Amenorrhea clinical manifestation and treatment
Shutting After
The Amenorrhea is a symptom which many gynecology department diseases altogether have, has the function or the organic pathological change by a hypothalamic pituitary gland ovary axis in some link causes. According to causes the Amenorrhea pathological change spot, may divide into the womb, the ovary, the pituitary gland and the hypothalamus Amenorrhea. The woman is 18 years old to be called the primary stage after not yet the incoming tide to stop menstruating, approximately composes the Amenorrhea total 5%, many are unusual for the congenital growth; Menstruation already incoming tide, but presents continual 6 not to pass through the traveler in every month, is called the secondary to stop menstruating, approximately composes 95%, the cause of disease varies. The traditional Chinese medicine this sickness called that it “the female month”, “the menstruation does not come”, “the blood to be dry”, “the blood to separate”.
[clinical manifestation]
Has been 18 year old of menstruations not yet the incoming tide, or the menstruation incoming tide has been also continual for 6 months not to pass by. Or is accompanied by the headache, the blurred vision, disgusting, the vomit, the periodic abdominal pain; Or has the pilosity, obese, to overflow the breast and so on.
[diagnosis]
1. has the typical symptom.
2. general physical checkup: The attention common growth and the nutritional status, the energetic nervous type, the mental level, is the body whether there is abnormal. When necessity surveys the height, the body weight, the span and the second characteristic growth situation, to be whether there is obese, the pilosity, to overflow the breast and so on.
3. gynecological examination: The attention vulva growth and the cloudy distributed situation, is the clitoris whether there is large, the vagina growth situation, the vagina, whether there is do the hymen obstruct, abnormally, the atrophy, in does not have and the size richly, the ovary whether to increase.
4. womb inspection
(1) bureaucratic way of talking mirror inspection: Understood that the bureaucratic way of talking depth, the width, the shape are whether there is abnormal, whether there is to adhere, takes the internal membrane to inspect whether there is the pathology change.
(1) peritoneoscopy: Looks straight ahead the womb and the germ cells outward appearance, the exception congenital growth is unusual, when necessity takes the ovary biopsy.
(3) womb axis oviduct iodine oil radiography: Understood that the palace cavity shape, is whether there is abnormal, the oviduct is whether unobstructed, is an exception tuberculosis.
(4) medicine test check: The progestogen and do the estrogen experiment, whether there is observe the endometrium to respond.
5. ovarian function inspection
(1) vagina mucus crystallization inspection: Understands the estrogen level.
(2) cervix of the uterus mucus crystallization inspection: Whether there is understands the estrogen level and the progestogen influence.
(3) foundation body temperature determination: Understood whether there is to ovulate and the yellow body function.
(4) female progestogen level determination: Understands the ovarian function.
6. pituitary gland functional check
in (1) determination blood PSH, LH content: If is higher than the normal level prompt ovarian function to be low; If is lower than the normal level expression pituitary gland function or the higher main center function is low.
(2) pituitary gland experiments excitedly: After generally medication, 15-30 minutes, before the LH value is higher than the medication 2-4 times, is good for the pituitary gland function, if does not elevate or elevates very little explained that sickness hands over possibly in the pituitary gland.
in (3) blood urges the young element (PRL) determination: If PRL<50ug/ml, should further make PRL. excited or the inhibition test, distinguishes PRL the functionality secretion to increase with the pituitary adenoma.
(4) sella tarcica x piece, bites, inspections and so on nuclear magnetic resonance: Is an exception the pituitary gland tumor.
7. chromosome inspection: The exception growth is unusual.
[treatment]
west 1. medical attention
(1) general treatment: Because to temporary Amenorrhea which the environment change, the mental anguish cause, may through strengthen the nutrition, the enhancement physique, avoids the mental strain and excessively tired and so on adjusts. Causes the Amenorrhea to the oral contraceptive, should stop the medicine observation.
(2) endometrium tuberculosis: Gives the anti-tuberculosis pharmacological treatment.
(3) endocrine treatment: Is suitable in the congenital germ cells maldevelopment, the ovarian function suffers injury, the pituitary gland function to be low, the ovarian function early aging and so on causes the Amenorrhea.
?Estrogen treatment: Uses in the age being light, estrogen level low patient.
?Progestogen treatment: Uses in having the ration estrogen secretion patient.
?Female progestogen treatment: The sequential application estrogen and the progestin, cause the menstruation type withdrawal bleeding.
?Induced ovulation: May select the Chromium phenol, the chorion to press the gonadotrophic hormone, to press the gonadotrophic hormone releasing hormone and so on. To the pituitary gland function insufficiency, after may select HMC (Amenorrhea, presses gonadotrophic hormone), the 75-150u/date, the intermuscular injection, applies drugs 3-5 days later, if the estrogen has not risen, may increase the amount used is the 150-225u/date, if the estrogen rose, may maintain the original quantity or the decrement, is mature to the graafian follicle, generally needs for 7~15 days. Or stops the medicine 1-2 dates after HMG end injection’s gives the chorion to press the gonadotrophic hormone intermuscular injection, 500-1000u/time, continuously 3-4 days. But must use under the ultrasound monitor, prevents to present the ovary to stimulate the syndrome excessively.
