Amenorrhea



Amenorrhea refers to the absence of menstrual bleeding. The condition can be one of two types – primary or secondary. If a girl by the age of 14 is still not menstruating or exhibiting any secondary sexual characteristics such as breast development and pubic hair, or if a girl by the age of 16 years is not menstruating, but has normal development of secondary sexual characteristics, it is referred to as primary amenorrhea.  Secondary amenorrhea on the other hand refers to a woman who has started menstruating normally but later stops for three or more months. Pregnancy, lactation, oral contraceptive pills, or menopause do not cause this absence of menstrual bleeding.

 

Symptoms for Amenorrhea

The symptoms of amenorrhea are indicative of another underlying condition or disorder. Depending on the medical issue causing the absence of menstruation, symptoms will vary from case to case. Some symptoms of amenorrhea include:

  • Absence of menstrual periods
  • Galactorrhea – when the breasts produce milk even if the woman is not pregnant or breastfeeding
  • Nipple discharge
  • Hair loss
  • Headaches
  • Disturbances in vision
  • Increased hair growth caused by an increase in androgen levels
  • Vaginal dryness
  • Distrubed sleep
  • Hot flashes / night sweats
  • Fluctuations in weight (either weight gain or loss)
  • Anxiety

If you miss more than three periods in a row and have ruled out pregnancy or menopause, contact your doctor at the earliest. Girls of 16 who have not yet started menstruating should seek medical attention as well.

 

Causes of Amenorrhea

The causes of primary amenorrhea are generally attributed to abnormalities of the reproductive or pelvic organs. Other causes of primary and secondary amenorrhea include:

  • Ovarian failure
  • Hormonal imbalance
  • Genetic defects
  • Infections in the reproductive system that may occur in the womb or after birth
  • Birth defects
  • Tumors
  • Abnormalities in the hypothalamus and pituitary gland
  • Anatomical defects in the genital tract
  • Kallman syndrome (deficiency in the levels of gonadotropins that are responsible for the normal growth and functioning of the sexual organs)
  • Malnutrition
  • Low body weight
  • Excessive weight gain
  • Postpartum pituitary necrosis (occurs after a woman has given birth)
  • Malfunction of the thyroid
  • Congenital heart disease
  • Anovulation (absence of the release of an egg)
  • PCOS or Polycystic Ovarian Syndrome
  • Cushing’s Disease
  • Chromosomal abnormalities as seen in Turner Syndrome and Fragile X Syndrome
  • Radiation or chemotherapy
  • Imperforate hymen (where the hymen is completely closed off and has no opening)
  • Vaginal septum (a membrane that divides the vagina)
  • Scarring of the uterus
  • Cystic Fibrosis
  • Absence of reproductive organs
  • Anorexia or bulimia
  • Depression
  • Chronic diseases such as tuberculosis
  • Drug abuse
  • High stress levels
  • Excessive amounts of exercise
  • Oral contraceptive pills
  • Certain medications such as anti-psychotic drugs, anti-depressants, and blood pressure drugs
 

Remedies for Amenorrhea

The cure and treatment for amenorrhea depends on the cause of the condition. For example, when primary amenorrhea is caused by abnormalities in the reproductive system, surgery and medication may be required. Amenorrhea caused by tumors would also need radiation therapy and medication or surgery to shrink or remove the tumor. When an overall systemic disease brings upon the condition, only by treating the disease itself can the absence of menstruation be remedied. Causes such as low body weight, excessive exercise, and high levels of stress are lifestyle factors that need to be balanced out to revert to the normal functioning of the body.

Apart from these traditional treatments, there are several home remedies for amenorrhea that may bring some symptomatic relief such as:

