Menarche (the first menstruation) does not come before the age of 16. Or interruption of more than 6 months without menstruation (without pregnancy reason).
According to Western medicine this can be due to many factors such as: obesity, excessive weight loss, anxiety, polycystic ovaries, ovarian insufficiency, it can be a secondary effect of drugs like chemotherapy, it may be related to thyroid alterations or brain tumor. Always refer the patient to the gynecologist and endocrinologist for proper examination.
For Chinese medicine the causes are very similar to dysmenorrhea. Energy and blood nutrition to the uterus, kidney, Ren Mai, Chong Mai is blocked or deficient. It is also related to liver and Spleen.
Amenorrhea due to Liver-Qi stagnation
It is of excess type. The cause is emotional which blocks Qi and stagnates blood.
Symptoms
- Sudden onset
- There may be pain and swelling of the lower abdomen, breasts and rib area.
- Irritability, nervousness, sighs, sadness.
- Alteration of urination and defecation
- Tongue with dark purple edges.
- Pulse tense and rough
Treatment
- Common points for amenorrhea (regardless of cause): CV-3, CV-4, SP-6, ST-29, Zi Gong
- Drain stagnant Liver-Qi and move blood: LR-14, LR-3, LI-4, SP-10, PC-6, moxibustion can be applied.
Other treatment versions:
- SP-8 SP-6 CV-3 LI-4 to activate blood energy to push. 3H raises barrier. Two options, if more of Chong Mai SP-4 + PC-6 can be crossed if more curious pairs KI-6 + LU-7 one from each pair on each side. If more LR-14 also cross Yin Wei SP-14, ST-25 to untie, CV-6 for Qi Ji problem, GB-34 and ST-9 important in this case. Some R, KI-7, to help H soften, called return to flow.
Amenorrhea due to Cold in Blood
It is of excess type. Cold attack stagnates the blood. Caught cold after childbirth or during menstruation.
Symptoms
- General cold, pallor
- Cold in lower abdomen
- May have Yang deficiency constitution of K or S, cold-sensitive person
- Pulse tense
- Tongue normal, white coating.
Treatment
Common points for amenorrhea (regardless of cause): CV-3, CV-4, SP-6, ST-29, Zi Gong
Amenorrhea due to Phlegm and Dampness
Due to improper diet (and certainly also Spleen-Qi deficiency) Phlegm and Dampness accumulate in the Lower Burner blocking energy and blood. It is of excess type.
Symptoms
- Obesity, heaviness, abdominal distension.
- Leukorrhea
- There may be infertility
- Oedema, loss of appetite, pasty stools.
- Tongue normal or pale, greasy coating
- Pulse slippery
Treatment
Common points for amenorrhea (regardless of cause): CV-3, CV-4, SP-6, ST-29, Zi Gong
- Eliminate Dampness and tonify Spleen-Qi: SP-9, CV-9, SP-3, ST-40, CV-12, BL-20, LR-13. Moxibustion can be applied. The person needs to lose weight.
Amenorrhea due to Qi-Blood deficiency
It is of empty type. The cause are chronic disorders that weaken Qi-Blood, or insufficient Earth (Spleen/Stomach-Qi deficiency) that do not produce energy and blood.
Symptoms
- Amenorrhea may come progressively, cycles lengthening and/or reducing bleeding quantity.
- Fatigue, pallor, dizziness, palpitations, insomnia. See General Syndromes -> Blood deficiency
- May be more Yin-Blood deficiency, affecting nutrition and hydration: thinness, weight loss, dryness of hair, skin, mucous membranes.
- Tongue pale, normal coating.
- Pulse weak and fine. Slightly rapid if there is Empty-Heat due to Yin-Blood deficiency.
Treatment
Common points for amenorrhea (regardless of cause): CV-3, CV-4, SP-6, ST-29, Zi Gong
- Tonify Qi-Blood:
CV-12, SP-10, ST-36, BL-20, Chong mai: SP-4 and PC-6. Moxibustion can be applied
Amenorrhea due to Kidney-Qi deficiency
It is of empty type. The cause is weak constitution. Kidney Jing deficient. There may also be Liver-Qi deficiency.
Symptoms
- Girls without menarche
- General fatigue, weakness of lower back and knees, tinnitus. See Kidney-Qi deficiency and
- Tongue pale, normal coating.
- Pulse weak and fine
Treatment
Common points for amenorrhea (regardless of cause): CV-3, CV-4, SP-6, ST-29, Zi Gong
- Tonify Kidney (and liver for drainage):