Amenorrhea

　　1. Disease
　　It mainly includes consumptive diseases, such as severe pulmonary tuberculosis, severe anemia, malnutrition, etc.; special endocrine diseases, such as 'obesity reproductive dysfunction malnutrition disease' and so on; the influence of some endocrine disorders, such as adrenal, thyroid, pancreas, and other functional disorders. The influence of these reasons may cause amenorrhea. However, amenorrhea caused by these diseases will naturally resume menstruation as long as the disease is cured.

　　2. Lower segment obstruction of the reproductive tract
　　For places such as the cervix, vagina, hymen, labia, etc., there is a part of congenital atresia, or adhesion caused by postnatal injury, although there is menstruation, the menstrual blood cannot flow out. This condition is called concealed or pseudoamenorrhea. The lower segment of the reproductive tract can be completely cured after treatment by the doctor.

　　3. Underdeveloped reproductive organs
　　Some people are congenitally without ovaries, or the ovaries are not fertile, unable to produce estrogen and progesterone, so the endometrium cannot undergo cyclic changes, and there will be no endometrial shedding, so there will be no menstruation. There are also some people who are congenitally without a uterus, or the endometrium is underdeveloped, or the endometrium is damaged. Even if the ovarian function is normal, and the secretion of estrogen and progesterone is normal, there will be no menstruation.

　　4. Tuberculous endometritis
　　This is due to the invasion of tuberculosis bacteria into the endometrium, causing inflammation of the endometrium and varying degrees of damage, and finally forming scar tissue, leading to amenorrhea. Therefore, timely treatment should be sought for tuberculosis endometritis, and it should not be delayed.

　　5. Abnormal function of the pituitary gland or hypothalamus
　　The pituitary gland can secrete gonadotropin, which has the function of regulating ovarian function and maintaining menstruation. If the function of the pituitary gland is disordered, it will affect the secretion of gonadotropin, thereby affecting the function of the ovary. Abnormal ovarian function will cause amenorrhea. In addition, abnormal function of the hypothalamus can also cause amenorrhea. The causes of hypothalamic dysfunction are many, such as mental stimulation, sadness and worry, fear and unease, tension and fatigue, as well as environmental changes, cold stimulation, etc. Amenorrhea caused by the hypothalamus is more common.

　　Amenorrhea has many harmful effects on women, mainly including the following aspects:

　　Osteoporosis and hypertension
　　Amenorrhea can lead to a series of menopausal symptoms in women, causing post-menopausal women to experience osteoporosis and weakness in the limbs. Due to elevated triglycerides, cholesterol, and low-density lipoprotein, it is also prone to cause atherosclerosis, coronary heart disease, and hypertension.

　　Decreased libido
　　Amenorrhea is a common gynecological symptom that has adverse effects on the patient's body, can cause atrophy of the uterus or insufficient physiological function, such as dyspareunia, reduced secretion, decreased libido, and others.

　　Early menopause can accelerate aging
　　Early menopause symptoms caused by early ovarian failure can accelerate aging in women, causing cardiovascular and cerebrovascular diseases, osteoporosis, decreased sleep quality, dysuria, frequent urination, and disharmony in sexual life. Blind dieting can lead to amenorrhea in women of childbearing age, causing endocrine disorders, leading to atrophy of the reproductive organs, affecting fertility. Therefore, women with early menopause need timely treatment.

　　Infertility
　　Women with amenorrhea should first determine the degree of amenorrhea to facilitate induction of ovulation and enable pregnancy. Mild amenorrhea patients may have ovulatory cycles; moderate amenorrhea patients have extremely low estrogen levels, no proliferative changes in the endometrium, and almost no development of follicles, which eventually leads to female infertility.

