WHAT IS AMENORRHEA/MENSTRUAL DISORDERS

Amenorrhea is the absence of menstrual bleeding and may be primary or secondary.

Primary amenorrhea is the absence of menstrual bleeding and secondary sexual characteristics (for example, breast development and pubic hair) in a girl by age 14 years or the absence of menstrual bleeding with normal development of secondary sexual characteristics in a girl by age 16 years.

Secondary amenorrhea is the absence of menstrual bleeding in a woman who had been menstruating but later stops menstruating for 3 or more months in the absence of pregnancy, lactation (the ability to breastfeed), cycle suppression with systemic hormonal contraceptive (birth control) pills, or menopause.

CAUSES OF AMENORRHOEA

Amenorrhea can result because of an abnormality in the hypothalamic-pituitary-ovarian axis, anatomical abnormalities of the genital tract, or functional causes.

Hypothalamic causes

• Craniopharyngioma (a brain tumor near the pituitary gland)
• Nutritional deficiency
• Low body weight

Pituitary causes

• Prolactinemia (high blood levels of prolactin, a hormone that stimulates secretion of milk from the breasts during breastfeeding) - Possibly caused by prolactinoma (a tumor of the pituitary gland secreting the hormone prolactin.
• Postpartum pituitary necrosis (death of pituitary cells after a woman delivers a baby)

Functional causes

• Anorexia/bulimia
• Chronic diseases (for example, tuberculosis)
• Excessive weight gain or weight loss
• Malnutrition
• Depression or other psychiatric disorders
• Recreational drug abuse
• Psychotropic drug use (drugs prescribed to stabilize or improve mood, mental status, or behavior) Excessive stress.
• Excessive exercise
• Cycle suppression with systemic hormonal contraceptive (birth control) pills. 

SYMPTOMS OF AMENORRHOEA

• Galactorrhea (breasts produce milk in a woman who is not pregnant or breastfeeding), headache, or reduced peripheral vision .
• Increased hair growth in a male pattern (hirsutism) may be caused by excess androgen (a hormone that encourages development of male sex characteristics).
• Vaginal dryness, hot flashes, night sweats, or disordered sleep may be a sign of ovarian insufficiency or premature ovarian failure.
• Noticeable weight gain or weight loss may be present.
• Excessive anxiety may be present in women with associated psychiatric abnormalities.

MENORRHAGIA

Menorrahagia is defined as menstruation at regular cycle intervals but with excessive flow and duration and is one of the most common gynecologic complaints in contemporary gynecology. Clinically, menorrhagia is defined as total blood loss exceeding 80 ml per cycle or menses lasting longer than 7 days.

CAUSES OF MENORRHAGIA

• Menorrhagia due to Disorders of Coagulation
• Hormonal Imbalance may also be a cause of Menorrhagia
• Miscarriage induced Menorrhagia
• Menorrhagia due to IUCD
  Commonly used intra uterine contraceptive devices are loop or Copper-T If the periods have become heavier following the introduction of a loop, it could possibly be the side effect of the same.
• Fibroids causing Menorrhagia
  If the periods are heavy and are becoming more painful, the possibility of fibroids (non-cancerous tumors of the uterus) should be considered.
• Psychological Upsets and overwork may also lead to menorrhagia
• Marital disharmony, domestic quarrels, undue anxiety, stress and tension are some of the other occasional causes for heavy bleeding.
• Occasionally bleeding from the anus due to piles may be confused with vaginal bleeding.

Bleeding Between Periods; Breakthrough Bleeding; Dysfunctional Uterine Bleeding; Inter menstrual Bleeding; Spotting; Bleeding, Breakthrough; Dysfunctional Uterine Bleedings; Uterine Bleeding, Dysfunctional

Abnormal uterine bleeding that is not related to MENSTRUATION, usually in females without regular MENSTRUAL CYCLE. The irregular and unpredictable bleeding usually comes from a dysfunctional endometrium.

MEDICAL CAUSES OF MENORRHAGIA

• Cervicitis-It may cause spontaneous bleeding,spotting, or post traumatic bleeding. Assessment reveals red, granular, irregular lesions on the external cervix. Purulent vaginal discharge (with or without odor), lower abdominal pain, and fever may occur.
• Dysfunctional uterine bleeding- Abnormal uterine bleeding not caused by pregnancy or major gynecologic disorders usually occurs as metrorrhagia, although menorrhagia is possible. Bleeding may be profuse or scant, intermittent or constant.
• Endometrial polyps-In most patients, endometrial polyps cause abnormal bleeding, usually inter menstrual or postmenopausal; however, some patients do remain asymptomatic.
• Endometriosis- Metrorrhagia (usually premenstrual) may be the only indication of endometriosis or it may accompany cyclical pelvic discomfort, infertility, and dyspareunia. A tender, fixed adnexal mass may be palpable on bimanual examination.
• Endometriti-It causes metrorrhagia, purulent vaginal discharge, and enlargement of the uterus. It also produces fever, lower abdominal pain, and abdominal muscle spasm.
• Gynecologic cancer- Metrorrhagia is commonly an early sign of cervical or uterine cancer. Later, the patient may experience weight loss, pelvic pain, fatigue and, possibly, an abdominal mass.
• Uterine leiomyomas -Besides metrorrhagia, uterine leiomyomas may cause increasing abdominal girth and heaviness in the abdomen, constipation, and urinary frequency or urgency. The patient may report pain if the uterus attempts to expel the tumor through contractions and if the tumors twist or necrose after circulatory occlusion or infection, but the patient with leiomyomas is usually asymptomatic.

Vaginal adenosis commonly produces metrorrhagia. Palpation reveals roughening or nodules in affected vaginal areas.

EXAMS AND TESTS FOR MENSTRUAL DISORDERS

• Blood tests may be performed to determine the levels of hormones secreted by the pituitary gland (FSH, LH, TSH, and prolactin) and the ovaries (estrogen).
• Ultrasonography of the pelvis may be performed to assess the abnormalities of the genital tract or to look for polycystic ovaries.
• CT scan or MRI of the head may be performed to exclude pituitary and hypothalamic causes of amenorrhea.
• Thyroid function tests
• Determination of prolactin levels
• Hysterosalpingogram (x-ray test) or saline infusion sonography (SIS), both of which examine the uterus
• Hysteroscopy (visual inspection of the uterine cavity)

HOMEOPATHY TREATMENT FOR MENSTRUAL DISORDERS:

Homeopathic care involves the thorough evaluation of each patient's exact symptoms. A single remedy is chosen that matches the subtleties of each case of disease. The remedy given restores balance to the many systems of the body that keeps you well.

General measures for menstrual disorders:

Some general measures that a patient can take before consulting a doctor are:

• Bed rest
• Avoid over exertion
• No vigorous exercise
• Cold showers
• Avoid anxiety and tension

Homeopathic medicines act well on these chronic menstrual problems. If the problem is continuing since many years the treatment will be long term. The recurrence of disease can be controlled with long term treatments.

Homeopathy needs a keen history of the patient suffering .homeopathy history includes any stress on mind (emotional level), environmental stress factors (family, work), etc.

HOMOEOPATHIC MEDICINES :  NATRUM MURIATICUM, PULSATILLA, SEPIA, OPIUM,LACHESIS

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