at the clinic
• Maintain a comfortable daily routine and sleep schedule

Preventive measures for the absence of menstruation are an important part of maintaining women's health; discuss an appropriate plan with your doctor.

Important to Know

The absence of menstruation is a symptom that requires attention to identify possible causes and rule out serious conditions. Treatment in the clinic is based on understanding the individual factors of each patient and thorough diagnostics. Early evaluation helps to choose an appropriate approach and reduce the risk of complications. Sometimes the condition requires ongoing monitoring and adjustments to the treatment plan. Considering the impact of stress, sleep patterns, physical activity, and comorbidities is important for comprehensive health support.

• It is important to determine the underlying cause, not just eliminate the absence of menstruation
• Early consultation helps prevent progression and complications
• Monitoring and plan adjustments are often necessary as the condition changes
• Stress, physical exertion, and comorbidities affect treatment outcomes
• Self-medication can hinder diagnosis and lead to side effects
• Clinic doctors manage patients from diagnosis through therapy monitoring and the postpartum period

If you are concerned about the absence of menstruation, it is best not to delay visiting a specialist. A detailed review of your complaints and ongoing observation will help provide the necessary recommendations and select effective ways to support your health. Additional information on causes and approaches is available on the clinic’s general page.

Self-Care Before the Appointment: What You Can and Cannot Do

Before your visit to Dr. Irina Ivanovna Kulbach, it is important to follow safety measures to avoid worsening your condition and distorting the picture of amenorrhea. If your condition worsens, seek help immediately.

What You Can Do Before the Appointment

• Note when the absence of menstruation began and the circumstances preceding it
• Keep a symptom diary: changes in well-being, additional symptoms
• Bring a list of all medications and supplements you are taking to the appointment
• Measure and record key indicators: temperature, blood pressure, pulse (if you know how)
• Reduce physical activity and try to rest
• Drink enough fluids to prevent dehydration
• Pay attention to your diet, avoiding abrupt changes in your eating habits
• Try to avoid stressful situations and maintain a comfortable sleep routine

What You Should Not Do Before the Appointment

• Do not stop or change prescribed medications without consulting your doctor
• Do not start taking new medications or remedies on your own
• Do not use “folk remedies” without specialist consultation
• Do not try to self-diagnose based on internet information or tests
• Do not ignore worsening symptoms or new symptoms appearing
• Do not postpone visiting the doctor if you suspect serious changes
• Do not use hormonal medications without a doctor’s prescription and supervision
• Do not engage in intense physical activities that may worsen symptoms

If you experience alarming symptoms or your condition worsens, contact Dr. Irina Ivanovna Kulbach immediately.

How I Can Help as a Doctor with Amenorrhea

During a consultation regarding the absence of menstruation, I will help you understand the causes of your condition and determine the optimal approach to treatment. My goal is not only to alleviate symptoms but to develop a consistent plan for examination, therapy, and monitoring. In our meeting, you will receive a comprehensive understanding of the situation and guidance on the next steps.

In a consultation about amenorrhea, I can assist you with the following:

• Analyzing your symptoms and medical history to identify possible causes
• Assessing the severity of the condition and identifying associated risk factors
• Reviewing current medications and evaluating their tolerability if you have already undergone treatment
• Developing an individualized plan for examinations and step-by-step treatment
• Considering comorbidities and current medications when selecting therapy
• Providing recommendations on lifestyle and daily routines tailored to your specific needs
• Discussing criteria for monitoring progress and scheduling follow-up consultations
• Conducting an initial assessment and differential diagnosis of the causes of amenorrhea
• Adjusting treatment in cases of insufficient effect or side effects

This comprehensive approach allows not only for identifying the problem but also for supporting you through all stages—from diagnosis to condition monitoring. It helps reduce the risk of complications and improve quality of life with this condition.

What questions can you ask a doctor about missed periods

During a consultation regarding missed periods, you can discuss the following topics with Irina Ivanovna Kulbach:

• Issues with the regularity and prolonged absence of menstruation
• Pain or discomfort in the abdominal area related to the cycle
• Sudden changes in weight and well-being associated with missed periods
• Recurring or worsening symptoms that interfere with daily life
• Lack of effectiveness from previously prescribed treatment or a need for a second opinion
• The impact of concomitant diseases or therapies on the menstrual cycle
• Questions about preparing for pregnancy and managing pregnancy when experiencing cycle problems

In case of sudden heavy bleeding, severe pain, or fainting — seek emergency care immediately rather than waiting for a scheduled appointment.

