Have you ever skipped a period? Or just stopped having your period? Continue reading because this is for you!
What is amenorrhea?
Amenorrhea is the absence of menstrual bleeding (the menses). There are two types of amenorrhea:
Primary Amenorrhea is when the menses has not started during puberty. It is considered as amenorrhea if a teenage girl has not started menstruation by the age 16. She should seek medical help. Primary amenorrhea is rare.
Secondary Amenorrhea is when a woman’s menstruation has previously occurred but has now ceased. It is considered as secondary amenorrhea if a woman with a regular cycle stops menstruating for three months and a woman with an irregular cycle stops for six months.
However, amenorrhea is normal when pregnant or while breastfeeding and after menopause. It’s normal for a woman to skip the occasional period especially when stressed, traveling, going through illness or a change in life.
Causes
Your ability to menstruate is dependant on a functioning menstrual cycle. Menstruation is regulated by a complex mechanism which integrates biochemical (hormones) and biophysical (ovaries and uterus) information to make everything run smoothly.
The principal causes of amenorrhea can be organised into four classifications:
- Vagina or uterus disorders
- Ovary disorders
- Anterior pituitary gland disorders
- Central nervous system disorders
Amenorrhea is not a disease in itself but instead a symptom of an underlying imbalance, disorder or disease.
Causes of Primary Amenorrhea
A family history of delayed menstruation may be a common cause. Additionally, it may also be caused by a genetic problem such as Turner syndrome (chromosomal condition), high levels of testosterone (androgens) or a malformation and absence of reproductive organs.
Causes of Secondary Amenorrhea
There are many reasons for menstruation to stop. Common causes may be gynaecological disorders, serious illness, excessive exercise, physical and mental stress as well as eating disorders, weight gain or loss.
Some medications such as oral contraceptives, antipsychotics, antidepressants, blood pressure or allergy medication and cancer chemotherapy may result in a stop in menstruation.
Long-term health conditions such as polycystic ovary syndrome (PCOS), premature ovarian failure or thalamic pituitary problems may be a cause of amenorrhea.
Hormonal imbalances may cause amenorrhea due to thyroid or pituitary problems which may include a benign or cancerous tumor in the pituitary gland or an over- or under-active thyroid.
Symptoms
The main sign is the absence of menstruation.
Other symptoms may occur depending on the cause, these include:
- Milky nipple discharge
- Headaches
- Vision changes
- Hair loss
- Excess facial hair
- Acne
- Pelvic pain
- Lack of breast development (primary amenorrhea)
Diagnosis
Determining the cause of amenorrhea is one of the most challenging tasks in gynaecology. Therefore, an intensive medical evaluation is important for diagnosis. A history exam will include the elimination of pregnancy, mental history, emotional and physical stress, weight loss or gain, alcohol or substance use and abuse, diet, exercise routine, medications, disease or illness, accidents or injuries, immune system abnormalities, your symptoms and family history.
Additional tests include:
- Hormone tests on
- Adrenocorticotropic hormone (ACTH) and cortisol
- Human Chorionic Gonadotropin (HCG) level for pregnancy
- Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH)
- Progesterone challenge
- Prolactin
- Testosterone
- Dehydroepiandrosterone (DHEA)-sulfate
- Thyroid stimulating hormone (TSH), T3, and T4
- Chromosome analysis
- Imaging studies (head CT or MRI scan, pelvic ultrasound)
- Laparoscopy
- PAP smear for maturation index
- Urine 17-ketosteroids
Risk Factors
Factors that may increase your risk of amenorrhea include:
- Eating disorders: Women suffering from disorders such as anorexia and bulimia may be at a higher risk.
- Athletic training: Excessive or rigorous athletic training can increase the risk. (competitive long-distance runners and professional ballet dancers are often affected)
- Family History: A woman may have inherited a predisposition of the problem if other women in the family have experienced amenorrhea.
- Constantly stressed: Stress affects your body in so many ways, the menstrual cycle is one of them.
Complications
Amenorrhea may include the following:
- Infertility: You cannot become pregnant if you do not ovulate and have a functioning menstrual cycle.
- Osteoporosis: You may be at risk of if your amenorrhea is caused by low oestrogen levels consequently resulting in weakening of bones.
Prevention
- Eat adequate amounts of calories and dietary fat in your diet
- Keep regular daily eating habits
- Avoid being obese or underweight
- Avoid excessive exercise
- Practice stress reduction and management (Yoga, meditation, etc)
Treatment of Amenorrhea
The cause of the amenorrhea will help to determine the treatment options.
There are quite a few pharmaceutical treatment options for amenorrhea. If you are “anti-pharmaceutical drugs” there are other options as well. Depending on the cause and severity of the amenorrhea pharmaceuticals may be required.
