Amenorrhea

To recognize amenorrhea it is necessary to know what would be considered
normal menstruation. The duration of a period is 28 +/- 3 days 65% of women, with a range of 18 to 40 days; once a menstrual pattern has been established the variation does not normally exceed 5 days. The average duration of flow is 5 +/- 2 days with a blood loss averaging 130 ml, usually heavier on the second day.

Amenorrhea can be of three broad types:

• Primary amenorrhoea where menstruation has never happened. Such
  a wide variation in normal onset times of periods occurs that applying this
  diagnosis is problematic. Usually primary amenorrhoea implies that menstruation
  has not started by the age of 16. With the safe and effective herbs available
  to the phytotherapist, treatment could start at the age of 15 if called
  for. However competent diagnosis is called for as there are a number of
  diverse cause to consider, including imperforate hymen, ovarian dysfunction
  or hormonal imbalance. Obviously the treatment will be dictated by the diagnoses
  cause.
  

• Secondary amenorrhoea when menstruation stops after at leastone period. This is a common occurrence with causes including pregnancy,
  stress, loss or gain of weight, menopause, breast-feeding, anaemia, excessive
  exercise, stopping contraceptive pill intake, some drugs, ovarian cysts
  or tumors etc.etc..
  

• Erratic or irregular menstruation. There may be 3 or 4
  periods in a year, or 3 close together followed by none for a few months.
  A similar range of cause is possible
  

Actions indicated for the processes behind this disease :

Emmenagogues are the classic treatment as they are triggers
for the menstrual process.

Hormonal Normalizers will help the body regulate the levels of the
various hormonal factors involved.

Uterine Tonics will contribute the nourishing, toning power they
have.

Other Actions will be indicated by the associated symptom picture
or case history. For example if anxiety and stress are an issue consider
appropriate nervines, or cramp is present anti-spasmodics.

System Support:

The reproductive system must be supported, but beyond this will become apparent
from the woman concerned.

Specific Remedies:

Most of the emmenagogues could be considered as specifics. However, care
should be taken with the stronger ones as they may be too stimulating and
cause cramping. Simple infusions can often solve this problem. Plants such
as Pennyroyal, Yarrow, Mugwort and other emmenagogues listed above can initiate
flow, but if not consider the following:

One possible prescription for amenorrhea associated with hormonal imbalance
:

Vitex agnus-castis 1 part

Caulophyllum thalictroides 2 parts

Artemisia vulgaris 2 parts as tincture 2 ml taken three times a day
until periods start

This supplies the following actions:

Emmenagogues (Artemisia vulgaris, Caulophyllum thalictroides,
Vitex agnus-castis)

Hormonal Normalizer (Vitex agnus-castis)

Uterine Tonic (Caulophyllum thalictroides)

One possible prescription for amenorrhea associated with stress :

Vitex agnus-castis 1 part

Cimicifuga racemosa 2 parts

Verbena officinalis 2 parts as tincture 2.5 ml taken three times
a day until periods start

This supplies the following actions :

Emmenagogues (Cimicifuga racemosa, Verbena officinalis,
Vitex agnus-castis)

Hormonal Normalizer (Vitex agnus-castis)

Uterine Tonic (Cimicifuga racemosa)

Nervine Relaxant (Cimicifuga racemosa, Verbena officinalis)

Broader Context of Treatment :

This will depend upon identifying causes. Thus, other therapeutic modalities
such as Osteopathy, Chiropractic, Acupuncture and so on, all have a potential
role.