　　Due to the different causes of amenorrhea, the clinical manifestations are also different. The main clinical manifestations of amenorrhea include:
　　1. Those with symptoms such as decreased libido, breast atrophy, axillary and pubic hair loss, infertility, and others are mostly due to insufficient secretion of gonadotropin.
　　2. Those with symptoms such as fatigue, anorexia, weight loss, and fainting are mostly due to insufficient secretion of adrenocorticotropic hormone.
　　3. Those with symptoms such as cold intolerance, pale and dry skin, bradycardia, low blood pressure, delayed response, drowsiness, dementia, and apathy are mostly due to insufficient secretion of thyroid-stimulating hormone.
　　4. Those with symptoms such as obesity, hirsutism, giant malformation, acromegaly, hypertension, rough skin, and increased red blood cells are mostly caused by pituitary tumors.
　　5. Those with symptoms such as infertility, hirsutism, and obesity are mostly due to ovarian dysfunction.

　　Amenorrhea is one of the common gynecological diseases in women. To prevent amenorrhea, one should pay attention to the following matters:
　　1. Avoid mental stimulation:Stabilize emotions and keep the flow of Qi and blood smooth.
　　2. Pay attention to dietary control:Obese patients should appropriately limit dietary and salt intake.
　　3. Strengthen physique:Strengthen physical exercise in daily life, often do health exercises or Tai Chi.
　　4. Strengthen nutrition:To prevent amenorrhea, pay attention to the spleen and stomach. Under the condition of good appetite, one can eat more meat, poultry eggs, milk, and fresh vegetables, and avoid spicy and stimulating foods.
　　5. Pay attention to keeping warm during menstruation:Especially pay attention to the lower part of the waist, keep the two feet warm, do not enter cold water, and refrain from eating cold and raw fruits and vegetables. Avoid taking cold and cool medicine during menstruation.

　　The main examination items for amenorrhea include the following:

　　1. Vaginal desquamation cell examination:This examination is a commonly used method to measure estrogen levels. After the cotton swab is soaked in physiological saline, the desquamated cells from the upper part of the vaginal lateral wall are taken, spread on a slide, fixed and stained, and the percentage of cells in the superficial, middle, and bottom layers are observed. The higher the percentage of superficial cells, the higher the estrogen level.

　　2. Cervical Mucus:It can also let the doctor understand the estrogen function of women. If the cervical mucus of amenorrhea patients is transparent, good-tension thin mucus, after drying on a glass slide under a microscope, it can be seen that the mucus has fern-like crystals, indicating that the patient's ovaries have the function of secreting estrogen.

　　3. Drug Test:This examination is a common amenorrhea diagnostic test, especially helpful in evaluating ovarian function and endometrial function when hormone measurement equipment is lacking. There are mainly two tests: progesterone test, estrogen test.

　　4. Measurement of Sex Hormone Levels:It is mainly the measurement of pituitary hormones and is very important for diagnosing the cause of amenorrhea. For patients with amenorrhea and low estrogen levels, further determination of blood FSH, LH, and prolactin (PRL) levels should be performed.

　　5. Basal Body Temperature Measurement:This examination can indirectly understand the female ovary's排卵function. After ovulation, the corpus luteum secretes progesterone, which has the effect of raising body temperature. During the normal menstrual cycle, the body temperature during the follicular phase is relatively stable, generally fluctuating below 36.5℃.

　　6. Other Examinations:Pelvic ultrasound can assist in diagnosing the presence of congenital uterine aplasia or malformation. Imaging examination of the saddle area can diagnose the presence of a pituitary adenoma. Diagnostic curettage, uterine iodine oil contrast, and endoscopic examination can understand the uterine cavity and endometrial situation. In addition, if it is necessary to exclude other endocrine abnormalities or developmental malformations, the hormone levels, biochemistry, pathophysiological examination, and karyotype examination of other related glands such as the thyroid and adrenal glands should also be checked.

　　The causes of amenorrhea come from many aspects. In addition to identifying the cause and giving对症 treatment, it is also necessary to follow certain principles in diet, strengthen the comprehensive supply of nutrition, improve the nutritional status of the body, and restore the body to a normal state. Therefore, it is not advisable to try the following therapeutic diet, which can also play a positive auxiliary therapeutic role for amenorrhea patients.

