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Amenorrhea in Teenagers in concepts of Homoeopathy

Amenorrhea in Teenagers in concepts of Homoeopathy

© Dr. Rajneesh Kumar Sharma MD (Homoeopathy)

For Well formatted and illustrated article, pl. see attached file.

Amenorrhea in Teenagers in concepts  of Homoeopathy.pdf

Introduction

Menstrual irregularities are common within first 2–3 years after menarche. If amenorrhea is prolonged, it is abnormal and can be associated with some major disease, depending on the adolescent whether she is oestrogen-deficient or oestrogen-replete.

Oestrogen-deficient amenorrhea (Psora) is concomitant with reduced bone mineral density (Syphilis) and increased fracture risk, while oestrogen-replete amenorrhea (Syphilis) can lead to dysfunctional uterine bleeding in the short term (Pseudopsora/ Sycosis) and predispose to endometrial carcinoma (Cancerous) in the long term.

Hypothalamic amenorrhea (Psora) is predominant cause of amenorrhea in the adolescents and often leads to polycystic ovary syndrome (Pseudopsora/ Sycosis). In anorexia nervosa (Psora), exercise-induced amenorrhea (Causa occasionalis) and chronic illness amenorrhea, energy shortage results in suppression of GnRH secretion (Psora) by hypothalamus.

Normal Menstrual Cycle

Menarche

Menarche is the time when a girl has her first menstrual period. It usually occurs between the ages of 10 and 14 years.

Physiology

Stimulation of Pituitary

Neurosecretory neurons of the preoptic area of the hypothalamus secrete a decapeptide, called Gonadotropin-releasing hormone (GnRH). This hormone is poured into the capillaries of the hypophysial portal system which transport it to the anterior pituitary, where it stimulates (Psora) the synthesis and secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Control of GnRH

The GnRH is released in rhythms in response to serum levels of gonadal steroids. Secretion of GnRH is also regulated by a number of neurotransmitters, including dopamine, endogenous opioids, norepinephrine, gamma amino butyric acid (GABA), and corticotropin- releasing hormone (CRH).

During puberty, GnRH rhythm or pulse increases in amplitude and frequency (Psora). Each GnRH pulse is followed by a matching LH pulse. Follicle-stimulating hormone is also secreted in a pulsatile manner, but the FSH peaks may be masked because of the long (3 hours) half-life of FSH.

Negative feedback control

The hypothalamus is specifically sensitive to circulating levels of oestrogen, which inhibit GnRH secretion by the hypothalamus (Psora). This is called negative feedback loop. This negative feedback loop is present since foetus throughout childhood and adolescence.

Positive feedback control

A critical level of oestrogen stimulates pulses of GnRH, which triggers the LH outpouring and ovulation (Psora). This is called positive feedback loop which only develops later in puberty. In the follicular phase of the normal menstrual cycle, rising levels of FSH stimulate the arrival of a dominant ovarian follicle and oestrogen production.

Luteal phase

After ovulation, a corpus luteum is formed, which produces progesterone to organize the endometrium for implantation of a zygote. After around 14 days, if implantation has not occurred, the corpus luteum degenerates and progesterone levels drop down (Syphilis). The endometrium can no longer be sustained and menstrual shedding occurs. The spiral arterioles connecting the functional as well as basal layers of the endometrium are able to clamp down (Sycosis), causing the menstrual bleeding to stop, generally within 7 days.

Oestrogen-deficient amenorrhea

This luteal phase is appropriately constant at 14 ± 2 days. Withdrawal of progesterone from an oestrogen-aware endometrium is necessary for normal menstruation and stoppage of the bleeding punctually. In the absence of adequate oestrogen priming, there is no positive feedback and ovulation does not occur, resulting in oestrogen-deficient amenorrhea (Psora/ Syphilis).

Oestrogen-replete amenorrhea

In the occurrence of suitable oestrogen levels, without ovulation, there is no progesterone withdrawal and amenorrhea occurs. Due to the effect of unconstrained oestrogen on the endometrium, there is risk for dysfunctional uterine bleeding (DUB) (Psora) in the short term and endometrial carcinoma (Cancerous) in the long term.

Hypothalamic-Pituitary-Ovarian Axis

The hypothalamic-pituitary-ovarian (HPO) axis becomes active in the second trimester of pregnancy. Gonadotropin levels are highest at mid gestation and drop at full term because of the negative feedback from placental hormones (Psora).

After birth, there is a mild secondary peak in gonadotropin levels due to withdrawal of placental steroids. At 1–2 years of age, gonadotropins levels remain low until puberty begins. Because they remain suppressed by circulating sex hormones primarily produced by the adrenals and mediated via the negative feedback loop (Psora/ Syphilis).

With age at puberty, the hypothalamus becomes less sensitive to circulating gonadal hormones. Pulses of GnRH increase in amplitude and frequency and are followed by pulses of LH and FSH. Secretion of both LH and FSH is more prominent during sleep. By the beginning of puberty, the amplitude of the pulsatile LH and FSH secretion increases distinctly, particularly during waking. In response to rising LH and FSH levels, the ovary produces oestrogen, which initiates sexual maturation, signalled by breast development called as thelarche.

There is a usual progress of pubertal development in both boys and girls. In girls, menarche usually occurs during Tanner stage 4 of breast development and within two to three years after thelarche. After menarche, the maturation of HPO axis takes about 5–7 years after which it works for the launch of regular menstrual cycles. The intermission from the first menstrual period to the second period can be pretty long, but following cycles usually vary from 21 to 45 days. Some cycles may fall out of this range. During first year after menarche, around 50% of cycles are anovulatory.

Hypothalamic-Pituitary-Ovarian Axis

Types of Amenorrhoea

Amenorrhea is the absence of natural menses in a woman of reproductive age. In adolescents, amenorrhea usually has been divided into primary amenorrhea and secondary amenorrhea.

Primary Amenorrhea

Absence of natural menses in a patient otherwise expected to have regular periods is called primary amenorrhea.

FEMALE GENITALIA/SEX - MENSES – absent Acon. aesc. agar. agn. alet. all-c. aln. Am-c. am-m. ammc. Anac. Ant-c. Apis Apoc. arg-n. Arist-cl. Ars. Ars-i. asar. asar-c. AUR. aur-ar. aur-i. aur-s. aven. Bar-c. Bell. bell-p. benz-ac. berb. Borx. brass-n-o. brom. Bry. Calc. calc-i. calc-p. calc-s. calc-sil. cann-s. canth. carb-v. CARBN-S. card-m. Caul. Caust. Cham. chel. Chin. chinin-ar. chlorpr. cic. cimic. cina Coca Cocc. Coch. colch. Coll. Coloc. CON. cortico. cortiso. croc. crot-t. Cupr. Cupr-act. Cycl. Cypr. dam. dig. dream-p. Dros. DULC. euphr. eupi. FERR. Ferr-ar. FERR-I. Ferr-p. Ferr-r. gast. gels. Glon. goss. GRAPH. Guaj. Ham. hedeo. Hell. helo. helon. hoit. Hyos. hyper. ictod. Ign. indg. Iod. joan. Kali-ar. KALI-C. kali-i. Kali-n. Kali-p. Kali-perm. kali-s. kreos. lac-d. lac-f. Lach. lil-t. linu-c. lob. luf-op. LYC. m-arct. Mag-c. Mag-m. mag-s. mand. mang-act. med. Merc. Merl. mill. Mit. nat-c. Nat-m. nat-p. nat-s. nat-sil. nep. Nux-m. Nux-v. ol-an. Ol-j. op. orot-ac. ovi-p. parth. ph-ac. Phos. Phyt. pin-l. pitu. Plat. plb. podo. Polyg-h. polyg-pe. polyg-xyz. polytr-c. PULS. puls-n. rhod. Rhus-t. rub-t. Sabad. sabin. sang. sanic. sec. SENEC. Seneg. SEP. sieg. SIL. Sin-n. spong. Staph. stram. sul-i. SULPH. syc. symph. tanac. tep. thal-xyz. ther. thiop. Thuj. thyr. TUB. urt-u. ust. Valer. verat. verat-v. vib. wies. wye. x-ray xan. yohim. Zinc. zinc-p.

Secondary Amenorrhea

Absence of natural menses for greater than 3 months’ duration in a patient who has already established regular menstrual cycles is called secondary amenorrhea.

