Amenorrhoea (secondary amenorrhoea) is the absence of a period for 3-6 months or more. It affects about 5% of fertile women. It is commonly seen in women who exercise vigorously. In western medicine, amenorrhoea is caused by either:
- Hypothalamus dysfunction – stress, excessive exercise, excessive weight loss, obesity or drugs (cannabis, antidepressants) lead to a sustained decrease in GnRH output resulting in amenorrhoea.
- PCOS – some women with PCOS can suffer with amenorrhoea, although PCOS tends to cause irregular menstrual cycles in most women (oligomenorrhea).
- Pituitary disease – some women can have high levels of the hormone prolactin in their blood which signals to the body that it is pregnant and to shut down menstruation.
- Adrenal or thyroid dysfunction – an underactive thyroid can lead to an increase in prolactin levels, which again signals to the body that it is pregnant and should shut down menstruation.
- Premature ovarian failure – where the ovaries are either exhausted or are resistant to stimulation by FSH and LH.
In Chinese medicine, amenorrhoea is due to a lack of qi, blood or yin, or a stagnation of qi and blood. In today's world, it is common to see both women and men overworking. Those that start early, have intense jobs (often corporate types) and have a lack of sleep will be qi and blood deficient. In society today, we equate being fit with being healthy. But this is not correct. Being fit is certainly healthy, but exercising too much is bad for health. I often see women in my clinic who exercise 5 times a week. This is too much. They often think that it will give them more energy, but exercise only helps to regulate energy, thereby giving you the feeling you have more, it can't give you more. Exercising too much will actually deplete energy levels making women physically weak and thereby less fertile. Dieting is also another big cause of amenorrhoea. Most women will reduce their food intake to lose weight rather than exercise. This starves the body making it weak and deficient. If you want to lose weight, eat regularly but exercise regularly too. Of course, not too much!