Questions to discuss during the consultation

• What is happening to me and what could it be?
• Why have my periods stopped right now?
• How can I tell if this is related to missed periods or another condition?
• What examinations are necessary in my particular case?
• What tests and investigations are essential for an accurate assessment?
• How should I prepare for the tests and the doctor's appointment?
• What treatment or management options are available for missed periods?
• Is it possible to fully restore the cycle or is this a long-term condition?
• What should I do if the prescribed treatment does not lead to improvement?
• Is it possible to avoid taking medications or undergoing surgical procedures?
• How long does treatment usually last, and when is a follow-up needed?
• How can I recognize signs of improvement or worsening of my condition?
• What should I do if there is a sudden deterioration or appearance of new symptoms?

If your complaints exceed the scope of a routine consultation, the doctor may refer you for additional examinations or to specialized services. This will help ensure your safety and timely treatment. In case of emergency conditions, we will provide necessary care and, if needed, organize further support.

How the Consultation Proceeds

A consultation with obstetrician-gynecologist Irina Ivanovna Kulbach involves a careful review of your complaints, assessment of your current condition, and development of a plan for further action. The scope of examinations and tests is determined individually, depending on your symptoms and indications. During a single appointment, the doctor performs a preliminary evaluation and outlines directions for further monitoring or treatment.

Main steps of the consultation:

1. Clarifying complaints and the purpose of the visit: what exactly concerns you, when symptoms began, what affects your condition, and what you expect from the appointment.
2. Collecting medical history and risk factors: gathering information about your menstrual cycle, stress levels, chronic illnesses, and lifestyle.
3. Discussing previous examinations and treatments: reviewing existing medical records and the list of medications you are taking.
4. Conducting a physical examination and, if necessary, special tests — based on indications and individual features.
5. Preliminary conclusion: the doctor explains the main possible causes and factors that need to be ruled out.
6. Planning further examinations if needed — which may include hormone blood tests, ultrasound examination of pelvic organs, and other methods.
7. Discussing treatment principles and health management options considering the obtained data and the patient’s preferences.
8. Determining timing for follow-up visits and controls, recommendations for monitoring your condition, and signals that require unscheduled medical attention.

If this is your first visit, the consultation will focus on detailed information gathering to identify the causes of absence of menstruation. If previous treatments did not yield expected results, main attention is given to analyzing the reasons for lack of effect and adjusting the therapy plan.

This approach helps create the clearest and most comfortable action plan tailored to your individual needs, enabling timely response to any changes in your condition.

Preparation for the Appointment

To make your consultation with the obstetrician-gynecologist as effective as possible and to help identify the causes of missed periods more quickly, it is important to prepare properly. This will speed up the diagnosis and the development of an individualized plan.

• Bring a list of all current medications, including names and dosages, if known
• Take with you the results of previous examinations, ultrasounds, blood tests, and hormone tests
• Note when and how the absence of menstruation began, as well as what relieves or worsens symptoms
• Do not stop taking prescribed medications without consulting your doctor
• If fasting is required for tests, do not eat or drink for at least 8–12 hours (confirm when booking)
• Avoid applying cosmetics and creams in the abdominal area before the examination (if instructed)
• If possible, bring a menstrual cycle diary and notes about your well-being
• Prepare a list of questions you want to discuss with the doctor
• If in doubt, clarify preparation details when booking or by phone

If you prepare thoroughly for your appointment, the consultation will be faster and will allow for a more accurate determination of the next steps in examination and treatment.

About the Doctor

Irina Ivanovna Kulbach is a highly qualified obstetrician-gynecologist with over 40 years of experience. She frequently treats patients experiencing absence of menstruation, including initial consultations and cases where previous treatments have been ineffective.

In her practice, Irina Ivanovna focuses on differential diagnosis of the causes and conducts ongoing monitoring. Patients receive a detailed analysis of their situation and a personalized plan for the next steps, taking individual health characteristics into account.

Why Patients Choose Dr. Irina Ivanovna Kulbach

When treating amenorrhea, Irina Ivanovna develops a treatment plan that takes individual characteristics into account and involves sequential steps. She conducts thorough differential diagnostics to rule out comorbid conditions and select a safe approach. The doctor reviews previous prescriptions and side effects, adjusting therapy as needed. During consultations, she clearly explains the treatment goals and effectiveness criteria, helping patients understand each step. Special attention is given to dynamic monitoring and timely adjustment of the plan. Patients can bring their test results — the doctor interprets them and incorporates them into ongoing treatment.