FEMALE GENITALIA/SEX - MENSES - suppressed menses

Abrot. Acon. aeth. Agn. alet. alum. alum-sil. alumn. Am-c. ambr. Anan. Ant-c. Apis apoc. Arg-n. arn. Ars. ars-h. ars-i. art-v. arum-t. Asc-c. aur. aur-ar. aur-i. Aur-m. aur-m-n. aur-s. Bar-c. bar-i. bar-s. BELL. berb. borx. Brom. Bry. bufo cain. Calc. calc-i. Calc-p. calc-s. calc-sil. Camph. Carb-an. carb-v. Carbn-s. card-m. caul. Caust. cean. Cham. chel. Chen-a. chin. chinin-ar. chion. chlol. Cimic. Coc-c. Cocc. coch. cod. coff. Colch. Coll. coloc. CON. Croc. Cupr. CYCL. Dig. dros. DULC. euph. euphr. Ferr. Ferr-ar. FERR-I. Ferr-p. galeoc-c-h. gast. Gels. glon. goss. GRAPH. guaj. hedeo. Hell. helon. hep. Hyos. ign. iod. IP. Kali-ar. KALI-C. Kali-chl. kali-i. Kali-m. Kali-n. kali-p. Kali-s. Kali-sil. Kalm. Kreos. lac-d. LACH. lap-a. leon. Lept. lil-t. lob. LYC. m-arct. macro. Mag-c. Mag-m. mag-s. mang. merc. merc-c. mez. mill. morph. mosch. Nat-m. Nat-s. Nicc. Nit-ac. Nux-m. nux-v. op. ox-ac. ozone Par. pegan-ha. petr. ph-ac. Phos. Phyt. plat. plb. podo. Prun. PULS. Puls-n. Rhod. Rhus-t. ruta Sabad. sabin. sang. sars. sec. semp. SENEC. Sep. SIL. spong. stann. Staph. Stram. stront-c. sul-i. SULPH. symph. Tanac. tax. ther. thuj. tub. uran-met. Uran-n. Ust. Valer. Verat. VERAT-V. visc. xan. Zinc. zinc-p. ziz.

Indications for evaluation of an adolescent with primary amenorrhea in adolescent-

  1. Not having menarche by age 15 years (Psora/ Syphilis)

FEMALE GENITALIA/SEX - MENSES - delayed in girls, first menses Abrom-a. acon. agn. alet. am-c. ant-c. apis Aur. aur-s. Bar-c. bry. Calc. Calc-p. calc-s. Carbn-s. castm. caul. CAUST. chel. cic. cimic. cocc. Con. croc. cupr. dam. dig. dros. dulc. Ferr. GRAPH. guaj. Ham. helon. hyos. KALI-C. Kali-p. kali-perm. lac-d. lach. Lyc. Mag-c. mag-m. Mang. merc. NAT-M. Petr. phos. polyg-h. PULS. sabad. Sabin. sang. sars. SENEC. Sep. sil. spig. staph. stram. stront-c. Sulph. Tub. valer. verat. vib. Zinc.

  1. Not having menarche even more than 3 years since thelarche (Syphilis).

Remedies same as above.

  1. Not having menarche by age 13 years and no secondary sexual development (Syphilis)

FEMALE GENITALIA/SEX - MENSES - delayed in girls, first menses - mammae, with undeveloped lyc.

  1. Not having menarche by age 14 years and-
    1. there is a suspicion of an eating disorder or excessive  exercise, or (Psora)
    2. there are signs of hirsutism, or (Sycosis)
    3. there is suspicion of genital outflow obstruction showing high possibility of a chromosomal or structural abnormality. (Syphilis)

Aetiology of Amenorrhea

Hypothalamic Causes of Amenorrhea

It is the most prevalent cause of amenorrhea in the adolescent age. Patients with hypothalamic amenorrhea have low LH, FSH, and oestrogen levels with preserved LH and FSH responsiveness to GnRH. It may be due to eating disorders, excessive exercise, medications, and psychosocial stress. (Psora)

Note- Leptin, a protein produced by the adipocytes, acts on the hypothalamus to regulate food consumption, energy disbursement, and body weight, the process called as energy homeostasis.

Eating Disorders

Amenorrhea is one of the features necessary for the diagnosis of anorexia nervosa. But dietary limitation, even with a normal body weight, can lead to hypothalamic amenorrhea. This is due to a disturbance in the neurotransmitter regulation of pulsatile GnRH release (Psora). Levels of LH, FSH, and oestradiol are low, pulsatile secretion of LH returns to a prepubertal pattern, and the uterus and ovaries shrink in size (Psora).

Low body weight, extreme exercise, stress-induced activation of the hypothalamic-pituitary-adrenal axis and caloric restriction with a negative energy balance contribute to this condition. (Causa occasionalis)

Hormonal and Other Changes in Patients with Hypothalamic Amenorrhea

AMENORHHOEA WITH ANOREXIA NERVOSA nat- m. puls. aur. calc. kali-p. sep.  sulph. tub. lach. merc. phos. sil. staph. verat.

In bulimia nervosa, patients are usually of normal weight and generally have regular menses.

AMENORHHOEA WITH BULIMIA NERVOSA lyc. sep.

Exercise-Induced Amenorrhea

Exercise-induced amenorrhea or female athlete triad results from suppression of the GnRH pulsatility leading to hypoestrogenism. (Causa occasionalis)

FEMALE GENITALIA/SEX - MENSES - absent - strain, after psychical and physical hypoth.

Medication-Induced Amenorrhea

Most antipsychotic drugs block pituitary dopamine D2 receptors, thus removing the inhibitory effect of dopamine on prolactin secretion by the pituitary. This leads Prolactin levels to increase considerably (Causa occasionalis). High prolactin concentrations act in three ways by-

1-     Inhibiting the HPO axis by suppressing pulsatile GnRH release (Psora)

2-     Inhibiting the effect of GnRH on the pituitary, and (Psora)

3-     Blocking the positive feedback effect of oestradiol on the hypothalamus. (Psora)

Methyldopa and Metochlopramide may also cause hyperprolactinemia and amenorrhea. SSRIs, tricyclics and monoamine oxidase inhibitors may also increase prolactin levels. (Causa occasionalis).

HYPERPROLACTENEMIA puls. tub. calc. lyc. merc. sabin. bry. phos.

Stress-Induced Amenorrhea

Physical and psychosocial stress disturbs homeostasis and forwards energy and other resources away from nonessential functions, such as reproduction to the central nervous system and cardiovascular systems (Psora/ Sycosis). This adaptive reply results in better alertness and arousal with increased pulse, blood pressure, and respiratory rate (Psora/ Sycosis). There is activation of the hypothalamic-pituitary-adrenal axis, with increased secretion of corticotropin-releasing hormone (CRH), and stimulation of the sympathetic nervous system, with release of epinephrine and norepinephrine (Psora/ Sycosis).

CRH and endogenous opioids directly inhibit GnRH release by the hypothalamus. In addition, glucocorticoids inhibit pituitary LH secretion as well as ovarian oestrogen and progesterone production. Stress-induced inhibitory effects on the HPO axis are responsible for the amenorrhea associated with depression, eating disorders, and excessive exercise.

FEMALE GENITALIA/SEX - MENSES - absent - strain, after psychical and physical hypoth.

Effect of Stress in Amenorrhea

 

Chronic Illness

Chronic illness can cause pubertal delay and amenorrhoea in many ways (Psora/ Syphilis). Since chronic illnesses may affect nutritional, behavioural, metabolic, and hormonal balance, different causes of the amenorrhea may be.

Kallmann Syndrome

The association of isolated hypogonadotropic hypogonadism (Syphilis) and anosmia (Psora/ Syphilis), a genetic disorder caused by one or more mutations of the KAL gene, is called Kallmann Syndrome.

The olfactory and GnRH neurons have a common origin outside the central nervous system in olfactory placode area. The GnRH neurons subsequently migrate from this region to their final destination in the preoptic area of the hypothalamus. In Kallmann syndrome, there is a defect in the process of migration of the olfactory and GnRH neurons (Psora/ Sycosis). Girls with Kallmann syndrome are not recognized till adolescence, when they present with failure of sexual development and primary amenorrhea.

KALLMANN SYNDROME con. iod. phos.

Pituitary Causes of Amenorrhea

Hyperprolactinemia

Hyperprolactinemia (Psora/ Sycosis) may cause amenorrhea. It effects on menstrual cycle via effect on the pulsatility of GnRH.

