Amenorrhea Homeo Treatment
Amenorrhea is classified as primary if menstrual bleeding has never occurred in the
absence of hormonal treatment or secondary if menstrual periods are absent for 3-6 months. Oligoamenorrhea is defined as a cycle length more than 35 days or less than 10 menses per year. Both the frequency and amount of vaginal bleeding are irregular in oligo amenorrhea. It is often associated with anovulation, which can also occur with intermenstrual intervals .
Primary Amenorrhea
This is a rare disorder occurring in 1% of the female population. However, between 3 and 5% of women experience at least 3 months of secondary amenorrhea in a given year. There is no evidence that race or ethnicity influence the prevalence of amenorrhea.
The absence of menses by age 16 has been used traditionally to define primary amenorrhea.
Secondary Amenorrhea or Oligoamenorrhea
Anovulation and irregular cycles are relatively common for 2-4 years after menarche and for 1-2 years before the final menstrual period. In the intervening years, menstrual cycle length is 28 days, with an inter menstrual interval normally ranging between 25 and 35 days.
Diagnosis
Evaluation of menstrual dysfunction depends on understanding the interrelationships between the four critical components of the reproductive tract:
(1) the hypothalamus
(2) the pituitary
(3) the ovaries
(4) the uterus and outflow tract.
Disorders of menstrual function can be thought of in two main categories: disorders of the uterus and outflow tract and disorders of ovulation. Many of the conditions that cause primary amenorrhea are congenital but go unrecognized until the time of normal puberty. All causes of secondary amenorrhea can also cause primary amenorrhea.
Disorders of the Uterus or Outflow Tract
Abnormalities of the uterus and outflow tract typically present as primary amenorrhea. In patients with normal pubertal development and a blind vagina, the differential diagnosis includes obstruction by a transverse vaginal septum or imperforate hymen, mllerian agenesis
Hypogonadotropic Hypogonadism
Low estrogen levels in combination with normal or low levels of LH and FSH are seen with anatomic, genetic, or functional abnormalities that interfere with hypothalamic GnRH secretion or normal pituitary responsiveness to GnRH. These disorders may present with primary or secondary amenorrhea. They may occur in association with other features suggestive of hypothalamic or pituitary dysfunction such as short stature, diabetes insipidus, galactorrhea, or headache.
Polycystic Ovarian Syndrome (PCOS)
This is diagnosed based on the presence of clinical or biochemical evidence of hyper androgenism in association with amenorrhea or oligomenorrhea. Symptoms generally begin shortly after menarche and are slowly progressive. Lean patients with PCOS generally have high LH levels in the presence of normal to low levels of FSH and estradiol. The LH/FSH abnormality is less pronounced in obese patients in whom insulin resistance is a more prominent feature. Most patients also have a polycystic ovarian morphology on ultrasound
Homoeopathic approach:
Pulsatilla:
Comes first to mind as the homoeopathic remedy for menstrual suppression.
It is indicated where the menses flow by fits and starts, or when the suppression is due to wetting of the feet; also, in delayed first menses in chlorotic girls.
The Pulsatilla patient is disinclined to exertion, with poor appetite and longing for acids,is apt to faint easily and suffers from a tremulous anxiety.
Calcarea carbonica :
This remedy is also, like Pulsatilla, indicated in amenorrhoea when the first menses are delayed, but with Calcarea there is apt to result congestion to the head or chest, giving rise to lung troubles.
It is typically indicated in fleshy, scrofulous girls with fair complexion, perspiring easily about the head and subject to acidity of the stomach.
Menstrual suppression in those decidedly scrofulous, or with lung affection
Ferrum metallicum :
This is another useful remedy for delayed first menses where there is debility, languor, palpitation, sickly complexion and puffiness about the ankles.
It corresponds to weakly, chlorotic women with flushed face, or pale and livid with blue margins about the eyes.
It is especially useful in those who have been dosed with quinine and nervines.
Sepia :
Insufficient or tardy menstruation occurring in the feeble and debilitated, those of dark complexion, delicate skin and who are sensitive to all impressions.
In delay of first menses where a leucorrhoea occurs in their stead with determination of blood to the chest and pale face, the remedy is well indicated.
A sallow complexion, frequent paroxysms of headache, felling of abdominal emptiness and ball like constipation, which are marked Sepia symptoms
by: Gen Wright
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