　　1. Stewed Pigs' Hooves with Sunflower Stalk:250 grams of pigs' hooves, 10 grams of sunflower stalk. First, clean the pigs' hooves, remove the dirt, and place them in a pot. Simmer over low heat until tender, add the sunflower stalk, bring to a boil, and simmer into a thick juice. Remove the residue and drink the juice. Take 2 to 3 times a day, 20 to 30 milliliters each time. It has the effects of promoting blood circulation, moving qi, and resolving blood stasis. It is suitable for amenorrhea due to blood stasis.

　　2. Stewed Pigs' Hooves with Chuanxiong:15 grams of Chuanxiong, 2 pigs' hooves, 80 milliliters of yellow wine. Clean the pigs' hooves, remove the hair, cut into several pieces, and place them in a large炖盅 with the Chuanxiong. Add 500 milliliters of water, steam until the pigs' hooves are tender, remove the Chuanxiong, and eat the pork and soup. It has the effects of promoting blood circulation, removing blood stasis, and beautifying the skin. It is suitable for women with blood stasis and amenorrhea due to Qi stagnation.

　　3. Goose Meat and Scallion Porridge:Goose meat 150 grams, minced pork 50 grams, glutinous rice 100 grams, chopped scallion and ginger, pepper, cooking wine, sesame oil, salt, and monosodium glutamate to taste. Remove the bones from the goose meat and cut into pieces, place in a bowl, add minced pork, chopped scallion and ginger, cooking wine, and salt, mix well and set aside. Add 1000 milliliters of water to the glutinous rice, bring to a boil, then add the goose meat and cook into porridge. Adjust with sesame oil, monosodium glutamate, and pepper. It has the effects of nourishing the kidneys and replenishing qi, dispelling wind and detoxifying, harmonizing the blood and brightening the complexion. It is suitable for the treatment of amenorrhea due to blood deficiency.

　　4. Fried ginger and cuttlefish:Ginger 50 grams, boneless cuttlefish 250 grams. Cut the ginger into thin strips, wash the cuttlefish and slice it, fry with oil, and serve with food. It has the effects of nourishing blood, promoting the flow of qi, and beauty. It has an auxiliary therapeutic effect for amenorrhea due to blood deficiency.

　　The causes of amenorrhea are different, so the treatment methods of Western medicine are also different.

　　1. Uterine Amenorrhea At present, there is no effective treatment for congenital absence of the uterus or complete damage to the endometrium. Pseudoamenorrhea caused by vaginal or hymen malformation can be treated by surgery to打通the passage, allowing menstrual blood to flow smoothly. For patients with uterine adhesion, the uterine cavity should be explored, and separation surgery should be performed according to the adhesion situation. An intrauterine contraceptive device should be placed for several months after surgery to prevent re-adhesion.

　　2. Ovarian Amenorrhea Due to the low function of the ovaries themselves, only sex hormone supplementation therapy can be used. Generally, a combined cycle of estrogen and progesterone is used to simulate a normal menstrual cycle. This can enable girls with this type of amenorrhea to have a similar menstrual cycle to normal girls, maintaining the normal psychological state of women, and more importantly, sex hormone supplementation therapy can prevent their reproductive tract atrophy and maldevelopment, prevent osteoporosis, and promote sexual development. The vast majority of ovarian amenorrhea cannot beget children for life due to the absence of follicle development in the ovaries. Artificial insemination techniques using donor eggs from others are required. Occasionally, there are reports of ovulation and pregnancy in women with early ovarian failure or ovarian insensitivity syndrome due to a small amount of residual undeveloped follicles in the ovaries, but it is very rare. Hypogonadism with Y sex chromosomes should be treated with sex hormone supplementation therapy after the gonads are removed.

　　3. Hypothalamic Amenorrhea For hypothalamic amenorrhea, the best choice should be gonadotropin HMG (Human Menopausal Gonadotropin), which can achieve a relatively high ovulation rate and pregnancy rate. Due to its high price, daily injection, and strict monitoring program, it is only suitable for married women who hope to give birth. For unmarried or women who do not require childbirth with hypothalamic amenorrhea, the main treatment principle is still hormone replacement therapy.