There are several causes of hyperprolactinemia-

Physiological states- pregnancy and lactation. (Maintaining Cause)

Drugs- clozapine, olanzapine, quetiapine, ziprasidone, zotepine etc. (Artificial chronic disease)

Endocrinopathies- primary hypothyroidism and PCOS. (Syphilis/ Sycosis)

Systemic diseases- systemic lupus erythematosus, rheumatoid arthritis and chronic renal failure. (Psora/ Sycosis/ Syphilis)

Tumors- Prolactinoma of the pituitary gland, as well as tumours of other organs can cause hyperprolactinemia. Prolactinomas result in oestrogen-deficient state via the inhibitory action of elevated prolactin levels on GnRH pulsatility and a subsequent decrease in pituitary release of LH and FSH. (Psora/ Sycosis/ Syphilis)

Isolated Gonadotropin Deficiency- Congenital isolated gonadotropin deficiency is defined by complete or partial absence of GnRH-induced gonadotropin secretion, normal anatomy of the hypothalamus and pituitary, normal baseline functioning of the remaining HP axis, and a normal sense of smell. (Syphilis)

When problems with olfactory function are present, this disorder is referred to as Kallman syndrome.

Craniopharyngioma- These are epithelial tumours arising from the craniopharyngeal duct in the sellar or parasellar region. They have uncertain pathogenesis, and present various symptoms including endocrine, visual, behavioural, and cognitive. Hormonal disturbance is predominant, and a deficit of LH/FSH is often seen. (Psora/ Sycosis/ Syphilis)

HYPERPROLACTINEMIA puls. tub. calc. lyc. merc. sabin. bry. phos.

Hormonal and Other Causes in Patients with Hyperprolactin Amenorrhea

Thyroid Causes of Amenorrhea

Hypothyroidism

Thryoid syndrome is more prevalent in females and often presents in adolescence. Rate of hypermenorrhea or oligomenorrhea is more but amenorrhea can also be seen. It may be due to the effect of TSH-releasing hormone on prolactin levels. This releasing hormone acts on the thyrotrophs to release TSH and on lactotrophs to release prolactin. Due to the increased levels of TSH-releasing hormone as in hypothyroidism, increased levels of prolactin are established, resulting in functional hyperprolactinemia (Psora).

Hypothyroidism- alum. am-br. ange-s. arg-n. bacls-7. calc. calc-i. calc-met. Calc-sil. carc. con. cortico. cortiso. gels. graph. hist. hypoth. Iod. kali-c. kali-i. levo. Lith-met. lith-p. lith-s. luf-op. lyc. merc. Nat-m. nux-v. penic. psor. rib-ac. sep. thala. thiop. Thyr.

Hyperthryoidism

The amenorrhea may be due to combination of hormonal abnormalities, nutritional deficiencies, and emotional stress caused by hyperthyroidism (Psora/ Causa occasionalis).

Hyperthyroidism results in increased levels of sex hormone-binding globulins, which may cause increased level of plasma oestrogen and circulating androgens, which in turn, may cause amenorrhoea (Psora/ Sycosis).

Hyperthyroidism- bell. coli. con. dys. ferr-i. Iod. kali-i. lach. lycps-v. nat-m. penic. spig. spong. thyr. thyreotr. v-a-b.

Thyroid causes of Amenorrhea

Adrenal Causes of Amenorrhea

Congenital Adrenal Hyperplasia

Congenital adrenal hyperplasia is a group of autosomal recessive disorders of steroidogenesis, characterized by a number of enzyme deficiencies, but mainly deficiency of 21-hydroxylase, which catalyses the conversion of progesterone to deoxycorticosterone and 17-OH progesterone to 11-deoxycortisol (Syphilis). In this condition, there is interruption in the pathway leading to synthesis of mineralocorticoids and glucocorticoids (Psora/ Syphilis). Consequently, progesterone, 17-OH progesterone, and its precursors are pushed away to androgen pathway (Sycosis). Hypothalamic secretion of CRH increases to compensate the effects of this block. Consequently, ACTH secretion is increased, additionally increasing the androgen synthesis (Sycosis).

Classical Congenital Adrenal Hyperplasia-

If enzyme deficiency is complete, it is called classical (Syphilis). It typically presents in infancy with salt wasting or ambiguous genitalia (Psora/ Syphilis).

Nonclassical Congenital Adrenal Hyperplasia-

If enzyme deficiency is partial, it is called nonclassical and is frequently seen (Psora/ Syphilis). It generally presents in childhood and is characterized by premature pubarche and in adolescence by hirsutism or amenorrhea (Psora/ Syphilis).

ADRENAL COMPLAINTS allox. adren. thall-m. p-benzq.

Cushing Syndrome

It is caused by high circulating levels of cortisol. The pathophysiology is by direct suppression of the HPO axis (Psora/ Sycosis). In adolescents, it may be due to-

  • Iatrogenic exogenous administration of corticosteroids (Artificial Chronic disease)
  • Hypersecretion of corticotropin by a microadenoma of the anterior pituitary (Cushing Disease) (Cancerous)
  • Secretion of corticotropin by an adrenal tumor (Cancerous)
  • Ectopic production of corticotropin by a nonpituitary tumor such as carcinoma of the lung (Cancerous).

GENERALS - CUSHING's syndrome cortico. cortiso.

 

Ovarian Causes of Amenorrhea

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by hyperandrogenism chronic oligo or anovulation, and polycystic ovaries (Psora/ Sycosis/ Syphilis).

The cause of PCOS is uncertain, but it may be due to combination of defects in insulin resistance and ovarian and/or adrenal hypersensitivity (Syphilis). The characteristic metabolic feature is insulin resistance and hyperinsulinemia, independent of obesity (Sycosis). The insulin resistance seems to be tissue-selective (Psora). The adrenal and ovary remain highly insulin-sensitive, whereas skeletal muscle is resistant. Via various ways, hyperinsulinemia stimulates increased androgen production (Psora). It directly activates ovarian insulin receptors to cause activation of the P450c17 enzyme, which activates IGF-1 receptors (Psora). Elevated insulin levels reduce the circulating levels of sex hormone binding globulin (SHBG). SHBG increases the levels of circulating free testosterone. The long term results of this insulin derangement include dyslipidemia, glucose intolerance, and central adiposity, which can increase the risk of premature cardiovascular disease (Psora/ Sycosis).

Characteristic hormonal findings in PCOS include high free testosterone, normal or low total testosterone, and elevated levels of DHEAS, androstenedione, LH, and the LH/FSH ratio (Psora/ Sycosis). The elevated androgen levels are secondary to defects in ovarian and/or adrenal steroidogenesis (Syphilis).

At the level of the ovary, there is an increased response in 17-OHP to GnRH analogue stimulation. There is ovarian hypersensitivity of cytochrome P450c17, which leads to the biosynthesis of androgens (Psora).

At the level of the adrenal gland, there is an exaggerated steroid response with corticotropin analogue stimulation that results in amplified production of 17-OHP and androstenedione (Psora).

The typical inhibitory feedback of oestrogen and progesterone on the hypothalamus is interrupted, by increased levels of androgens. The result is an increase in GnRH pulsatility, which leads to excessive LH secretion and the abnormal LH/FSH ratio (Psora/ Sycosis).

FEMALE GENITALIA/SEX - TUMORS - Ovaries – cysts am-c. am-i. am-m. Apis apoc. arg-met. arg-n. arn. ars. aur. aur-i. Aur-m-n. bar-c. bar-i. bell. Bov. brom. bry. Bufo calc. calc-f. calc-i. calc-s. canth. carb-an. carc. chin. Coloc. con. ferr-i. foll. form. graph. Iod. kali-bi. Kali-br. kali-c. lac-c. Lach. lil-t. lyc. mag-i. mag-m. med. merc. murx. naja nat-m. nit-ac. Oncor-t. ov. Pall. Phos. Plat. podo. prun. puls. rhod. Rhus-t. sabin. sec. sep. sil. staph. sulph. syc. syph. ter. thuj. zinc.

Gonadal Dysgenesis

It refers to a number of disorders in which gonadal development is abnormal, leading to streak gonads (Syphilis). Oestrogen levels are low and LH and FSH levels are markedly high. The most common type is Turner syndrome (45, X karyotype), others being pure gonadal dysgenesis (where the karyotype is normal) and Swyer syndrome (XY gonadal dysgenesis) (Psora/ Syphilis).

