The menstrual cycle usually begins at around the age of 14 for girls. However, if it does not start after 18 years of age, or stops for about three months, then it is a case of amenorrhea. Amenorrhea (an absecne of menstruation) is normal before puberty,during pregnancy, while breast-feeding and also after menupause.Primary amenorrhea describes the situation where the menstrual periods do not begin at puberty.In secondary amenorrhea, the menstrual periods stop when they would normally be expected to be present.In Traditional Chinese Medicine (TCM), the causes of amenorrhea are "insufficiency of the liver and kidney", "deficiency of both qi and blood" and "blood stasis insufficiency of the liver and kindey due to stagnation of qi".

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1. Insufficiency of the Liver and Kidney: Girls over 18 have not started their mentrual cycle, or the mentruation is light, leading gradually to amenorrhea. The girl may show physical fatigue and sore legs and loins. There may also be dizziness or tinnitus(ringing in ears). The tongue would be reddish with little fur, while the pulse is deep and weak.

2. Deficiency of both Qi and Blood: Mentrual cycle is delayed gradually, while the quantity becomes lighter, blood is light in color and thin. There may be dizziness, blurred vision, palpitation (noticeable or irregular heartbeat), shortness of breath, lusterless hair or emaciation (body wasting) with sallow complexion. The tongue would be pale with very little fur, while the pulse would be deep and moderate.

3. Blood Stasis due to Stagnation of Qi: The mentrual cycle stops for months, the woman gets angry easily, feels fullness in the chest and hypochondrium region, and there may be lower abdomen pain. The blood stasis may also cause purplish spots on the borders of the tongue and a deep and uneven pulse.

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Syndrome (a)
Insufficiency of the Liver and Kidney

To treat by Herbal medicine
Therapeutic Principle: In TCM, the liver stores "blood" and the kidney stores "essence". The liver depends on the kidney to provide the nourishment to produce blood and the kidney depends on the liver to provide blood to produce essence. Therefore, they both rely on each other. One should nourish the kidney and the liver to regulate menstruation.
The recipe of plus or minus Bolus is to tone the kidney and liver.

Recipe: Modified Bolus
1. dodder seed, Semen Cuscutae 12g (strengthening waist)
2. eucommia bark, Cortex Eucommiae 9g strenthening knees, muscles, joins)
3. wolfberry fruit, Fructus Lycii 12g (improving vision)
4. glossy privet fruit, Fructus Ligustri Lucidi 12g (improve vision, white hair, waist,tinnitus.)
5. eclipta, Herba Ecliptae 12g (dizziness,white hair, tinnitus, lassitude in loins and legs)
6. dogwood fruit, Fructus Corni 9g (to astringe seminal emission and sweating)
7. Chinese angelica root, Radix Angelicae Sinensis 9g (nourish blood)
8. prepared rehmannia root, Radix Rehmanniae 9g (nourish kidney-yin)
9. Chinese yam, Rhizoma Dioscoreae 15g (nourishing and replenishing spleen and kidney)
10. poria, Poria 9g (nourish and replenish spleen) Decoct the above drugs in water for oral administration.

To treat by Acupuncture and Moxibustion

  

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Syndrome (b)
Deficiency of both Qi and Blood

To treat by Herbal medicine
Therapeutic principle: Deficiency of qi will block the blood circulation and affect the flow of the menstruation. Stimulating the qi and nourishing the blood will help regulate menstruation.

Prescription/Formula: Recipe: Modified Ginseng Nutrition Decoction
1. ginseng, Radix Ginseng 6g
2. astragalus root, Radix Astragali Seu Hedysari 15g
3. roasted bighead atractylodes rhizome, Rhizoma Atractylodis Macrocephalae 12 g
4. poria, Poria 9g
5. schisandra fruit, Fructus Schisandrae 9g
6. Chinese angelica root, Radix Angelicae Sinensis 9g
7. prepared rehmannia root, Radix Rehmanniae Praeparata 12g
8. white peony root, Radix Paeoniae Alba 9g
9. cinnamon bark, Dortex Cinnamomi 3g
10. human placenta, Placenta Hominis 12g

Decoct the above drugs in water for oral administration. pilose antler, Cornu Cervi Pantotrichum 6g (if large uterine bleeding) (ground into fine power to be swallowed)

To treat by Acupuncture and Moxibustion

  

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Syndrome (c)
Deficiency of both Qi and Blood

To treat by Herbal medicine
Therapeutic Principle: Deficiency of both the qi and the blood can be cured by removing blood stagnation and regulating the blood in the meridians. Regulating the qi will help circulate the blood.

