A woman who is not on menopause nor pregnant and has not had her period for three consecutive times may be diagnosed as suffering from amenorrhea. In this type of condition, the woman should consult her health specialist or doctor. If by the age of 16, a woman has still not started menstruating, she may have a condition termed as “primary amenorrhea;” if a woman had been menstruating previously and is not near menopause, not breastfeeding or not pregnant, she may be suffering from what is known as “secondary amenorrhea.”

Western Medicine Perspective on Amenorrhea in Conventional Medicine

Normal menstrual cycles based on the viewpoint of Western conventional medicine depend on a complex feedback system between the ovaries, pituitary gland, and the hypothalamus, and also to the cyclical response of the endometrium (uterine lining) to sex hormones. Hypothalamic conditions such as ovarian disorder, pituitary malfunction, gonadotropin-releasing hormones and other conditions are the hormones responsible for primary amenorrhea. Secondary amenorrhea, on the other hand, can be the result of a dysfunction of the pituitary, thyroid, or adrenal gland, or an ovarian dysfunction.

Doctors tend to prescribe to their amenorrhea patients hormonal therapy because a lot of the time, they see that hormonal imbalances are tied to their menstrual irregularities. For regulating the menstrual cycle, doctors usually turn to hormonal treatments as these irregularities are strongly linked to hormone imbalances. Estrogen and progesterone are allowed to either start or restart and estrogen hormone is given to start or bring back the period of a woman.

Traditional Chinese Medicine’s Viewpoint on amenorrhea

TCM theory states that the organs responsible for regulating menstruation and Blood are the Kidneys, Spleen, and Liver. They govern the equal and smooth flow of emotions. Qi, and Blood, anxiety, resentment, irritation, and anger and other intense emotions may cause Liver energy flow to slow down, and as a consequence result in Blood Stasis, particularly in the lower body. One of the primary functions of the Spleen is to create Blood and Qi; if this organ is weak, a deficiency of Blood and/or Qi may eventually develop in the body. There wouldn’t be enough blood for normal menstruation, or an adequate amount of Qi to normalize menstrual cycles. A weak Spleen can also result in a state of Dampness in the body, and the uterus can be blocked with the accumulation of Phlegm-Damp. The Kidneys are responsible for conception, reproduction, and the aging process. These are the organs that also produce Kidney-essence, the main ingredient for menstrual blood.

Distinguished between Excess patterns or Deficiency patterns, amenorrhea can be considered a deficiency when Blood is inadequate or has been used up; amenorrhea is seen as an excess problem when there is Blood Stasis, an accumulation of Phlegm-Dampness that can block the flow of menses, or when Blood or Qi flow becomes stagnant.

In addition to this, certain lifestyle habits can also result in amenorrhea. Kidney Qi Deficiency or Blood Deficiency can result from longstanding usage of contraceptive pills. Too much sports activities or extremely strenuous physical exercise that abuses the sinews and muscles can result in Spleen and Liver exhaustion. The Spleen is too overworked to create new and adequate amounts of Blood and a tired Liver may not be able to store Blood properly. All these can result in amenorrhea.

Herbal Therapy and Patterns of Amenorrhea in Traditional Chinese Medicine (TCM)

Secondary amenorrhea may be caused by one or more of these four patterns:

• Qi Blood Deficiency
• Kidney Liver Deficiency
• Phlegm Dampness Retention
• Qi Stagnation with Blood Stasis

The first two patterns are Deficiency patterns and the last two are patterns of Excess. In order to treat a deficiency pattern, the Kidney must be tonified. Excess patterns of Phlegm Dampness Retention and Qi Stagnation with Blood Stasis, need to be cleared by the usage of Chinese herbal remedies. Kidney Liver Deficiency can come about from an irregular sex life, poor nourishment of the Liver and Kidney, and overall weakness of the body. The symptoms of Kidney Liver Deficiency include:

• A thin, rapid and wiry pulse
• Cracks in the tongue
• No tongue coating
• Red tongue
• Profuse sweating
• Hot flashes
• Anxiety
• Congestion in the chest
• Dream-disturbed sleep
• Insomnia
• Knee and back pain
• Palpitations
• Dizziness
• A thin body
• No menstrual flow for a considerable period of time

Angelica, root of dioscorea, and rehmannia are the best herbal plants known to tonify Liver Blood and Kidney-essence. Deficiency patterns can be resolved with Gui Shen Wan (Restoring Kidney Formula).