In addition to delayed puberty and primary amenorrhea, other clinical features include short stature, webbed neck, low hairline, widely spaced nipples, cubitus valgus, cardiac anomalies (coarctation of the aorta), and a horseshoe kidney (Syphilis).

FEMALE GENITALIA/SEX - INFANTILISM; genital bar-c. calc-hp. calc-p. chim. con. ferr. helon. iod. Ov. phos. senec.

Premature Ovarian Failure

Premature ovarian failure (premature ovarian insufficiency) can occur at any age and is characterized by elevated gonadotropins in the presence of oestrogen deficiency (Psora/Syphilis).

Its main causes are autoimmune oophoritis, mumps oophoritis, chemotherapy, radiation, galactosemia, Trisomy 21, female fragile X carriers, and sarcoidosis. (Psora/ Sycosis/ Syphilis)

In galactosemia, galactose or galactose-1-phosphate may be toxic to the ovary since the neonatal period through adulthood, leading to ovarian atrophy or failure (Psora/ Syphilis). Autoimune oophoritis may supplement autoimmune conditions such as thyroiditis, Addison’s disease, hypoparathyroidism, diabetes mellitus, myasthenia gravis, and vitiligo (Psora/ Syphilis).

FEMALE GENITALIA/SEX - ATROPHY – Ovaries apis bar-c. Bar-m. Carbn-s. Con. helon. IOD. orch. ov. plb. x-ray

Uterine Causes of Amenorrhea

Androgen Insensitivity (Testicular Feminization Syndrome)

Androgen insensitivity is rare disorder, caused by an X-linked recessive inheritance of a single gene (Psora/ Syphilis). It is most commonly due to a complete defect in the binding of androgens at androgen receptor sites (Syphilis). Testosterone levels are normal. Patients appear phenotypically female in their external habitus, but have XY chromosomal pattern. Characteristically, there is normal breast development, minimal axillary and pubic hair, a short vagina, absent uterus and cervix. Testes are present, but are cryptorchid, without spermatogenesis (Psora). Androgen insensitivity is often diagnosed in adolescence, when there is primary amenorrhea.

FEMALE GENITALIA/SEX – STERILITY agn. Alet. alum. Am-c. anag. anan. apis apoc. arg-n. ars. AUR. Aur-i. aur-m. aur-m-n. Bamb-a. bar-c. Bar-m. bers-l. BORX. bov. brom. Calad. Calc. calc-i. cann-i. cann-s. Canth. caps. carbn-s. carc. Caul. caust. chlam-tr. cic. cissu-c. cocc. Coff. Con. Croc. dam. dros. dulc. erios-co. Eup-pur. Ferr. Ferr-p. Fil. form. Goss. Graph. grew-oc. gunn-p. helo. helon. Hyos. ign. Iod. Kali-bi. Kali-br. kali-c. Kreos. Lach. lappa lec. lil-t. mand. med. Merc. mill. mit. morph. NAT-C. NAT-M. nat-p. Nux-m. nux-v. Oncor-t. Orig. Ov. Phos. physala-p. phyt. pitu-a. pitu-gl. Plat. plb. Puls. pyren-sc. retin-ac. roye-l. rub-c. ruta Sabal Sabin. sec. Senec. SEP. Sil. sol-so. Sul-ac. sulph. Syph. tarent. ther. trium-r. vern-co. vib. wies. x-ray Zinc.

Uterine Adhesions (Asherman Syndrome)

Asherman syndrome is the presence of intrauterine synechiae or scarring, classically from a previous infection or from a curettage procedure following a postpartum or post-abortal endometritis (Psora/ Syphilis). In addition to amenorrhea, there are recurrent abortions or infertility.

FEMALE GENITALIA/SEX - INJURIES - operation; ailments from glycyr-g.

M¨ullerian Agenesis

It is congenital malformation of the genital tract, resulting in absence of the vagina, abnormal or absent uterus, and normal ovaries (Syphilis). In addition, skeletal, ear, and renal deformities may be present (Syphilis). The syndrome, called Mayer–Rokitansky–Kuster–Hauser syndrome, is the second most common cause of primary amenorrhea. Patients with M¨ullerian agenesis have normal secondary sexual characteristics and ovarian function, but have primary amenorrhea (Psora).

M¨ullerian agenesis may be due to the activation of anti-M¨ullerian hormone or the anti-M¨ullerian hormone receptor through a genetic mutation (Syphilis), which results in increased secretion of the hormone or the receptor, acting on the developing female foetus, to cause regression of the M¨ullerian duct.

GENERALS - DISABLED – congenital syph.

Cervical Agenesis

In amenorrhoea, rarely, isolated cervical agenesis with a normal uterus can be found (Psora/ Syphilis). There may be cyclic abdominal pain, and a distended uterus on examination (Sycosis). Due to obstruction of the outflow outlet, hematosalpinx and endometriosis are common (Psora/ Sycosis/ Syphilis).

GENERALS - DISABLED – congenital syph.

Vaginal Causes of Amenorrhea

Imperforate Hymen

It may be seen in childhood, but may also be missed and may present in adolescence with cyclic abdominal pain and primary amenorrhea. Typically, there is bulging, bluish hymen, behind which there is a blood-filled mass in the distended vagina, the condition called as hematocolpos (Psora/ Sycosis).

Transverse Vaginal Septum

It is due to incomplete fusion of the M¨ullerian duct portion of the vagina and the urogential sinus component (Syphilis). The thickness and placement of the septum may vary at lower vagina, middle vagina, or upper vagina but the external genitals are normal. A perforation in the septum is frequently present, but patients may still have amenorrhea and hematocolpos. Other malformations of the urological tract or rectum may be associated.

GENERALS - DISABLED – congenital syph.

Vaginal Agenesis—Isolated

Vaginal agenesis is classically associated with uterine agenesis (Psora/ Syphilis). Isolated vaginal agenesis with a normal uterus is rare.

GENERALS - DISABLED – congenital syph.

Clinical Evaluation

The efforts are made to diagnose primary or secondary amenorrhea. Then to see whether patient is oestrogen-deficient (Psora) or oestrogen replete (Syphilis).

Both for primary and for secondary amenorrhea, main is the history and physical examination, along with some basic tests to rule out pregnancy, thyroid disease or hyperprolactinemia. For high PRL levels, an MRI should be done to rule out prolactinoma. The case history should include the age at thelarche, the age at which the patient’s mother had menarche, whether or not the patient is sexually active, and any medications continued. Specific information should be acquired regarding weight loss, dieting, and exercise.

Primary amenorrhoea

Pubertal development and possible genital outflow obstruction must be evaluated in primary amenorrhoea. Any cause of secondary amenorrhea can also cause primary amenorrhea. Any major discrepancy in Tanner staging of the breast and pubic hair development should arouse suspicion of a chromosomal abnormality such as androgen insensitivity (46, XY) or Turner syndrome (45, X). Examination of external genitalia should be performed to assess the patency of the hymen. A rectoabdominal examination can be performed to rule out any pelvic mass. A pelvic ultrasound must be done to see presence of uterus and rule out any obstructive lesion.

Secondary amenorrhoea

The physical examination should include signs of hyperandrogenism and insulin resistance as well as evidence of weight loss. Height and weight should be accurately measured and BMI calculated. The presence of hyperandrogenism may show PCOS or congenital adrenal hyperplasia. Bimanual vaginal examination or a rectoabdominal examination may be done. Whether or not the

Progestin challenge test can be done. After administration of a 7-day course of Progestin, menstrual bleeding within a few days of discontinuing the medication indicates oestrogen sufficiency. If there is no response to the progestin challenge test, the patient is oestrogen-deficient.

LH, FSH and oestradiol levels even in the face of a positive response to the progestin challenge test must be done.

Prognosis of Amenorrhea in Adolescents

In oestrogen-replete prolonged amenorrhea secondary to an ovulation, hyperplasia of the endometrium occurs. Under the influence of uncontrolled oestrogen stimulation, the endometrium becomes thick; blood supply outgrows and begins to slough off irregularly, leading to dysfunctional uterine bleeding (DUB). The menstrual bleeding is characteristically painless.

In the oestrogen-deficient adolescent, main problem is morbidity is reduction in bone mineral density and increased risk of fracture. The adolescent years are critical for growth of bone mass and any condition interfering with this process can result in failure to achieve peak bone mass, predisposing to a life-long increased risk of fractures.

In anorexia nervosa, severe reduction in bone mass occurs shortly after illness.

Exercise-induced amenorrhea also causes reduction in bone mass and increased fracture risk.

