August 05,2019
Amenorrhea
Amenorrhea is an absence of the menstrual flow occurring at
any time between Puberty and the menopause, except during pregnancy and
lactation, when such a condition is physiological.
Classification based on cause:
1.
Physiological :
a.
During Pregnancy
b.
Sometimes during adolescence
c.
Before puberty
d.
After menopause
e.
Sometimes during lactation
2.
Pathological:
a.
Primary Amenorrhea: When the menarche
does not appear even when the girl is over 18 years of age.
i. Cryptomenorrhea
ii. Rudimentary
or infantile uterus or ovaries
iii. Congenital
absence of uterus or ovaries
iv. Sex
chromosomal defect
v. Endocrinal
Causes- Hypothyroidism, Juvenile diabetes mellitus
vi. Injury
or disease of Midbrain
vii. Frohlick’s
Syndrome
viii.
Tuberculosis, Anemia
ix. Poor
Nutrition
x. Some
drugs(Androgens)
b.
Secondary Amenorrhea: Cessation of menses
for 3 or more months following normal menstruation-
i. Cervical
Stenosis or amputation of cautery
ii. Uterine
Injury, tuberculosis, Hysterectomy, radiation, D&C
iii. Bilateral
Ovarian Tumor
iv. Premature
Menopause
v. Bilateral
oophorectomy
vi. Cushing
Syndrome
vii. Acromegaly
viii.
Phycological upset, anorexia nervosa, mental disease,
worry, emotional shock
ix. Injury
or disease to mid brain
x. Hypo
or hyperthyroidism, Addison’s disease
xi. T.B
, Kala-azar, Malaria, Typhoid fever, Diabetes, Alcoholism, Poor Nutrition,
Obesity
xii. Certain
drugs, contraceptive pills, androgens
Commonest cause of secondary amenorrhea is pregnancy.
Symptoms:
In chronic amenorrhea the symptoms are often only such as
are characteristic of the pathological condition of which the amenorrhea itself
is but a symptom and are better
considered in connection with those
conditions.
Acute suppression may give rise to symptoms which in character
and intensity, will vary from those of ordinary menstruation- backache, heaviness
and weight, pelvic pains to symptoms of profound disorder leading sometimes to
severe and dangerous diseases.
Diagnosis:
The diagnosis of the amenorrhea is self-evident, but the
diagnosis of the pathological condition which produces it is often a matter of
difficulty and can only be accomplished by a thorough understanding of these
respective states.
Investigations:
Causes of amenorrhea are to be remembered and the
investigation is to be conducted accordingly.
1.
Complete Blood picture, Hb%, E.S.R, Cholesterol,
Sugar
2.
Complete Urine Examination
3.
X- ray of chest and pituitary fossa
4.
Vaginal cytology
5.
Hormonal assays
6.
USG
Prognosis:
This depends on ability to remove existing cause and is
usually favourable.
Homeopathic
Remedies for Treatment of Amenorrhea:
ACONITE:
Fear that menses will not return and terrible consequences follow,
labour like pressing in womb, patient bent double; tendency of head or chest
complaints; vertigo or fainting on rising from recumbent position; amenorrhea
in young plethoric girls who lead a sedentary life; menses stopped from cold
bath; from sudden checking of perspiration; from violent emotion or fright;
vagina dry, hot and sensitive.
CALCAREA CARBONICUM:
Especially useful in scrofulous or tuberculous subjects;
fair pump girls, of a leuco-phlegmatic temperament
; malnutrition; disturbances of indigestion; weary , languid, want of vitality;
anaemia.
CIMICIFUGA:
In rheumatic, neuralgic, choreic, or hysterical subjects; menses irregular,
delayed or suppressed; ovarian irritation; uterine cramps; bearing down in
uterine region and small of back, limbs heavy and torpid; suppression from cold
and emotions; more generally useful in all classes of amenorrhea than other
remedies.
FERRUM PHOSPHORICUM:
Anemia in weakly; chlorotic persons with fiery redness of face
; sexual desire lessened; sterility,
nervousness and debility; great disposition to keep quiet ; pale face, with
blue margins around eyes; pressure in head and stomach; exophthalmic goiter after suppression of menses.
GRAPHITIS
First menses delayed, or disturbances at the menopause. ‘’Graphitis
is in climax what Pulsatilla is in youth’’. Menses late, scanty and pale; pain
in the epigastric as if everything will be torn into pieces; patient inclined
to obesity; induration of ovaries.
Other homeopathic remedies for Amenorrhea are Helonias,
Pulsatilla, Phosphorus, Senecio, Sepia.
Biochemic Remedies useful for treatment of amenorrhea are Calcarea
Phophorica, Kai Phosphorica, Kali Sulphuricum; Kali Muriaticum
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