Qi Blood Deficiency can be caused by the following factors:

• Prolonged breast feeding
• Surgery
• Miscarriage
• Excessive bleeding from childbirth
• Chronic illness

With this type of pattern, menses become fewer and weaker over time up to the point they stop altogether. Symptoms of Qi Blood Deficiency include:

• A weak and thin or a wiry and thin pulse
• A pale and thin tongue
• Loose stools
• Lassitude
• Weakness of the limbs
• Palpitations
• Dizziness
• A pale complexion

Treatments for this type of pattern include Angelica and Ginseng, both considered Blood tonics. For Qi Blood Deficiency, one of the most popular remedy is Ba Shen Tang (Chi Blood Tonic).

Blood Stasis and Qi Stagnation

The most common sign of Blood Stasis is emotional trauma or stress. After a longstanding or intense bout of emotional trauma or stress, menstruation can stop altogether. Symptoms of these two patterns include:

• A deep choppy or a thin wiry pulse
• A sticky white-yellowish tongue coating
• Purplish color on the sides of the tongue
• Constipation
• Urge to drink cold water
• Thirst
• Loss of appetite
• Fullness or swelling of the stomach with a dislike to pressure
• Fullness sensation under the rib cage or in the chest
• Anxiety
• Depression
• Absence of menstruation

Herbal remedies for this type of pattern include white peony, angelica, and bupleru. Another potent formula to resolve this pattern is Hsiao Yao San (Liver Spleen Harmonizer).

Phlegm Dampness Retention

A weak Spleen or longstanding excess weight is the most common reason for this pattern of disharmony. Dairy products, greasy foods, raw foods, or cold foods can also contribute to this condition. Spleen Deficiency and excess weight can cause problems in metabolism, Spleen Deficiency can contribute to metabolism problems, and retention of Phlegm Dampness may result in the loss of menstruation.

Symptoms of Phlegm Dampness Retention include:

• A slippery and thin pulse
• Sticky white-yellow tongue coating
• Excessive sticky mucoid vaginal discharge
• Lassitude
• A sensation of sticky phlegm in the mouth
• Vomiting
• Nausea
• A feeling of congestion and fullness in the lower rib cage and chest

Herbal treatments of tangerine peel, cyperus tuber, and atractylodes lancea tuber are ideal for treating this type of pattern. The herbal formula Cang Fu Dao Tan Tang (Phlegm Cleansing) is a very powerful formula for this specific type of amenorrhea.

Drugs vs. Acupuncture for the Treatment of Amenorrhea in Overland Park

Apart from herbal therapy, the TCM modalities of moxibustion and acupuncture are also widely-used for the treatment of amenorrhea. Although both the objectives of Western conventional medicine and traditional Chinese medicine are to restore menses and the normal menstrual cycle, there is a huge difference in how they set out to achieve this. Western medicine brings back the normal function of the ovary-pituitary-thalamus axis by the utilization of hormone therapy. Traditional Chinese medicine, on the other hand, activates the body to normalize naturally-occurring hormones and bring back normal hormone function. The following clinical study shows that the two medicinal approaches produce quite different longstanding results.

This study was done in China at the Thousand Buddha Mountain Hospital in Jinan. It was aimed to determine the effectiveness of acupuncture for the treatment of amenorrhea versus conventional drug therapy. A hundred women participated in the study. They all had been suffering from amenorrhea for at least six months from the continuous use of birth control pills for several months. Around 60 of the participants were treated with acupuncture while the rest used medications. Liver Qi Stagnation and Spleen Liver Deficiency were the two patterns of amenorrhea seen in the group treated with acupuncture. Moxibustion and the acupuncture points Sp 9, Lv 13, and Bl 8 were treated to address Liver Qi stagnation. The points treated to address Spleen Liver Deficiency included the Sp 4, St 36, Bl 23, Bl 20, bl 32, Sp 6 Ki 12, and Ren 3. The course of treatment totaled six and entailed twenty sessions with five-day breaks between the courses. The group treated with medications was first given Stilbestrol. Later on, they were injected with Progesteronum. A month after the end of treatment, the group given acupuncture showed an effective rate (improvement, great improvement, cure) of 96.5% while the medication group treated with drugs was 97.4%. At first, no difference was seen in both groups, but later on after half a year, the effective rate of the group given acupuncture dropped to 94.7% while that of the medication group, was 78.9%. This result suggested that the effects of acupuncture can last quite much longer than medications.

Several studies conducted in China show that Chinese herbal medicine, moxibustion, and acupuncture produce far-better results than that of Western medicine for the treatment of amenorrhea and other forms of menstrual disorders.