Homoeopathic Treatment

Repertory of Amenorrhoea/ oligomenorrhoea

ABDOMEN - DISTENSION - general - tympanitic - menses, with absent aral.

ABDOMEN - DISTENSION - painful - accompanied by - menses; absent castm.

ABDOMEN - DISTENSION - tympanitic - menses, with absent aral.

ABDOMEN - PAIN - Hypogastrium - menses - scanty - pressing pain asc-c.

ABDOMEN - PAIN - Hypogastrium - menses – scanty asc-c.

Absent minded, absorbed, buried in thought - menses, during mur-ac.

Asthma; bronchial - menses - absent, with spong.

Asthma; bronchial - menses - scanty, with arg-n.

BACK - Aggravation - menses - delayed – absent Senec.

BACK - MENSES - absent agg. senec.

BACK - PAIN - lumbar region, lumbago - night - right, with scanty menses aqui.

BACK - PAIN - pressing - lumbar region - night, increasing, right, with scanty menses aqui.

BACK - PAIN - Sacral region - menses - scanty - pressing pain asc-c.

BACK - PAIN - Sacral region - menses – scanty asc-c.

Bones - SORE, pain - menses, during scanty carb-v.

Breasts - BREAST-milk, general - menses, during - absent, with bell. bry. calc. lyc. phos. puls. rhus-t. sabin. stram.

Breasts - BREAST-milk, general - scanty - metritis, in, from suppression of menses, or getting feet wet PULS.

Breasts - INDURATION, breasts - menses, during - absent, with dulc.

Breasts - SORE, pain - menses, during - absent, with dulc. zinc.

CHEST - CANCER - Mammae - scirrhus - accompanied by - menses; absent brom.

CHEST - INDURATION - mammae - menses - absent, with dulc.

CHEST - INFLAMMATION - Heart - Endocardium - scanty menses, with nat-m.

CHEST - MILK - menses – absent bell. bry. calc. lyc. phos. puls. rhus-t. sabin. stram.

CHEST - MILK - menses - absent, with bell. bry. calc. lyc. phos. puls. rhus-t. sabin. stram.

CHEST - PAIN - sore, bruised - mammae - menses - absent, with dulc. zinc.

CHEST - PALPITATION of heart - accompanied by - menses – absent ars-i.

Chorea - menses - absent or difficult, with Puls.

Clinical - chorea, general - menses, during - absent or difficult puls.

Clinical - endocarditis, heart, inflammation - menses, with scanty nat-m.

Conjunctiva - inflamed - menses absent, with euphr.

Constitutions - WOMEN, constitutions - menses, scanty ferr. ign. kali-br. Kali-i. Puls.

Constitutions - WOMEN, constitutions - plethoric, strong, menses painful and slight or even absent, with lumbar or inguinal pains Petr.

Constitutions - WOMEN, constitutions - plethoric, strong, menses painful and slight or even absent, with lumbar or inguinal pains - menstrual colic Verat-v.

Constitutions - WOMEN, constitutions - plethoric, strong, menses painful and slight or even absent, with lumbar or inguinal pains - young, suffered for years from headaches Asar.

COUGH - Excited or aggravated by - menses - absence of senec. cupr.

Epilepsy - menses - absent, with puls.

Epistaxis - menses - absent, with apis bry. carb-an. cham. dulc. ferr. Lach. lyc. phos. Puls. senec. sil.

Eruptions; tendency to - acne - menses - scanty, with sang.

Eruptions; tendency to - pimples - red, small, menses scanty, with con.

EXTREMITIES - PAIN - menses - during - agg. - scanty menses – sore carb-v.

EXTREMITIES - PAIN - menses - during - agg. - scanty menses carb-v.

EXTREMITIES - PAIN - menses - scanty, with carb-v.

EXTREMITIES - PAIN - sore, bruised - menses - during – scanty carb-v.

EXTREMITIES - PAIN - sore,bruised - menses, - during - scanty menses carb-v.

EXTREMITY PAIN - SORE, bruised - menses – scanty carb-v.

EYE - CATARACT - accompanied by - menses; absent lyc.

EYE - CATARACT, opacity of lens - menses, with absent lyc.

EYE - INFLAMMATION - Conjunctiva - accompanied by - menses; absent euphr.

EYE - INFLAMMATION - Conjunctiva - menses; with absent uphr.

EYE - INFLAMMATION - conjunctivae - menses, with absent euph.

EYE - INFLAMMATION - menses - absent, with euph.

EYES - CATARACT, opacity of lens - menses, with absent lyc.

Eyes - CONJUNCTIVITIS, infection - menses, with absent euph.

EYES - INFLAMMATION - conjunctivae, conjunctivitis - menses, with absent euph.

EYES - INFLAMMATION - menses - absent, with euph.

Eyes - INFLAMMATION, eyes - menses, during - absent, with euph.

FACE - DISCOLORATION - pale - menses – absent lob.

FACE - ERUPTIONS - acne - menses - during - agg. – scanty sang.

FACE - ERUPTIONS - acne - menses - during – scanty sang.

FACE - ERUPTIONS - General - women, in young, especially during scanty menses sang.

FACE - ERUPTIONS - women, in young, especially during scanty menses sang.

FACE - PAIN - General, aching, prosopalgia - menses - scanty, with caust. lob. mez.

FACE - PAIN - menses - scanty, with caust. lob. mez.

Face - pain, neuralgia, prosopalgia, aching - menses, scanty, with caust. lob. mez.

Face - pale and hot - menses - absent, with lob.

Face - PALE, face - menses, during - absent, with lob.

Female - AMENORRHEA, menses, absent - girls, in young Ign. x-ray

Female - AMENORRHEA, menses, absent - milk, in breasts, with puls. Rhus-t.

Female - AMENORRHEA, menses, absent - molimen, only Ant-c. Calc. Con. Cur.

Female - AMENORRHEA, menses, absent - sexual, desire absent Helon. Sep.

Female - AMENORRHEA, menses, absent - strain, after psychical and physical hypoth. ign.

Female - AMENORRHEA, menses, absent - women, in – feeble Ars. IGN. SEP.

Female - AMENORRHEA, menses, absent - women, in – hysterical cypr. ign. sil.

Female - AMENORRHEA, menses, absent - women, in – plethoric CALC. petros.

Female - AMENORRHEA, menses, absent - women, in – psoric psor. sulph.

Female - AMENORRHEA, menses, absent - women, in – scrofulous bar-c. sulph.

Female - AMENORRHEA, menses, absent - women, in Ars. bar-c. Calc. cypr. Ign.

petros. psor. Puls. SEP. sil. sulph.

Female - AMENORRHEA, menses, absent Acon. aesc. agar. agn. alet. all-c. aln. Am-c. am-m. ammc. Anac. Ant-c. Apis Apoc. arg-n. Arist-cl. Ars-i. Ars. asar. aur-i. AUR. aven. Bar-c. bell-p. Bell. benz-ac. berb. Borx. brom. Bry. calc-i. calc-p. calc-s. calc-sil. Calc. cann-s. canth. carb-v. CARBN-S. card-m. Caul. Caust. Cham. chel. Chin. chinin-ar. chlorpr. cic. Cimic. cina Coca Cocc. Coch. colch. Coll. Coloc. CON. cortico. cortiso. croc. crot-t. Cupr. Cycl. Cypr. dam. dig. Dros. DULC. euph. eupi. Ferr-ar. FERR-I. Ferr-m. Ferr-p. FERR. gast. gels. Glon. Goss. GRAPH. Guaj. Ham. hedeo. Hell. Helon. Hyos. hyper. ictod. IGN. indg. Iod. Kali-ar. KALI-C. kali-i. Kali-n. Kali-p. Kali-perm. kali-s. kreos. lac-d. Lach. lil-t. linu-c. lob. LYC. Mag-c. Mag-m. mag-s. mand. mang. Merc. Merl. mill. Mit. nat-c. Nat-m. nat-p. nat-s. nat-sil. nep. Nux-m. Nux-v. ol-an. Ol-j. op. ovi-p. parth. ph-ac. Phos. Phyt. pin-l. pituin. Plat. plb. podo. Polyg-h. PULS. Rhus-t. Sabad. sabin. sang. sanic. sec. SENEC. SEP. sieg. SIL. Sin-n. spong. Staph. stram. sul-i. SULPH. symph. tanac. tep. thiop. Thuj. thyr. TUB. urt-u. ust. Valer. verat-v. verat. Vib. wies. wye. x-ray xan. zinc-p. Zinc.

