Amenorrhoea (Anartava) Written by Swati Sharma

Amenorrhoea

Amenorrhoea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen during pregnancy and lactation (breastfeeding), the latter also forming the basis of a form of contraception known as the lactational amenorrhea method. Outside of the reproductive years there is absence of menses during childhood and after menopause.

Classification -
I Physiological
↓  
1) Primary

• Before puberty

2) Secondary

• During pregnancy
• During lactation
• Following menopause

II Pathological
↓  
1) Cryptomenorrhoea (Concealed)

• Congenital
• Acquired

2) Real (True)

• Primary
• Second

Physiological

Before puberty

Pituitary gonadotrophins are not adequate enough to stimulate the ovarian follicles for effective steroidogenesis. So, oestrogen levels are not sufficient enough to cause bleeding from endometrium.

During Pregnancy
Increased estrogen and chorionic gonadotrophins.
↓
Suppresses the pituitary GnRH
↓
No maturation of ovarian follicles.

During Lactaion
Due to increased prolactin 
↓
Inhibits ovarjxi response to FSH 
↓
No follicular growrth 
↓
Hypoestrogenic growth 
↓
No menstruation.

Following Menopause
No more response follicles are available in ovaries for GnRH to act.
↓
No Oestrogen
↓
Elevation of Pituitary Gonadotropins.

Pathological

Basic factors which are responsible for onset and continuation of normal menstruation these are

Normal female chromosomal pattern.
Co-ordinated Hypothalamo - pituitary ovarian axis.
Responsive endometrium.
Anatomical patency of outflow tract.
Active support of thyroid and adrenal glands. 

Cryptomenorrhoea
There is priodic shedding of endometrium and bleeding but the menstrual blood fails to come out from genital tract due to obstruction in the passage.
or Cyrptomenorrhoea means the occurence of menstrual symptoms without external bleeding.

Treatment

1. Vasti chikitsa:- Shatavryadi vasti

Internal Use

• Fish, kulathi, kanji, til, gomutra, curd, vinegar.
• pit vardhak dravya.
• Krishna til decoction+ sugar.
• Jyotishmati part + Sarji kshar with cold water.
• Danti, Madanfal, Yavshuk with Snuhi kshir
• ghrit:- falghrit, shataavri ghrit.

External Use

Varti:- Madanfal, Danti, Snuhikshir, ekshvaaku Varti of all of them should b made by crushing them properly and is to be kept in vagina.

Pathaya

Fish, kulath, kanji, til, mash, sura, gomutra, shukt, curd (Pit vardhak aahar – vihar)