As women we experience approximately 500 menstrual cycles in our lifetime. Impressive, isn’t it! But when we miss our period for 3 months and we are not pregnant, breastfeeding or menopausal then we have amenorrhea (absence of menses). This can be a serious symptom of a greater underlying imbalance and reason for a consultation with a doctor.
Types of Amenorrhea
There are two types of amenorrhea.
Primary amenorrhea – when menstruation fails to occur by 16 years of age
Secondary amenorrhea – when menstruation has previously occurred, but has been absent for at least three months (if your cycle was regular) or six months (if your cycle was irregular)
Causes of Amenorrhea
There are a number of things that can lead to not getting your period. Primary amenorrhea is caused by a genetic abnormality in about one-third of cases. Hormonal imbalances, environmental exposures, malnutrition, low body weight, eating disorders, anemia, strenuous exercise, stress, infectious disease (like mumps or tuberculosis), cancer treatments, autoimmune disease, polycystic ovaries, and structural defects can also lead to amenorrhea.
Five of the most common causes of secondary amenorrhea are:
- Ovarian failure (pre-mature menopause)
- Elevated prolactin levels
- Inadequate estrogen production
- Chronic lack of ovulation (due to PCOS or other causes)
- Low body weight/ low body fat
How Do I Know What is Causing My Amenorrhea?
A full spectrum of tests, combined with a physical exam and comprehensive intake should give enough information to determine the cause of amenorrhea for most women. Your Naturopathic Doctor will ask you questions about your:
- Menstrual and fertility history
- Emotional stress
- Weight gain or weight loss
- Lifestyle including alcohol intake, dietary practices and exercise
- Prior medical history – accidents, illnesses or injuries
- Medications and supplements
- Family medical history
Laboratory testing will likely be needed as well. A pregnancy test, pelvic ultrasound, blood tests for cholesterol levels and thyroid functioning as well as blood or saliva tests for hormone levels are often indicated.
Treatment of Amenorrhea
In Naturopathic Medicine we strive to treat the underlying cause of imbalances rather than just the symptoms. When you see a Naturopathic Doctor for your amenorrhea the treatment will be individualized to you – treating your individual imbalances rather than your symptom of amenorrhea. Once the underlying imbalance is corrected, the symptom will resolve.
Nutrition for Amenorrhea
- Achieve and maintain a healthy body weight. Women who are underweight can have amenorrhea due to a lack of adequate body fat to manufacture hormones. Women who are overweight can have amenorrhea as a result of excess androgens associated with excess body fat.
- Consume adequate protein. You need at least 40 grams of protein daily.
- Consume adequate calories. Depending on your body type (height, weight) you will have individual caloric needs. A minimum of 1500 calories daily is a good guideline for anyone.
- Consume 20% of your calories as fat. Good quality fats such as nuts, seeds, extra-virgin olive oil, flaxseed oil, and fish oil ensure you are consuming enough fats to produce sex hormones (including estrogen and progesterone)
- Consume 55-65% of your calories as complex carbohydrates. Brown rice, wild rice, millet, oatmeal, amaranth, quinoa, barley, spelt, kamut and buckwheat provide fiber, B vitamins and support proper detoxification of hormones
- Ensure you are getting the nutrients you need by eating a diverse selection of foods every day.
Lifestyle Changes for Amenorrhea
- Sleep in a dark room
- Go to bed before 11pm
- Eat regular meals (at regular times). Eat every 3 hours.
- Maintain a steady, healthy body weight. Avoid rapid weight gain or weight loss.
- Balance thyroid function. Measure basal body temperature to determine if your thyroid is underactive.
- Avoid environmental toxins – pesticides, preservatives and food additives. Consider hair mineral analysis to assess toxic burden
- Consider cranial sacral therapy, Reiki, or rolfing to bring awareness to emotions connected to femininity, sexuality, body image, maturation, independence, and second chakra issues
Herbal Medicines for Amenorrhea
There is an entire class of botanical medicines that is used for amenorrhea. These herbs are known as emmenagogues and are used to promote menstruation.
Some of the most common herbal medicines used for amenorrhea are include:
- Mugwort (Artemesia vulgaris)
- Partridgeberry (Mitchella repens)
- Blue cohosh (Caulophyllum talictroides )
- Chaste tree (Vitex agnus-castus)
- Black cohosh (Actea racemosa)
These herbs should be used under supervision of a qualified Naturopathic Doctor and should be taken only as prescribed.
There is help available for amenorrhea. You can have a normal menstrual cycle – but only if you address the underlying cause of your lack of menses. Contact a qualified Naturopathic Doctor for a consultation today.
The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.