Female - BLEEDING, uterus, metrorrhagia - scanty – repeated cinnm.

Female - BLEEDING, uterus, metrorrhagia - scanty - running, riding a bicycle or jumping rope, from pitu-a.

Female - BLEEDING, uterus, metrorrhagia – scanty carb-v. caul. cinnm. coc-c. cocc. lyss. nux-v. phos. pitu-a. thuj. ust.

Female - CRAMPING, pain, genitalia - uterus - menses, during - absent, with caul. cimic.

Female - DYSMENORRHEA, painful menses - flow, agg., the more the flow, the more the pain - absence of pain, flows only in the Cocc. mag-c. plb.

Female - DYSMENORRHEA, painful menses - flow, amel. - scanty flow, with caul. gnaph. graph.

FEMALE - LEUCORRHEA - General - menses - during – scanty calc-p. Caust. Mez.

FEMALE - LEUCORRHEA - menses - during – scanty calc-p. CAUST. MEZ.

FEMALE - MENSES - absent, amenorrhea – afternoon mag-c.

FEMALE - MENSES - absent, amenorrhea - anemia, with goss. kronth. rub-t. xan.

FEMALE - MENSES - absent, amenorrhea – atonic eup-per. hedeo. helon.

FEMALE - MENSES - absent, amenorrhea - bathing, after cold ant-c.

FEMALE - MENSES - absent, amenorrhea - brain complaints, with HELL.

FEMALE - MENSES - absent, amenorrhea - chilliness, with puls-n.

FEMALE - MENSES - absent, amenorrhea - climacteric period, in arist-cl. puls. sep.

FEMALE - MENSES - absent, amenorrhea - colds, after aral. arist-cl. bell-p. caj. cimic. hedeo. ol-j. senec.

FEMALE - MENSES - absent, amenorrhea - colic, with aral.

FEMALE - MENSES - absent, amenorrhea - confinement in prison, camps, travel, flight, due to arist-cl.

FEMALE - MENSES - absent, amenorrhea – congestive coll. helon.

FEMALE - MENSES - absent, amenorrhea - cough, with senec.

FEMALE - MENSES - absent, amenorrhea - delivery, parturition, after chlorpr.

FEMALE - MENSES - absent, amenorrhea - distension of abdomen, with apoc.

FEMALE - MENSES - absent, amenorrhea - dropsy, with asc-c. senec. xan.

FEMALE - MENSES - absent, amenorrhea - exertion, after mental and physical hypoth.

FEMALE - MENSES - absent, amenorrhea - exertion, from, with constipation cann-s.

FEMALE - MENSES - absent, amenorrhea - fear, fright, from acon. CALC. CYCL. lyc. OP. plat. puls. RHUS-T.

FEMALE - MENSES - absent, amenorrhea - fever, during lob.

FEMALE - MENSES - absent, amenorrhea - girls, in young - backache, with senec.

FEMALE - MENSES - absent, amenorrhea - girls, in young apoc. cortico. cortiso. hell. nep. podo. polyg-h. senec. thala. wildb. x-ray

FEMALE - MENSES - absent, amenorrhea - gout, in bry.

FEMALE - MENSES - absent, amenorrhea - grief, from ign. nat-m. sep.

FEMALE - MENSES - absent, amenorrhea - indigestion, with goss. puls-n.

FEMALE - MENSES - absent, amenorrhea - liver complaints, with chel.

FEMALE - MENSES - absent, amenorrhea - love disappointment, from HELL.

FEMALE - MENSES - absent, amenorrhea - lungs, with complaints of lob. ol-j. sang.

FEMALE - MENSES - absent, amenorrhea - mental exertion, after hypoth.

FEMALE - MENSES - absent, amenorrhea - milk in mammae, with Rhus-t.

FEMALE - MENSES - absent, amenorrhea - molimen only ANT-C. CALC. CON. CUR. senec.

FEMALE - MENSES - absent, amenorrhea – nervous valer.

FEMALE - MENSES - absent, amenorrhea - operation, after abdominal canis-exc.

FEMALE - MENSES - absent, amenorrhea - ovaries, from atrophy of plb-i.

FEMALE  -  MENSES  -   absent,  amenorrhea  -   physical   exertion,  from,  with constipation cann-s.

FEMALE - MENSES - absent, amenorrhea - pregnancy, since

FEMALE - MENSES - absent, amenorrhea - pregnancy, since wye.

FEMALE - MENSES - absent, amenorrhea - scarlatina, after bac. 

FEMALE - MENSES - absent, amenorrhea - sexual desire absent HELON.

FEMALE - MENSES - absent, amenorrhea - swelling of legs, with apoc.

FEMALE - MENSES - absent, amenorrhea - tuberculosis, in bac. lob. ol-j.

FEMALE - MENSES - absent, amenorrhea - weakness, with general parth.

FEMALE - MENSES - absent, amenorrhea - weaning, after sep.

FEMALE - MENSES - absent, amenorrhea - women, in – feeble ARS. SEP.

FEMALE - MENSES - absent, amenorrhea - women, in – hysteric CYPR. SIL.

FEMALE - MENSES - absent, amenorrhea - women, in – nervous ars. ter.

FEMALE - MENSES - absent, amenorrhea - women, in – plethoric CALC. PETROS.

FEMALE - MENSES - absent, amenorrhea - women, in – psoric PSOR.

FEMALE - MENSES - absent, amenorrhea - women, in – scrofulous BAR-C. sulph.

FEMALE - MENSES - absent, amenorrhea abrot. ACON. aesc. agar. agn. alet. all-c. aln. aloe alum. am-br. AM-C. am-m. ammc. ANAC. anet-g. ANT-C. ap-g. APIS APOC. aral. arg-n. ARGE-PL. ARIST-CL. arn. ARS-I. ARS. ART-V. arum-t. asar-c. asar. asc-c. asc-i. ASC-T. aur-ar. aur-i. aur-m-n. aur-s. aur. aven. bac. BAR-C. bell-p. BELL. benz-ac. berb. BORX. brom. BRY. caj. calc-i. calc-o-t. calc-p. calc-s. calc-sil. CALC. canis-exc. cann-s. canth. carb-v. CARBN-S. card-b. card-m. caru. CAUL. CAUST. CHAM. cheir. chel. CHIN. chinin-ar. chlorpr. cic. CIMIC. cina cinnm. cob-n. COCA COCC. COCH. colch. COLL. COLOC. CON. cortico. cortiso. CROC. crot-t. CUPR. cur. CYCL. CYPR. dam. dict. dig. DROS. DULC. elat. ery-a. ery-m. eup-per. euph. euphr. eupi. FERR-AR. FERR-I. ferr-ma. FERR-P. FERR. foen. foll. gast. gels. GLON. GOSS. GRAPH. GUAJ. HAM. hedeo. HELL. HELON. hip-ac. hoit. HYOS. hyper. hypoth. ictod. IGN. imp. indg. inul. IOD. iris joan. KALI-AR. KALI-C. kali-i. kali-m. KALI-N. KALI-P. KALI-S. kreos. kronth. lac-d. LACH. lam. leon. lept. LEVIST. lil-t. linu-c. lob. LYC. MAG-C. MAG-M. mag-s. mand. mang. menth-pu. MERC. MERL. mill. MIT. myrrha nat-c. NAT-M. nat-p. nat-s. nat-sil. nep. NUX-M. NUX-V. ol-an. OL-J. op. orig-v. ovi-p. parth. petr. petros. ph-ac. PHOS. PHYT. pin-l. pitu-a. pitu-p. PLAT. plb-i. plb. podo. polyg-h. psor. puls-n. PULS. rhod. RHUS-T. ROSM. rub-t. RUTA SABAD. sabin. sang. sanic. sec. SENEC. SENN. SEP. sieg. SIL. SIN-N. spong. STAPH. stram. sul-i. SULPH. syc. symph. tanac. tep. ter. thal. thala. thiop. thlas. THUJ. thyr. TUB. urt-u. ust. VALER. verat-v. verat. verbe-o. vib. vince. wies. wildb. wye. x-ray XAN. zinc-phic. ZINC. ziz.

FEMALE - MENSES - frequent, too early, too soon - scanty, and alum. AM-C. ant-c. apis arg-n. ARS. asaf. asar. aur. berb. cact. caul. cimic. CON. cur. gink-b. lam. lept. LIL-T. MANG. nat-m. nit-ac. nux-v. ol-an. petr. PHOS. puls. ruta SEP. SIL. THUJ.