(4) surgery treatment
?Bureaucratic way of talking adhering, expands the rich neck, the separation adheres, and lays aside in the palace the birth control by against to adhere again.
?To the ovary, the pituitary gland and the other spot’s tumor feasible surgery treats.
2. Chinese medicine treatment
(1) kidney is mad the insufficiency: The primary stage stops menstruating, or first menstruation evening, after menstruation mistake, the quantity are few, the color pale gloomy nature is thin, to the Amenorrhea, dizziness tinnitus, the waist knee worn out and aching, a night of frequent micturition, morbid leucorrhoea are gradually few, the facial color is gloomy, the tongue substance is pale, liver moss thin Run, the weak pulse thin incapable, the ruler arteries are weak.
Governs the law: Invigorates the kidney the profit essence, transfers to a new post flushes, no matter what.
Fang Yao: Cuscuth japonica, fruit of the Chinese wolfberry, ripe, red and yellow garden raspberry, codonopsis pilosula, first Ukraine, sealwort, Chinese angelica, fruit of the glossy privet each 15 grams, placenta, epimedium macranthum, boschiniakia glabra each 10 grams.
Traditional Chinese medicine: Medicinal herbs pill.
(2) hepatorenal loss: Abortion, miscarriage, long illness or post-natal, reduces gradually after the quantity, the silk thread business postpones, even stops menstruating, a dizziness item of astringence, the waist knee worn out and aching, the annoyed intermittent fever, morbid leucorrhoea quantity are few, the genitals do astringently, then the physique becomes emaciated really, the facial color is chlorosis, flesh Run, the hair does not fall off, the sexual desire is faint, the tongue substance is pale, liver moss thin Bai Huobo yellow, arteries thin incapable.
Governs the law: Nutritious hepatorenal, raises the blood to fill in the essence.
Fang Yao: Ripe, Chinese yam, fruit of the glossy privet, fruit of the Chinese wolfberry, first Ukraine, Chinese angelica, Poris cocos each 15 grams, mountain cornus 12 grams, Eucommia, cuscuth japonica, merinda officinalis each 10 grams.
Traditional Chinese medicine: Woman cocking pill.
(3) vitality is weak: After menstruation gradually extends, gradually reduces after the quantity, the color pale nature is thin, subsequently the luting, the tired asthenia, pants the lazy word, is dizzy vertigo, palpitation losing sleep, the hair acupuncture point used for treating milk insufficiency, the flesh owes Run, the tongue substance is pale, liver moss thin white, the arteries are fragile.
Governs the law: The profit gas raises the blood to regulate menstruation.
Fang Yao: The codonopsis pilosula, roasts the radix astragali, Bai Zhu, the Poris cocos, the Chinese angelica, the root of herbaceous peony, each 15 grams, the aspiration, roasts licorice each 10 grams ripe, the dried orange peel, Gui Xinge 6 grams.
Traditional Chinese medicine: Eight precious ingredients Yin principle along pill, black-boned chicken Bai Fengwan.
(4) stagnation of flow of vital energy blood silt: The silk thread business does not decide successively, the quantity are few, gradually to Amenorrhea, after or violent anger, the amenia is not suddenly good, the sentiment will is despondent, the chest coerces, the breast, the lower abdomen painfully swollen, the tongue substance gloomy or has the ecchymosis silt spot, liver moss thin Bai Huobo yellow, the arteries string is astringent.
Governs the law: Regulates the flow of vital energy the blood circulation, dispels the silt to pass passes through.
Fang Yao: The Chinese angelica, the herbaceous peony, the Achyranthes Bidentata, e the technique, each 15 grams, the peach kernel 12 grams, the safflower, is dried ripe, the vinegar bupleurum chinensis, the platicodon grandiflorum, the rhizome of Ligusticum wallichii, licorice each 10 grams.
Traditional Chinese medicine: Blood government office by silt pill.
(5) phlegm hinders wet: The menstrual period postpones, after the quantity are gradually few, but to luting, god weary tired, the physique is gradually fat, chest wan completely stuffy, the food few phlegm are many, morbid leucorrhoea quantity are many, the color white matter is thick, tongue substance pale fat, liver moss white greasy, the arteries slide.
Governs the law: The dry or wet phlegm reduction, the blood circulation passes passes through.
Fang Yao: Poris cocos, dark green technique, Chinese angelica each 15 grams, the pinellia, the dried orange peel, the fresh licorice, the system attach, south the gallbladder the star, to be dried fragrant, the Divine Comedy, the rhizome of Ligusticum wallichii each Io gram, the ginger 3 pieces.
Traditional Chinese medicine: Two Chen Wan.
[prevention and recuperation]
1. active treatment menstruation later period, volume of menstrual flow few and so on diseases, in order to avoid the condition further develops, causes the Amenorrhea.
2. maintains has ease of mind, avoids the excessively mental strain, reduces the spiritual stimulation.
3. the adjustment diet, nourishing substances and so on attention protein absorb the human, avoids dieting excessively or losing weight, creates malnutrition initiation this sickness.
4. the attention menstrual period and the puerperal period health care, do not ford in spite of the rain, overwork and so on.
