Amenorrhea or absence of menstruation has many causes. Sometimes it can be the result of a medication or hormonal imbalances. When hormones are involved, the amenorrhea could co-exist with medical problems such as polycystic ovarian disease or thyroid problems.
If women are underweight they could also be disposed to amenorrhea. Exercise and more exercise is the mantra nowadays for prevention of disease but in some cases of amenorrhea the cause is actually overexercise.
As a general rule, if there has been no menstrual cycle for three months it is labelled as amenorrhea. It is an imbalance that women should aim to rectify as it can lead to infertility and osteoporosis.
In the ancient Chinese medicine classics, they referred to No Period as “moon affair not coming” as the menstrual cycle was observed as occurring during certain moon phases.
Can Stress and mental-emotional disorders cause amenorrhea?
Western medicine does state that stress can can cause the menstrual cycle to stop. Chinese medicine goes one step further and outlines which type of emotional responses in excess contribute to cessation of the menstrual cycle.
We ask Ilana Sowter, a Melbourne based Chinese medicine practitioner specializing in women’s health what the different emotions mean in relation to amenorrhea. She says “Often there can be a mix of different emotional states so its important to consult with the patient on a deeper personal level to get to the true root cause of their problem. I have made a brief list below for general review but I stress its important to look at the whole picture, the mental-emotional state as well as all the accompanying physical signs and symptoms”
Anger: This includes impatience, irritability, resentment and hatred which all stagnate and block the free flow of liver energy. The liver meridian flows through the genitals and the blood of the liver is involved with the menses.
Grief and Sadness: These prolonged emotions can cause the energy of the lungs and heart to weaken and upset the production and flow of blood. Chinese medicine says that the blood from the heart can’t flow to the uterus.
Worry and excessive dwelling: This state of mind if held to too long further weakens the spleen and lungs. In particular, if the spleen is damaged then blood won’t be produced causing No Period.
Listen to Heiko Lade and Ilana Sowter on Radio Kidnappers on the 2nd December talk about amenorrhea.
Amenorrhea is divided in deficient and excess pattern disharmonies according to Chinese medicine.
There are a number of organs and systems when deficient that lead to menstrual imbalances.
Commonly in clinical practice a deficiency of liver and kidney energy is seen often with other symptoms like tiredness, low back ache, knee ache and dizziness. Examples of formula that may be prescribed are gui shen wan and dang gui di huang yin.
Blood deficiency is another cause and can include symptoms such dizziness, seeing spots before the eyes, cramps , tiredness and a pale complexion and the formula ba zhen tang is an example of a formula that may be prescribed.
Spleen deficiency symptoms include cold hands and feet, tiredness, bloating and loose stools and a formula such as si jun zi tang or gui pi tang could be prescribed.
Imbalances in the body when the energy and blood is just plain stuck keeps contributing to more build up especially if more tonics are misappropriately taken. In cases like this, taking isolated herbs such as dangui, ginseng or astragulus root can just worsen the problem and cause more discomfort. The Chinese herb treatment strategy involves herbs and formula to move the stuckness so a formula like tao hong si wu tang might be appropriate. The formula could be modified by adding ze lan to encourage further blood movement.
Overweight women would tend to have a damp-phlegm constitution according to Chinese medicine diagnosis and medicinals such as ban xia and fu ling could be prescribed as part of a formulation.
How long could it take to restore regular and healthy menstrual flow?
Giovanni Maciocia in his text book Obstetrics & Gynecology in Chinese Medicine says “Amenorrhea responds well to treatment with Acupuncture and/or herbs, but both the patient and the practitioner must give it time; in some cases it may take several months, even a year or longer, to bring the periods back”
Heiko Lade has a Master’s degree in Chinese Medicine from the University of Technology, Sydney.