Amenorrhoea (absence of periods)

Amenorrhoea is the absence of periods, where levels of female reproductive hormones are not sufficient to stimulate menstruation. Amenorrhoea is called primary when a woman has never had a period, whilst secondary amenorrhoea refers to the ceasing of periods in a woman who previously has had menstrual cycles.

Amenorrhoea may also result from potentially serious disorders of the ovaries, the hypothalamus, or the pituitary gland; therefore, you should always consult your doctor for an evaluation of the cause. Prolonged amenorrhoea can result in early bone loss and increased risk of osteoporosis. Amenorrhoea occurs naturally in women who are breast-feeding, but in these circumstances it does not put the bones at risk.

Women with amenorrhoea may have symptoms of absent periods, increased facial hair, decreased pubic and armpit hair, deeper voice, decreased breast size, and secretions from the breast.

A common factor in amenorrhoea is the relationship between body weight and the cessation of periods. It can be an indication of underlying eating disorders in this women who are constantly dieting and show signs of obsessive behaviour in their attitudes to food. It may be a sign of anorexia nervosa. Stress may also cause amenorrhoea as the production of stress hormones is at the expense of reproductive hormones.

This condition is also quite common in very athletic women – obsessive exercisers who go to the gym, jog, run or do aerobics 5 or more times a week. It’s often seen in ballet dancers, gymnasts and long distance runners.

Secondary amenorrhoea may follow a period of oral contraceptive use, when it is called “post-pill amenorrhoea”. Ultrasound examination of the ovaries shows that there are no developing follicles, and the ovaries may be thought to have gone to sleep.

It’s essential that any absence of periods – whether they haven’t started in a young woman, haven’t restarted after pregnancy or coming off the contraceptive pill, or where they’ve stopped after previously being normal – is investigated to determine the underlying cause. It may be an indicator of serious underlying conditions and could lead to early menopause.

Nutritional Supplements that could help. (Refer to the individual supplement for cautions in use.)

Supplement/Herb What it does Dosage
Acetyl-L-carnitine It may have effects on brain chemicals and the hormones that control female reproductive hormones. It has been shown to help women resumed menstruating within three to six months after beginning supplementation. as directed
Blue cohosh A traditional herb for lack of periods, it stimulates menstrual blood flow and is a uterine tonic. as directed
Agnus castus Helps to balance hormones and raise levels of luteinising hormone and progesterone. as directed
Vitamin B6 B6 is needed to maintain the correct balance of female reproductive hormones (e.g. oestrogen) . as directed

Acupuncture has been shown to induce ovulation in women with disorders involving lack of ovulation. Preliminary studies show that levels of oestrogen and progesterone, as well as levels of the related hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone), may all be affected by acupuncture

Diet and Lifestyle Factors

When compared with women who menstruate regularly, women who menstruate infrequently or not at all often have lower dietary intakes of fat (especially saturated fat), protein, and total calories, as well as a greater proportion of carbohydrate and fibre in their diet.

The diet should include lots of wholegrain cereals, nuts, seeds, soya products, shellfish and oily fish.

Eat at least 5 portions of fruit and vegetables daily.

Drink 2 litres of water daily.

Moderate exercise typically increases bone density and has many benefits to the overall health of premenopausal women. Intensive or excessive exercise can contribute to amenorrhoea and increase the risk of early bone loss due to added stress on the body and it’s effects on hormone balance.

Excessive stress causes the body to produce increased amounts of the adrenal hormone cortisol, and a few studies have linked high cortisol levels to low levels of reproductive hormones and to amenorrhoea. Avoid any caffeinated drinks such as coffee, tea, cola and chocolate which all stimulate the production of adrenalin and cortisol.

Smoking may contribute to amenorrhoea. A survey study found that young women smoking one pack or more per day were more likely to experience amenorrhoea than other women.

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