Recipe: Modified Decoction for Removing Blood Stasis in the Chest.
1. peach kernel, Semen Persicae 9g
2. safflower, Flos Carthami 9g
3. Chinese angelica root, Radix Angelicae Sinensis 9g
4. red sage root, Radix Salivae Miltiorrhizae 15g
5. chuanxiong rhizome, Rhizoma Ligustici Chuanxiong 9g
6. red peony root, Radix Paeoniae Rubra 12g
7. cinnamon bark, Cortex cinnamomi 3g
8. cyathula root, Radix Cyathulae 12g
9. bitter orange, Fructus Aurantii 9g
10. lindera root, Radix Linderae 9g
11. prepared nutgrass flatsedge rhizone, Rhizoma Cyperi 9g

Decoct the above drugs in water for oral administration.

To treat by Acupuncture and Moxibustion
In acupuncture, there are two approaches to curing deficiency of both qi and blood: a) alleviating blood stagnation or b) blood depletion.

(a) Symptoms of Blood stagnation:
1. absence of menses for about 3 months
2. pain and hard masses in lower abdomen
3. Tension and fullness in the chest and hypochondrium region
4. dark purple tongue coating with purplish spots on its borders, deep string- taut pulse
Therapeutic principle: By resolving blood stasis and regulating the circulation of Qi, the blood should be activated by selecting the Ren, Fott-Taiyang and Foot -Jueyin Meridians.
Prescription/Formula: Zhongji (Ren 3), Guilai (S29), Xuehai(Sp10), Taichong(Liv 3), Hegu(L14), Sanyinjiao(Sp6)

(b) Symptoms of Blood depletion:
1. delayed menstruation
2. decreased menses and gradual Amenorrhea
3. dizziness and vertigo, tinnitus, lassitude, poor appetite, loose stools, dry skin
4. lower back and knees are sore and weak
5. pale tongue, white coating, slow pulse
Therapeutic principle: Regulate the blood and qi by selecting points of the Ren, Liver, Spleen and Kidney Meridians.
Prescription/Formula: Guanyuan(Ren 4), Ganshu (B18), Pishu(B20), Shenshu(23), Zusanli (S36), Sanyinjiao (Sp6) 3. Alternatitive treatment: Auricular Acupuncture Prescription: kidney, liver, spleen, shenmen

  

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5. Healing by Other Therapies

(a) Qigong and other therapies

For effect of Qigong on Metabolism, click here.

Generally speaking, Qigong is good for healing effect of this specific ailment, however individual results may vary. It improves the flow of the qi and the circulation of the blood, so you'll experience more energy, but, you won't see/ feel any immediate effects, as with many exercises and therapies, it takes a few weeks or even months of practice before you'll see any significant improvements.

The following types of Qigong may help:

• Static Qigong:
  Relaxation Qigong
  Inner-Nourishing Qigong
  Relaxing Quiescent Qigong
  
• Dynamic Qigong:
  Fifteen Sets of Taiji-Qigong Exercise
  Baduanjing of Internal Exercise
  

For the information of different types of Qigong ,just click a link above.

This information is for education purpose only. We strongly advise you seek a licensed Qigong master to learn the correct ways to conduct these exercises before attempting them.

Effects: Enriching the blood and regulating menstuation, increasing the circulation of the blood and stops the pain.

Caution: Not to be taken by those who have poor appetite due to deficiency of the spleen, or those suffering from diarrhea, or those with deficiency of yin.

(c) Life style
1) Don't have anxiety, disappointment or fear.
2) Don't work too hard. Have enough sleep.
3) Don't live in damp places, such as basement.
4) Do appropriate exercise, and take part in normal group activities.

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6. Psychological Adaptation to a Chronic and Severe Illness
One encounters different health problems in the course of one's life. Some problems are acute yet minor and often improve by themselves or yield to simple self-management. Severe and acute conditions often necessitate the help of health professionals who may provide fast relief with specific interventions. However, when the condition is chronic, the management required is quite different.

Please click the following button to learn "Psychological Adaptation to a Chronic and Severe Illness".

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Acknowledgments:
Healthphone.com greatly acknowledges the support and dedication of our
Healing Centre Panel, without whom this section would not be possible.

We also greatly acknowedge Ms. Najaf Munir, MBBS, for her editorial support. Ms. Munir simplified the highly technical medical documents into easy-to-read documents, for the enjoyment and education of our numerous visitors.