How Should Amenorrhea Be Treated?

Menstruation is a normal physiological phenomenon for women. As women age, menopause may occur, which is a normal physiological process. However, some women may experience menopause before reaching the age of natural menopause, which is often caused by underlying diseases. Such cases require prompt medical attention, especially for women of reproductive age, as menopause can not only endanger their physical health but also impact their fertility. It is important to treat menopause as early as possible.

1. Etiological Treatment: Identify and appropriately treat the organic diseases that cause menopause. For example, tuberculous endometritis requires anti-tuberculous treatment. Patients with intrauterine adhesions should undergo dilation of the uterine cavity and placement of an intrauterine device to prevent re-adhesion. After a clear diagnosis of pituitary or ovarian tumors, treatment plans are determined based on the location, size, and nature of the tumor, with options including surgery, radiotherapy, chemotherapy, and other comprehensive measures.

2. Hormone Replacement Therapy: Hormone replacement therapy can be used for women with congenital ovarian dysplasia, ovarian dysfunction or damage leading to premature ovarian failure. Typically, artificial cycles of sex hormones are employed. After administration of sex hormones, menstrual-like periodic withdrawal bleeding occurs, which not only corrects the physiological and psychological state of the patient but also promotes the development of reproductive organs and secondary sexual characteristics to a certain degree.

(1) Low-dose estrogen cycle therapy aims to stimulate pituitary function and secrete luteinizing hormone, thereby increasing ovarian estrogen secretion and promoting ovulation.

(2) Sequential estrogen and progesterone therapy suppresses the hypothalamus-pituitary axis, and menstruation and ovulation may resume after discontinuation of medication.

(3) Combined estrogen and progesterone therapy suppresses pituitary gonadotropins, and menstruation and ovulation may occasionally resume after discontinuation due to rebound effects. Oral contraceptives are taken once a night, starting from the fifth day of menstruation and continuing for 22 days before discontinuation. The second course begins on the fifth day of the next menstrual cycle, and this treatment is continued for 3-6 cycles.

3. Traditional Chinese Medicine Treatment: Some cases of menopause in women are caused by endocrine disorders. In such cases, it is sufficient to regulate the endocrine system. Traditional Chinese medicine emphasizes the principles of harmonizing qi, regulating blood, and promoting flow. Through the use of traditional Chinese medicine, it can help restore the function of the ovaries and uterus in women, thereby restoring estrogen secretion and achieving the goal of treating menopause.