  • Boil half a cup of water and add a teaspoon of saffron. Boil till the water reduces down to a concentrated tablespoon. Divide this concentrate into three parts and have it over the course of the day. Saffron is a powerful antioxidant that can treat chronic inflammatory conditions as well as reduce stress that may be causing amenorrhea.
  • Drinking two to three glasses of tomato juice daily is said to improve blood circulation and treat amenorrhea.
  • Raw beetroot or fresh beetroot juice is considered an effective treatment for amenorrhea.
  • Foods such as papaya, sesame seeds, ginger, and bitter gourd can increase the internal body temperature and improve ovulation. This in turn can result in regular periods.
  • There is a substance known as butylidene-phthalide found in celery seeds that help to stimulate menstrual bleeding.
  • There are a number of herbs known as emmenagogues that bring on menstrual bleeding. These should be taken only under qualified supervision as they can react adversely with other medication and can be dangerous if not taken in the proper dosages. Herbs used to treat amenorrhea include chamomile, angelica root, Blue cohosh, false unicorn root, and lemon balm.
  • Chamomile is a relaxant and an antispasmodic that can be had as a supplement or drunk as a tea. Absence of menstruation caused by stress and anxiety can be treated with chamomile.
  • Angelica root tea or extract can reduce stagnation in the reproductive system. Angelica root essential oil can also be massaged onto the abdominal area to induce menstruation.
  • Blue Cohosh is believed to be a powerful uterine stimulant. It improves blood flow to the pelvic region and can also be combined with Black cohosh to treat other menstrual problems.
  • False unicorn root has been used down the ages to treat problems with menstruation and infertility. The Native Americans believe that this herb can prevent miscarriages as well as bring on menstruation.
  • Lemon balm – Melissa is a relaxant and calms the system down to encourage normal menstruation.
  • An infusion of stinging nettle leaf when drunk regularly is an effective treatment for amenorrhea.
  • The herb Pennyroyal is one of the best natural remedies for amenorrhea. It stimulates the reproductive system and encourages menstruation. It should be taken as a tea but only under supervision due to its strong properties. Penny royal essential oil can be fatal if taken internally as it is extremely toxic.
  • Mix half a teaspoon of cinnamon in a glass of milk and drink this every day to instigate weight loss. Weight loss is important to ensure regular menstruation.
 

Diet for Amenorrhea

Changing your diet is crucial when it comes to treating amenorrhea. Since problems such as obesity, low body weight, and iron deficiency are common causes of the condition, an amenorrhea diet is recommended to improve overall health and functioning of the systems.

  • Include more iron-rich foods in your diet such as liver, seafood, spinach, soy beans and kidney beans. This prevents nutritional deficiencies such as anemia that could be causing the absence of menstrual bleeding.
  • Avoid crash diets to reduce weight as this can further aggravate the condition of amenorrhea. Stick to a regime of healthy food and regular exercise to reduce weight safely.
  • Avoid fatty foods and products high in trans-fats. Use olive oil to cook to aid weight loss and add natural dietary fiber to improve your digestion and metabolism.
  • If you are underweight, increase your intake of protein and low-fat dairy products. This will help you gain weight in a healthy manner.
  • Do not forget your daily vitamin and mineral supplements along with folic acid as such deficiencies can lead to amenorrhea.
  • It is believed that following a gluten-free diet can prevent menstrual irregularities and can even restore fertility.

Suggestions for Amenorrhea

There are several alternative treatments for amenorrhea that are gaining popularity. These include:

  • Counseling and nutritional therapy for cases where amenorrhea is caused by eating disorders, stress, obesity, and malnutrition.
  • Ayurvedic treatment for amenorrhea that focuses on improving the digestive system and restoring balance in the body. Ayurveda encourages the use of spices such as black pepper, cinnamon, fennel, ginger, clove, celery seeds and soya to cure irregularities in the reproductive system.
  • Yoga and meditation can help you improve pelvic floor muscles, reduce stress and get into shape.
  • Regular massages with essential oils can reduce tension and improve overall health.

References

  1. Deligeoroglou, E., Athanasopoulos, N., Tsimaris, P., Dimopoulos, K. D., Vrachnis, N. and Creatsas, G. (2010), Evaluation and management of adolescent amenorrhea. Annals of the New York Academy of Sciences, 1205: 23–32. doi: 10.1111/j.1749-6632.2010.05669.x
  2. CUMMING, D. C., WHEELER, G. D. and HARBER, V. J. (1994), Physical Activity, Nutrition, and Reproduction. Annals of the New York Academy of Sciences, 709: 55–76. doi: 10.1111/j.1749-6632.1994.tb30388.x

 
Amenorrhea - Frequently asked questions