Women's Health

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Your menstrual cycle occurs as the result of a complex hormonal interaction involving your brain, ovaries, and adrenal, pituitary and thyroid glands. If anything interferes with this delicate hormonal balance, you may experience irregular or absent periods. If you have irregular periods or your periods have stopped (amenorrhea), you should see your gynecologist or medical doctor for a more thorough investigation.

There are many possible causes of secondary amenorrhea and irregular periods, including:

• Stress. Mental stress can temporarily alter the functioning of your hypothalamus — an area of your brain that controls the hormones that regulate your menstrual cycle. Ovulation and menstruation may stop or become irregular as a result. Regular menstrual periods usually resume after your stress decreases.
• Medication. Certain medications can cause menstrual periods to stop. For example, antidepressants, antipsychotics, some chemotherapy drugs, and oral corticosteroids can all cause amenorrhea.
• Illness. Chronic illness may postpone menstrual periods by delaying ovulation. Menstruation typically resumes once you recover.
• Hormonal imbalance. A common cause of amenorrhea or irregular periods is polycystic ovary syndrome (PCOS). This condition causes relatively high and sustained levels of estrogen and androgen, a male hormone, rather than the fluctuating levels seen in the normal menstrual cycle. This results in a decrease in the pituitary hormones that lead to ovulation and menstruation. PCOS is associated with obesity, amenorrhea or abnormal -- often heavy -- uterine bleeding, infertility, acne, and sometimes excess facial hair.
• Low body weight. Excessively low body weight interrupts many hormonal functions in your body, potentially halting ovulation. Women who have an eating disorder, such as anorexia or bulimia, often stop having periods because of these abnormal hormonal changes.
• Excessive exercise. Women who participate in sports that require rigorous training, such as ballet, long-distance running, or gymnastics, may find their menstrual cycle interrupted. Several factors combine to contribute to this loss of
 periods in athletes, including low body fat, stress, and high energy expenditure.
• Thyroid malfunction. An underactive thyroid gland (hypothyroidism) commonly causes menstrual irregularities, including amenorrhea. Thyroid disorders can also cause an increase or decrease in the production of prolactin — a reproductive hormone generated by your pituitary gland. An altered prolactin level can affect your hypothalamus and disrupt your menstrual cycle.
• Pituitary tumor. A noncancerous (benign) tumor in your pituitary gland (adenoma or prolactinoma) can cause an overproduction of prolactin. Excess prolactin can interfere with the regulation of menstruation. This type of tumor is treatable with medication but it sometimes requires surgery.
• Uterine scarring. Asherman's syndrome, a condition in which scar tissue builds up in the lining of the uterus, can sometimes occur after uterine procedures, such as a dilation and curettage (D and C), Caesarean section, or treatment for uterine fibroids. Uterine scarring prevents the normal buildup and shedding of the uterine lining, which can result in very light menstrual bleeding or no periods at all.
• Premature menopause. Menopause usually occurs between ages 45 and 55. If you experience menopause before age 40, it's considered premature. The lack of ovarian function associated with menopause decreases the amount of circulating estrogen in your body, which in turn thins your uterine lining (endometrium) and brings an end to your menstrual periods. Premature menopause may result from genetic factors or autoimmune disease but often no cause can be found.
• Pregnancy. In women of reproductive age, pregnancy is the most common cause of amenorrhea.

• Contraceptives. Some women who take birth control pills may not have periods. When oral contraceptives are stopped, it may take 3-6 months to resume regular ovulation and menstruation. Contraceptives that are injected or
implanted, such as Depo-Provera, also may cause amenorrhea as can 
progesterone-containing intrauterine devices such as Mirena.
• Breast-feeding. Mothers who breast-feed often experience amenorrhea. Although ovulation may occur, menstruation may not. Pregnancy can result despite the lack of menstruation.
• Chinese medicine is extremely effective at treating the underlying conditions that disrupt the menstrual cycle.
  According to Chinese medicine, a “healthy” menstrual cycle:
• Is about 29 days (we follow the moon)
• Is regular (+/- one or two day every month)
• Flows 3-7 day
• Has a fresh red blood color (not purple, black, or too pale pink)
• Is of average consistency (not watery or thick like molasses)
• Is of average flow (not overly light or very heavy)
• Has no clots

Acupuncture is the traditional Chinese method of placing extra-thin needles at strategic energy points on your body to improve functioning and promote natural healing. Acupuncture is frequently used to help regulate menstrual cycles, reduce stress, and improve blood flow to the pelvic area and uterine lining.

Herbal therapy is an essential treatment modality for gynecological conditions (including infertility) in Chinese medicine, and provides an important compliment to acupuncture. While acupuncture stimulates the flow of Qi and blood, herbal formulas are designed to nourish and replenish deficiencies in the metabolic, endocrine, and immune systems.

Studies have shown that herbal formulas may

• Regulate menstrual cycles
• Alleviate endometriosis pain
• Thicken an unresponsive endometrium
• Restore normal menstruation in patients with amenorrhea and oligomenorrhea

Chinese herbal formulas are safe and effective when prescribed by your Chinese medicine practitioner.

Each women’s cycle is unique. Some women barely noticed when their period comes and goes. For others, however, their period can be a monthly ordeal with mood swings, weight gain, painful cramps, and heavy bleeding. The range of symptoms that correspond with monthly cycles is called premenstrual syndrome or PMS.

In the West, these symptoms are often thought to be a normal part of the menstruation. In Chinese medicine, however, PMS is considered to be the result of an underlying imbalance or deficiency.

A healthy period according to Chinese medicine:

Is regular - every 26 to 31 days
Is free of cramps, bloating, breast tenderness and headache
Has adequate flow (neither scanty nor excessively heavy) that lasts for 3-5 days
Has bright red blood flow free of clots (in Chinese medicine, clots are a sign of stagnation)

Premenstrual syndrome (PMS) is the name of a group of symptoms that may begin up to 14 days before your menstrual period. The symptoms usually stop once your period begins. Symptoms may include:

• Irritability
• Mood swings
• Depression
• Anxiety
• Confusion or fuzzy thinking
• Fatigue
• Insomnia
• Changes in libido
• Cravings, especially for salty or sweet foods
• Alcohol intolerance
• Acne
• Abdominal and pelvic cramps
• Bloating
• Weight gain
• Headaches
• Migraines
• Breast swelling and pain
• Heart pounding (palpitation)
• Nausea
• Fainting
• Urinary problems

Premenstrual dysphonic disorder is a more extreme version of PMS.

The most common explanation for PMS, from a Western point of view, is that it's an imbalance between your two main reproductive hormones, estrogen and progesterone, and/or a disruption in the feedback system that regulates your reproductive hormones. Researchers feel that that some women’s brain are more sensitive to these hormones and that PMS symptoms occur because your brain overreacts to progesterone and estrogen causing changes in the brain chemicals called neurotransmitters.

Estrogen and progesterone can alter:

• Serotonin: these changes may cause depression and carbohydrate cravings.
• GABA (gamma-aminobutyric acid): this neurotransmitter is important for feeling calm.
• Endorphins: the good hormones that influence the experience of pain and pleasure.
• Norepinephrine: influences mood and plays a role in blood pressure and heart rate.