Primary amenorrhea is defined as lack of menstruation by age 14 in the absence of development of secondary sexual characteristics, or absence of menstruation by age 16 regardless of the development of secondary sexual characteristics. Secondary amenorrhea is defined as absence of periods for six months in a woman who has previously been menstruating, and is considered normal during pregnancy, lactation and menopause.
How Chinese medicine treats amenorrhea
Chinese medicine attempts to restore normal menstruation by addressing the root cause of the imbalance. Hormonal regulation is almost always a priority with amenorrhea, and depending on the details and severity of the condition, different therapies may be prescribed.
Acupuncture can be used to regulate imbalances in the hypothalamic-pituitary-ovarian axis and restore normal hormonal functioning.
Nutritional counseling is a key component if athletic amenorrhea, eating disorders or poor diet are factors.
Herbal treatment can be used to move blood into the uterus, and after a few months of treatment may stimulate a period.
Stress reduction techniques may be important, depending on the cause.
Causes of amenorrhea
Amenorrhea is a symptom with many potential causes. Primary amenorrhea often stems from developmental problems, while secondary amenorrhea is often caused by hormonal disturbances from the hypothalamus and the pituitary gland, or from premature menopause.
The main causes of amenorrhea include:
Primary amenorrhea
- Turner syndrome
- Mullerian agenesis
- Androgen insensitivity syndrome
- Hermaphroditism
- Kallmann syndrome
- Aromatase deficiency
- Congenital adrenal hyperplasia
- Prader-Willi syndrome
- Galactosemia
- FSH and LH receptor anomalies
- Delayed hypothalamic-pituitary maturation
- Swyer syndrome
- Vaginal obstructions
Secondary amenorrhea
- Pregnancy
- Anovulation
- Menopause
- Hyperprolactinemia
- Polycystic ovarian syndrome (PCOS)
- Thyroid disorders
- Exercise amenorrhea
- Stress
- Eating disorders
- Asherman’s syndrome
- Drug side effects
- Hemochromatosis
- Androgen-secreting tumors
Diagnosis of amenorrhea
The diagnosis of amenorrhea is extremely complex, and is dependent on the underlying cause. It is based on several factors, including age of onset and level of hormonal involvement.
Western treatment of amenorrhea
Oral contraceptives or estrogen therapy are the most common treatments for amenorrhea, and serve to regulate menstruation. Appropriate treatment of underlying conditions causing amenorrhea is also usually of high importance. Women are unable to conceive naturally during a period of amenorrhea; however, athletic or drug-induced amenorrhea have shown no long-term impact on fertility, once menstruation resumes. For those patients not planning to have biological children, treatment may not be necessary.