FEMALE - MENSES - General - pain - flow - absence of, only in Cocc. mag-c. plb.

FEMALE - MENSES - late, too - scanty, and ACON. bov. CALC. con. GRAPH. kali-c. MERC. nat-m. sep. sil. valer. vib.

FEMALE - MENSES - pain - flow - absence of, only in COCC. mag-c. plb.

FEMALE - MENSES - painful, dysmenorrhea - flow - amel. - scanty, with caul. gnaph. graph.

FEMALE - MENSES - profuse - absent every other period LACH.

FEMALE - MENSES - scanty - acne, with sang.

FEMALE - MENSES - scanty - anemia, with manc.

FEMALE - MENSES - scanty - ceases when lying down Cact.

FEMALE - MENSES - scanty - chill, with NAT-M.

FEMALE - MENSES - scanty – clotted cocc. germ-met.

FEMALE - MENSES - scanty - cold, from a NUX-M.

FEMALE - MENSES - scanty - convulsions, during – epileptic ART-V. BUFO CAUST. KALI-BI.

FEMALE - MENSES - scanty - convulsions, with Glon.

FEMALE - MENSES - scanty - days, first three mag-m.

FEMALE - MENSES - scanty – daytime Bov. MAG-C.

FEMALE - MENSES - scanty - decreasing until they disappear cocc.

FEMALE - MENSES - scanty - dyspnea, with arg-n.

FEMALE - MENSES - scanty - epilepsy, in ART-V. Bufo Caust. Kali-bi.

FEMALE - MENSES - scanty – evening mag-c.

FEMALE - MENSES - scanty - exertion - agg., physical and mental Glon.

FEMALE - MENSES - scanty - exertion - mental, from NUX-M.

FEMALE - MENSES - scanty - exertion agg., physical and mental GLON.

FEMALE - MENSES - scanty - first three days mag-m.

FEMALE - MENSES - scanty - fright, from NUX-M.

FEMALE - MENSES - scanty - irritation of ovaries, with APIS xan.

FEMALE - MENSES - scanty - late, and valer.

FEMALE - MENSES - scanty - leucorrhea – after SEP.

FEMALE - MENSES - scanty - leucorrhea - consisting mostly of cub.

FEMALE - MENSES - scanty - leucorrhea – with Mez.

FEMALE - MENSES - scanty - lying down ceases CACT.

FEMALE - MENSES - scanty - mental exertion, from NUX-M.

FEMALE - MENSES - scanty - morning, flowing only in carb-an. plut-n. SEP.

FEMALE - MENSES - scanty - motion agg. SEP.

FEMALE - MENSES - scanty – night bov. bros-gau. cact.

FEMALE - MENSES - scanty - orgasms of blood, with merl.

FEMALE - MENSES - scanty – pale graph.

FEMALE - MENSES - scanty - pale, and graph.

FEMALE - MENSES - scanty - profuse, then choc. hydr-ac. NAT-M.

FEMALE - MENSES - scanty - profuse, then choc. Nat-m.

FEMALE - MENSES - scanty - sexual desire lost LACH.

FEMALE - MENSES - scanty - sexual desire lost Lach.

FEMALE - MENSES - scanty - short, and am-c.

FEMALE - MENSES - scanty - sleepiness, with HELON.

FEMALE - MENSES - scanty - sterility, in CANTH.

FEMALE - MENSES - scanty - stomach troubles, with cocc. puls.

FEMALE - MENSES - scanty – watery phos.

FEMALE - MENSES - scanty - watery, and phos.

FEMALE - MENSES - scanty - weakness, from NUX-M.

FEMALE - MENSES - scanty - women – fleshy Kali-br. Kali-i.

FEMALE - MENSES - scanty - women – hysteric NUX-M. FEMALE - MENSES - scanty - women – plethoric Petros.

FEMALE - MENSES – scanty  acet-ac. acon. agav-t. agn. alet. Alum. alumin-p. alumin-sil. alumn. AM-C. anac. ange-s. ant-t. Apis aqui. ARG-N. ARIST-CL. arn. ARS-MET. Ars. Art-v. Asaf. asar. Atro-pur. aur-ar. aur-m-n. aur-s. Aur. bamb-a. Bar-c. Bar-s. Berb. Borx. both-ax. Bov. bry. Bufo buni-o. Buth-a. Cact. cael. Calc-ar. calc-f. calc-hp. calc-p. calc-s. calc-sil. calc. cann-i. canth. Carb-an. Carb-v. CARBN-S. carl. Caul. Caust. cham. chel. choc. cic. Cimic. Cocc. colch. Coloc. CON. Conch. croc. Crot-h. crot-t. cub. cupr. cur. CYCL. des-ac. dig. dros. DULC. Elaps erig. Euphr. eupi. Ferr-ar. ferr-i. Ferr-p. Ferr. form. Gels. glon. goss. GRAPH. guaj. hed. helon. Hep. hip-ac. hir. hist. hura hydrog. hyos. Ign. iod. Ip. iris Kali-ar. Kali-bi. kali-br. KALI-C. Kali-i. kali-n. Kali-p. KALI-S. kali-sil. kalm. lac-ac. lac-c. lac-d. LACH. lam. laur. leon. lept. Lil-t. lith-c. lob. Lyc. lycps-v. m-arct. Mag-c. mag-m. mag-s. MANG. Meli. merc-f. Merc. merl. mez. mill. mosch. naja Nat-ar. Nat-c. NAT-M. nat-s. nat-sil. nicc- met. Nit-ac. nit-s-d. Nux-m. Nux-v. oena. ol-an. ozone Petr. petros. phel. PHOS. pip-n. Pitu-a. pitu-p. plat. Plb. pneu. psor. PULS. rat. rhod. rhus-t. ruta Sabad. sabin. sacch-l. sang. Sars. sel. SENEC. SENEG. SEP. Sil. Stann. Staph. stram. stront-c. stront-n. SULPH. Syph. tanac. tarent. tell. ter. thuj. thymol. thyreotr. tong. trios. ust. valer. verat-v. verat. vib-od. Vib. visc. wye. Xan. zinc-phic. Zinc.

Female - MENSES, general - frequent, too early, too soon - scanty, and alum. Am-c. ant-c. apis arg-n. Ars. asaf. asar. aur. berb. cact. caul. cimic. Con. cur. lam. lept. Lil-t. Mang. nat-m. nit-ac. nux-v. ol-an. petr. Phos. puls. ruta Sep. Sil. Thuj.

Female - MENSES, general - late, too - scanty, and Acon. bov. Calc. con. Graph.kali-c. Merc. nat-m. sep. sil. valer. vib.

Female - MENSES, general - pain, flow, only after the flow - only in the absence of flow Cocc. mag-c. plb.

Female - MENSES, general - profuse - alternate period - absent, every Lach.

Female - MENSES, general - scanty, - acne, with sang.

Female - MENSES, general - scanty, - ceases when lying down Cact.

Female - MENSES, general - scanty, - chill, with NAT-M.

Female - MENSES, general - scanty, - clotted cocc. 

Female - MENSES, general - scanty, - cold, from a NUX-M.

Female - MENSES, general - scanty, - consisting mostly of vagina discharge cub.

Female - MENSES, general - scanty, - convulsions with Glon.

Female - MENSES, general - scanty, - copious, then choc. Nat-m.

Female - MENSES, general - scanty, - days, first three mag-m.

Female - MENSES, general - scanty, - daytime Bov. MAG-C.

Female - MENSES, general - scanty, - decreaseng until they disappear cocc.

Female - MENSES, general - scanty, - dyspnea, with arg-n.

Female - MENSES, general - scanty, - epilepsy, in ART-V. Bufo Caust. Kali-bi.

Female - MENSES, general - scanty, - evening mag-c.

Female - MENSES, general - scanty, - exertion, from - agg. physical and mental Glon.

Female - MENSES, general - scanty, - exertion, from NUX-M.

Female - MENSES, general - scanty, - first three days mag-m.

Female - MENSES, general - scanty, - fleshy, women Kali-br. Kali-i.

Female - MENSES, general - scanty, - fright, from NUX-M.

Female - MENSES, general - scanty, - hysterical, women NUX-M.

Female - MENSES, general - scanty, - infertility, in Canth.

Female - MENSES, general - scanty, - irritation of ovaries, with Apis xan.

Female - MENSES, general - scanty, - late, and valer.

