Menstruation, deficient

Christopher Hobbs:

“When menstruation stops before menopause, it is most likely that a deficiency of blood and vital energy exists. It is more common among women who eat a diet that focuses on raw fruits and vegetables or excludes all animal products for many years. Signs of blood deficiency include pale tongue, pale cheeks, a feeling of coldness, avoidance of cold weather, and fatigue. Women who engage in intense physical activity, such as marathon running, can also experience a cessation of the menstrual flow.”

Etiologic and Contributing Factors

1. Hormonal Imbalances
   • Polycystic Ovary Syndrome (PCOS): Irregular ovulation due to excess androgens.
   • Thyroid Disorders: Both hypothyroidism and hyperthyroidism can affect menstrual cycles.
   • Low Progesterone or Estrogen: Leads to insufficient endometrial buildup.
2. Lifestyle Factors
   • Excessive Stress: Chronic stress disrupts the hypothalamic-pituitary-ovarian (HPO) axis.
   • Excessive Exercise: Overtraining, especially in athletes, can suppress ovulation.
   • Poor Diet or Eating Disorders: Nutritional deficiencies affect hormone production.
3. Medical Conditions
   • Uterine or Endometrial Issues: Scarring (Asherman’s syndrome) or thinning of the uterine lining.
   • Chronic Illness: Conditions like diabetes or autoimmune diseases.
   • Genetic Disorders: Such as Turner syndrome or Fragile X-associated primary ovarian insufficiency.
4. External Factors
   • Medications: Hormonal contraceptives, antidepressants, or chemotherapy.
   • Environmental Toxins: Endocrine disruptors like BPA or pesticides.

When to Seek Professional Help

• Chronic Irregularities: Menstrual cycles consistently longer than 35 days or fewer than 21 days.
• Absence of Menstruation: Missing periods for three consecutive cycles (amenorrhea).
• Severe Pain: Pelvic pain accompanying deficient menstruation.
• Other Symptoms: Hair loss, unexplained weight gain/loss, acne, or galactorrhea (milky discharge).
• Fertility Concerns: Difficulty conceiving or planning pregnancy.
• Signs of Serious Illness: Sudden changes in menstrual patterns, excessive fatigue, or systemic symptoms (e.g., fever).