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
a. Primary Amenorrhea: When the menarche does not appear even when the girl is over 18 years of age.
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
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.
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.
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.
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
This depends on ability to remove existing cause and is usually favourable.
Homeopathic Remedies for Treatment of Amenorrhea:
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.
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.
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.
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.
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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