Q While dieting, my period suddenly stopped and it's now been three months. Why does secondary amenorrhea happen?
A Secondary amenorrhea is when previously regular periods stop for three months or more. The most common cause is rapid weight loss, excessive exercise, or stress suppressing the hypothalamus and cutting off the ovulation hormones. Pregnancy must be ruled out first.
Detailed Answer
The causes of secondary amenorrhea fall into four broad categories: hypothalamic (excessive exercise, weight loss, or stress suppressing GnRH secretion), pituitary (such as a prolactinoma), ovarian (premature ovarian insufficiency, PCOS), and uterine (Asherman syndrome - intrauterine adhesions). Pregnancy must be excluded first, after which FSH, LH, prolactin, TSH, and estradiol tests help identify the cause. When rapid weight loss occurs together with bradycardia and amenorrhea, anorexia nervosa must always be considered.
Korean Medicine Clinic Perspective
In Korean medicine, amenorrhea caused by sudden weight loss or excessive exercise is understood as Qi and Blood Deficiency (gihyeol-bujok) - a state in which the body lacks enough Blood, so the very material needed to fill the uterus is in short supply. We first replenish Blood using Samul-tang (Four-Substance decoction) type formulas, and when the cause is stress-related, we take a soothing-Liver, regulating-Qi (sogan-igi) approach to release the stagnated Qi.
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