Amenorrhea

Amenorrhea is the absence of menstrual periods in a woman of a reproductive age. There are two types of amenorrhea. Primary amenorrhea involves women who do not undergo puberty, and never have a period. Secondary amenorrhea occurs when periods cease after puberty.

The condition is only normal prior to puberty, during pregnancy and lactation, and following menopause.

Amenorrhea should be taken seriously, as it can indicate pregnancy, or signal a serious underlying medical disorder.

Causes

Disruption of any part of the hormonal system regulating the menstrual cycle can result in amenorrhea. Primary amenorrhea can be caused by:

·         Structural abnormality of the uterus or fallopian tubes; or

·         Genetic disorders affecting the function of the reproductive system.

Other factors will give rise to secondary amenorrhea, including:

·         Use of certain drugs;

·         Sudden weight loss;

·         A tumour within the reproductive organs; and

·         Stress.

Symptoms and diagnosis

Depending on the cause, amenorrhea may be accompanied by other symptoms. These might include:

·         Acne;

·         Increased brittleness of the bones (osteoporosis);

·         Excessive body hair;

·         Hot flashes; and

·         Deepening of the voice.

Primary amenorrhea is diagnosed in girls who have not undergone puberty by the age of sixteen. Usually, these patients are assessed for any potential problems.

Secondary amenorrhea is diagnosed when a woman of a reproductive age has not menstruated for over six months.

Treatment

The underlying treatment causing amenorrhea needs to be treated as soon as possible. Some genetic disorders, particularly those causing primary amenorrhea, cannot be treated.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Acupuncture [1, 2]:

Recommendation: Weakly in favor (Early studies show acupuncture may be able to help treat amenorrhea. More studies are needed)

Grade of Evidence: Low level of evidence

Reflexology:

Recommendation: No recommendation (There is insufficient evidence to support claims that reflexology is able to help treat amenorrhea)

Grade of Evidence: Very low level of evidence

Phytoestrogens [3, 4]:

Recommendation: Weakly in favor (Early studies show phytoestrogens may be able to help treat amenorrhea. More studies are needed)

Grade of Evidence: Low level of evidence

 * www.gradeworkinggroup.org

Summary References

Treatments:

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962314/

2. http://online.liebertpub.com/doi/abs/10.1089/acu.2012.0914

3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210008/

4. http://www.biohealth2u.com/Pueraria-mirifica-menopause.html