The Holistic approach
Firstly, a holistic approach to treatment requires exploring the emotional, mental, spiritual and physical aspect of a patient integrated with medicines (natural or pharmaceutical).
Nutrition
Food certainly is medicine. This is especially true when it comes to hormonal production. Your body makes hormones from the nutrients it gets. In other words, if your body does not get the nutrients it needs, it will not function properly. Think of a car engine, if you give it the wrong fuel, it will break down. Your body works in the same way.
Diet related things you can do to prevent or treat amenorrhea:
- Reduce saturated fats
- Combine carbohydrates with lean protein every meal
- Spread your meals and snacks out evenly throughout the day.
- Drink one glass of water for every 10 kg body weight
- Limit dairy products
- Reduce or eliminate sugar
- Limit or avoid alcohol and caffeine intake
- Eat good quality and mainly plant based or whole foods
- Avoid processed food
- Avoid artificial sweeteners and preservatives
Important Nutrients to prevent and treat amenorrhea:
- Magnesium: Helps to balance blood sugar.
- Calcium; Maintains bone density and reduce headaches, pain and mood swings.
- Chromium: Regulates blood sugar, cravings and weight loss.
- Zinc: Supports thyroid health and regulate hormone levels and blood sugar.
- Iron: Increase energy
- Amino Acids: Restore ovarian function, maintains hormonal balance and improve insulin sensitivity
- Vitamin D: Controls calcium absorption
- Vitamin B Complex: Reduce anxiety and irritability as well as regulates sex hormone levels.
Important foods:
- Eat plenty fresh fruits and vegetables.
- Flaxseed: Helps to increase Sex Hormone Binding Globulin (SHBG) and assists with metabolising oestrogen in the body.
- Peony: Influences low progesterone, modulates oestrogen and prolactin as well as reduces elevated androgens (testosterone).
Herbs
Herbs have a long history for the treatment of “retention of menses” as amenorrhea is referred as in medieval botanical texts. However, delayed puberty (primary amenorrhea) may generally not respond as well to botanical therapies in comparison to the very good results medicinal plants have had in secondary amenorrhea.
Chaste Tree Berries
Chaste tree has successfully been used for a full scope of menstrual disorders, including amenorrhea.
How it works:
Chaste tree acts on the hypothalamus and pituitary gland by increasing Luteinizing Hormone (LH) production and mildly inhibiting the release of Follicle Stimulating Hormone (FSH). As a result, there is a shift in the ratio between oestrogen and progesterone, in favour of progesterone. However, it may be used to balance hormones in both oestrogen or progesterone dominance.
Chaste tree stimulates ovulation, and for that reason produces progesterone. The rise in progesterone levels, and increased ability to ovulate may be an effective treatment for some cases of amenorrhea. It can also be used to lengthen a short luteal phase (second half of the cycle) which may increase fertility.
Chaste tree berries inhibit the pituitary gland from releasing prolactin by combining dopamine receptors, particularly when stress causes elevated prolactin. Elevated prolactin levels may cause some cases of amenorrhea. During testing, prolactin release was significantly reduced with no side effects noted.
Don’t expect immediate results when using Chaste Tree, because it doesn’t provide the body with actual hormones. It activates the menstrual cycle glands and organs to get the body to do its job correctly. This balancing function takes time. It usually begins to take effect after three months.
Stinging Nettle
Ancient physicians used Stingy Nettle to induce or regulate menstruation and increase libido.
Its anti-androgenic features allow it to minimise high levels of androgens (testosterone) in women which helps to improve menstrual irregularities or amenorrhea. Even though stingy nettle does not contain any hormones, it may help normalise or increase the sex hormones in the body by increasing Sex Hormone-Binding Globulin (SHBG).
Stingy Nettle may also be used to reduce heavy periods. It is rich in iron which may assist with anemia. Additionally, it has also been found to have antioxidant, anti-inflammatory and anti-diabetic properties.
This detoxifying herb stimulates the liver and kidney function and clears toxins. It helps to improve the breakdown of excess hormones.
Stress Management
As mentioned, stress greatly affects the menstrual cycle. When stressed, the hypothalamus and pituitary gland steal hormones from the reproductive system for the synthesising of cortisol and adrenaline. As a result, the body does not have enough of the right hormones to function correctly.
Learn how to manage your stress here.
Change your attitude towards menstruation
Change the way you think and feel about your menstrual cycle. First of all, being a woman, and having the menses is a beautiful thing. Your body works in such an intricate way. You can conceive, grow and carry a baby to bring it into this world. You wouldn’t have been able to do this if you didn’t have a menstrual cycle. The survival of our species is dependent on it.
Additional
Acupuncture may be used to help balance hormones and induce menstruation.
By massaging your uterus you may improve circulation, promote movement of fluids, create hormonal balance and reduce stress.
