Amenorrhea 

Abnormal absence or suppression of menstruation. Amenorrhea is a symptom of the absence of menses. This is not a disease but a symptom of the disease. Physiological Amenorrhea occurs during pregnancy and sometimes during lactation. Pathological Amenorrhea is of two types: 

1) Primary

2) Secondary

Primary Amenorrhea is a condition used for the female patient who has never menstruated.

Causes of Primary Menstruation

Delayed puberty, is a consequence of anatomical defects of the female reproductive system e.g. endometrial hypoplasia. The causes can be grouped as:

I) Endocrine:

Hypothalamic:

• Obesity
• Environmental change 
• Anorexia nervosa 
• Kallman’s syndrome 
• Hydrocephalus 
• Head injury meningitis

• Pituitary dwarf 
• Empty sella syndrome 
• Pituitary tumors 
• Hyperprolactinemia

III) Ovarian:

• Polycystic ovarian syndrome 
• Testicular feminization 
• Ovarian tumors.

IV) Thyroid

V) Adrenal

VI) Pancreas: Juvenile Diabetes mellitus

VII) Drugs and Diseases

VIII) Chromosomal (C)

IX) Uterovaginal Atresia (U) 

• Cryptomenorrhea 
• Rokitansky – Kuster – Hauser Syndrome. 
• Endometrial tuberculosis 
• Pregnancy

Secondary Amenorrhea: the cessation of menstruation

The causes of secondary Amenorrhea

I) Endocrine (E)

• Hypothalamic 
• Pituitary: Cushing syndrome, acromegaly, Sheehan’s disease Hyperprolactinemia 
• Ovary: PCOs, premature Menopause, ovarian tumor (Arrhenoblastoma) 
• Thyroid Disease 
• Adrenal 
• Pancreas

II) Nutrition

III) Drugs and Disease

IV) Uterovaginal (U)

Primary health care is the line treatment for Primary and Secondary Amenorrhea. Malnourished girls having Anemia can have spontaneous menses within six months of weight gain.

For Anemia, she has to take an adequate amount of food, afternoon rest, boiled water, deworming, and iron-folic acid capsule/day for months or should take Lohasav (Ayurvedic Pharmacopoeial) Product with the consultation of an Ayurvedic Product. 

For obese individuals, they should try to lose weight, avoid oily fatty diets, and engage in exercise. 

Women with functional amenorrhea due to excessively low weight should be encouraged to reduce exercise and regain some weight. In estrogen deficiency, women's replacement therapy can be given to relieve symptoms and treat Osteoporosis. Women who have had a hysterectomy can be treated with estrogen only. Women with a uterus should be treated with estrogen/progestogen therapy, as unopposed estrogen increases the risk of endometrial cancer.

For postmenopausal women, HRT has been shown to relieve Menopausal Symptoms and reduce the chances of Osteoporotic Fracture. But it has adverse effects. If a woman does not want to take HRT because of the side effects, then give her the Herbal Treatment. Or the Herbs containing Phytoestrogen with the consultation of the Ayurvedic Physician.

Educate the Patient, Education should be given to Women so that they will get back their menses in most situations. Amenorrhea psychologically upsets women. Ref: Hutchison’s Clinical Methods – Edited by – Michael Glynn. William Drake Davidson’s Principles and Practice of Medicine.

Herbs To Treat Amenorrhea

• Angelica sinensis: Useful in treating Amenorrhea
• False Unicorn: Useful to treat infertility.
• Lemon Balm: Has efficacy in treating Migraine and Headaches related to amenorrhea.
• Fenugreek: Helps to provide relief from Amenorrhea. Chasteberry: Helps to maintain Hormonal Balance. It helps to decrease the level of Prolactin hormone in the body. Prolactin is a hormone secreted by the pituitary gland.
• Cinnamon: Useful to treat Amenorrhea.
• Parsley: Take fresh juice of Parsley daily 2 teaspoons twice a day or use Parsley in cooking. Parsley contains apiol, which is a constituent of Estrogen.
• Sesame: Black Sesame is effective in Amenorrhea. Add one Teaspoon Black Sesame in One cup of water. Boil it until it becomes half. Then take one teaspoon.

Natural Home Remedies

• Drink Ginger Tea. Boil one cup of water. Add small pieces of Ginger to it. Keep this for 15 minutes. Then strain it and take this water twice a day. 
• Eat Beetroot daily. 
• Take one cup of water. Add a pinch of Saffron in it. Boil this until the quantity becomes one tablespoon. Drink this water. 
• Sesame Seeds, Papaya, and Bitter gourd are advisable. 
• Take iron-rich food, seafood, spinach, soybeans, and kidney beans. 
• Chamomile tea is advisable if Amenorrhea is due to stress and strain. 
• Take Amla Juice daily.