• Clear action plan with defined stages of treatment and result monitoring
• Examinations only as indicated, without unnecessary procedures or burden
• Consideration of comorbidities and drug interactions to ensure safety
• Monitoring condition dynamics and therapy adjustment in case of weak effect or side effects
• Analysis of previous prescriptions and assessment of medication tolerance
• Explanation of the treatment plan in simple language, including risks and alternative options
• Focus on preventing complications and maintaining long-term health
• Ability to manage complex and chronic cases with a comprehensive approach

This approach is characterized by comprehensive patient care and flexible tactics depending on the situation's development. Irina Ivanovna helps systematically identify the causes of amenorrhea and supports patients throughout the treatment process, reducing anxiety and making the path to improvement clearer.

Case Studies

Initial Consultation for Absence of Menstruation

A middle-aged patient came for the first time with complaints of prolonged absence of menstruation and general deterioration of well-being. It was important to rule out serious hormonal and gynecological disorders, as well as to assess the impact of stress and lifestyle. The physician conducted a thorough medical history intake, performed an examination, and ordered necessary tests as indicated. Over time, the patient reported improvement in well-being and restoration of the menstrual cycle within several months. Further monitoring involves regular check-ups and adjustments as needed.

Therapy Adjustment Due to Insufficient Effect

A young woman sought care after a course of treatment with another specialist during which no improvement in the menstrual cycle was observed. Special attention was given to reviewing previous prescriptions and analyzing drug tolerance. Additional examinations were conducted to clarify the cause, which allowed therapy to be adjusted. Over time, symptoms decreased and the cycle normalized. Ongoing follow-up includes regular evaluation of treatment effectiveness.

Chronic Course with Comorbid Conditions

A middle-aged patient with prolonged absence of menstruation and accompanying endocrine disorders came for consultation for comprehensive management. The physician considered the impact of chronic diseases and prescribed medications, planning treatment with overall safety in mind. Continuous monitoring and adaptation of the approach based on control results were performed. Over several months, the condition stabilized and the patient’s quality of life improved.

Symptom Exacerbation and Need for Monitoring

A woman presented with worsening symptoms following a stressful event, accompanied by abrupt cessation of menstruation. It was important to quickly exclude dangerous conditions and adjust the follow-up plan. The physician ordered a broader scope of examinations and recommended measures to reduce stress. As a result of monitoring, the patient’s condition improved, and the subsequent strategy included prevention of possible exacerbations and regular observation.

Management After Therapy Change and Second Opinion

A patient with irregular menstruation sought a second opinion after a change in medical strategy that raised concerns about side effects. The physician evaluated the medical history, comorbid factors, and reviewed prescriptions. Recommendations were given for treatment correction and control plans. The patient reported improved well-being and reduced troubling symptoms at subsequent visits. The plan includes regular support and assessment of progress.

How long does a consultation last?

Usually, a consultation takes from 30 to 60 minutes; the exact time is specified when booking.

How should I prepare for the appointment?

It is recommended to write down your main complaints, prepare a list of current medications, and any questions for the doctor.

What should I bring to the consultation?

Bring results of previous examinations, tests, medical records, and a list of medications you are taking.

Do I need to come on an empty stomach?

Usually not, unless otherwise specified when booking or by the doctor.

How many visits are usually required?

It depends on the cause and complexity of the case; on average, several visits are needed for examination and monitoring.

When can I expect the first results of treatment?

This is individual and depends on the chosen approach and the body's response.

What should I do if my condition worsens before the appointment?

If your condition worsens with severe pain, bleeding, or fainting, seek emergency medical help.

Can I combine treatment with my current medications?

Discuss all medications during the appointment; do not change or stop them on your own.

Is it possible to have an online consultation?

Yes, online consultations are available; please check the conditions when booking.

Can I come with tests and examinations already done?

Yes, bring all existing results for a more accurate assessment.

Do I need to come back for follow-up visits, and how often?

Follow-up visits are required to monitor progress and adjust therapy; frequency depends on the situation.

Can I get a second medical opinion?

Yes, the doctor is ready to review your history and provide an additional consultation.

What should I do if symptoms return after improvement?

Contact your doctor for reassessment and possible treatment adjustment.

What tests are needed if menstruation is absent?

The choice of tests depends on symptoms and indications; the doctor will prescribe them individually.

Can I treat myself?

Self-treatment is not recommended; it is important to follow the specialist’s prescriptions and recommendations.

What does the treatment plan for absence of menstruation include?

The plan includes examination, therapy selection, and subsequent monitoring of the condition.

Can I come without prior preparation?

It is advisable to follow preparation recommendations to ensure the most accurate results.

How quickly should I see a doctor if I have problems with my menstrual cycle?

If menstruation is absent for an extended period or symptoms appear, it is best not to delay seeing a specialist.