Female - MENSES, general - scanty, - leucorrhea, with - after Sep.

Female - MENSES, general - scanty, - leucorrhea, with Mez.

Female - MENSES, general - scanty, - morning, flowing only in carb-an. Sep.

Female - MENSES, general - scanty, - motion agg. Sep.

Female - MENSES, general - scanty, - orgasms of blood, with merl.

Female - MENSES, general - scanty, - pale, and graph.

Female - MENSES, general - scanty, - plethoric, women Petros.

 Female - MENSES, general - scanty, - profuse, then choc. Nat-m.

Female - MENSES, general - scanty, - sexual desire lost Lach. Sep.

Female - MENSES, general - scanty, - short, and am-c.

Female - MENSES, general - scanty, - sleepiness, with Helon.

Female - MENSES, general - scanty, - sterility, in Canth.

Female - MENSES, general - scanty, - stomach troubles, with cocc. puls.

Female - MENSES, general - scanty, - vagina discharge, with – after Sep.

Female - MENSES, general - scanty, - vagina discharge, with Mez.

Female - MENSES, general - scanty, - watery, and phos.

Female - MENSES, general - scanty, - weakness, from NUX-M.

FEMALE - PAIN - cramping - uterus - menses - absent, with caul. cimic.

FEMALE - STERILITY - menses - scanty, with am-c.

Female - VAGINAL, discharge, leucorrhea - menses, during - scanty, during, calc-p. Caust. Mez.

Female - VAGINAL, discharge, leucorrhea - menses, like the menses - scanty, with calc-p. Caust. Mez.

FEMALE GENITALIA - LEUCORRHOEA - scanty menses,with calc-p. Caust.

FEMALE GENITALIA - MENSES, - absent, amenorrhoea - molimen only Ant-c. Con. Cycl.

FEMALE GENITALIA - MENSES, - absent, amenorrhoea Acon. aesc. agar. agn. alet. Am-c. am-m. Ant-c. Apis Apoc. arg-n. Ars-i. Ars. AUR. Bar-c. Bell. benz-ac. berb. Borx. Bry. calc-s. Calc. canth. carb-v. CARBN-S. card-m. Caul. Caust. Cham. chel. Chin. chinin-ar. cic. cimic. cina Cocc. colch. Coll. Coloc. CON. croc. crot-t. Cupr. Cycl. dig. Dros. DULC. euph. Ferr-ar. FERR-I. Ferr-p. FERR. gels. Goss. GRAPH. Guaj. Ham. Hell. helon. Hyos. Ign. Iod. Kali-ar. KALI-C. kali-i. Kali-n. Kali-p. kali-s. Lach. lil-t. lob. LYC. Mag-c. Mag-m. Merc. mill. nat-c. Nat-m. nat-p. Nux-m. Nux-v. ph-ac. Phos. Plat. podo. PULS. Rhus-t. Sabad. sabin. sang. sec. SENEC. SEP. SIL. Staph. stram. SULPH. TUB. Valer. verat-v. verat. xan. Zinc.

FEMALE GENITALIA - MENSES, - pain,flow only in the absence of - flow only after the Mag-c.

FEMALE GENITALIA - MENSES, - pain,flow only in the absence of Cocc. mag-c. plb.

FEMALE GENITALIA - MENSES, - scanty – daytime Bov. MAG-C.

FEMALE GENITALIA - MENSES, - scanty - morning, flowing only in carb-an. Sep.

FEMALE GENITALIA/SEX - LEUKORRHEA - menses - scanty menses, with calc-p. Caust. Mez.

FEMALE GENITALIA/SEX - MENSES - absent - accompanied by – apyrexia nat-m.

FEMALE GENITALIA/SEX - MENSES - absent - accompanied by - Joint pains caul.

FEMALE GENITALIA/SEX - MENSES - absent - accompanied by - Tongue - mapped tongue Nat-m.

FEMALE GENITALIA/SEX - MENSES - absent - bathing; cold ant-c.

FEMALE GENITALIA/SEX - MENSES - absent - cold; after taking a asar-c. hell. senec.

FEMALE GENITALIA/SEX - MENSES - absent - complaints of menses are present; only Ant-c. Calc. Con. Cur. cycl. Senec.

FEMALE GENITALIA/SEX - MENSES - absent - feeble women; in Ars. SEP.

FEMALE GENITALIA/SEX - MENSES - absent - girls; in apoc. aqui. cortico. cortiso. nep. polyg-h. thala. x-ray

FEMALE GENITALIA/SEX - MENSES - absent - grief; from ign.

FEMALE GENITALIA/SEX - MENSES - absent - hysteric women; in Cypr. Sil.

FEMALE GENITALIA/SEX - MENSES - absent - long period wies.

FEMALE GENITALIA/SEX - MENSES - absent - milk in mammae, with phos. Rhus-t.

FEMALE GENITALIA/SEX - MENSES - absent - nervous women; in ars. ter.

FEMALE GENITALIA/SEX - MENSES - absent - plethoric women; in CALC. Petros.

FEMALE GENITALIA/SEX - MENSES - absent - psoric women; in Psor.

FEMALE GENITALIA/SEX - MENSES - absent - scrofulous women Bar-c. Sulph.

FEMALE GENITALIA/SEX - MENSES - absent - sexual desire – without Helon.

FEMALE GENITALIA/SEX - MENSES - absent - strain, after psychical and physical hypoth.

FEMALE GENITALIA/SEX - MENSES – absent Acon. aesc. agar. agn. alet. all-c. aln. Am-c. am-m. ammc. Anac. Ant-c. Apis Apoc. arg-n. Arist-cl. Ars-i. Ars. asar-c. asar. astat. aur-ar. aur-i. aur-s. AUR. aven. Bar-c. bell-p. Bell. benz-ac. berb. bism-sn. Borx. brass-n-o. brom. Bry. calc-i. calc-p. calc-s. calc-sil. Calc. cann-s. canth. carb-v. CARBN-S. card-m. Caul. Caust. Cham. chel. Chin. chinin-ar. chlorpr. cic. cimic. cina Coca Cocc. Coch. colch. Coll. Coloc. CON. cortico. cortiso. croc. crot-t. Cupr-act. Cupr. Cycl. Cypr. dam. dig. dream-p. Dros. DULC. euphr. eupi. Ferr-ar. FERR-I. Ferr-p. Ferr-r. FERR. gast. gels. Glon. goss. GRAPH. Guaj. Ham. hedeo. Hell. helo. helon. heroin. hoit. Hyos. hyper. ictod. Ign. indg. Iod. joan. Kali-ar. KALI-C. kali-i. Kali-

n. Kali-p. Kali-perm. kali-s. kreos. lac-d. lac-f. Lach. lil-t. linu-c. lith-c. lob. luf-op. LYC. m-arct. Mag-c. Mag-m. mag-s. mand. mang-act. mang-m. med. Merc. Merl. mill. Mit. nat-c. Nat-m. nat-p. nat-s. nat-sil. nep. Nux-m. Nux-v. ol-an. Ol-j. op. orot-ac. ovi-p. parth. ph-ac. Phos. Phyt. pin-l. pitu. Plat. plb. podo. polon-met. Polyg-h. polyg-pe. polyg-xyz. polytr-c. puls-n. PULS. rhod. Rhus-t. rub-t. Sabad. sabin. sang. sanic. sec. SENEC. Seneg. SEP. sieg. SIL. Sin-n. spong. Staph. stram. sul-i. SULPH. syc. symph. tanac. tep. thal-met. thal-xyz. ther. thiop. Thuj. thyr. TUB. urt-u. ust. Valer. vanad. verat-v. verat. vib. wies. wye. x-ray xan. yohim. zinc-p. Zinc.

FEMALE GENITALIA/SEX - MENSES - copious - alternate period, every – absent Lach.

FEMALE GENITALIA/SEX - MENSES - late, too – scanty Acon. bov. Calc. con. Graph. Merc.

FEMALE GENITALIA/SEX - MENSES - pain - absence of pain; flow only in the Cocc. mag-c. plb.

FEMALE GENITALIA/SEX - MENSES - painful - flow – scanty caul. gnaph. graph.

FEMALE GENITALIA/SEX - MENSES - scanty - acne, with sang. 

FEMALE GENITALIA/SEX - MENSES - scanty - anemic women; in mang.

FEMALE GENITALIA/SEX - MENSES - scanty - chill; with NAT-M.

FEMALE GENITALIA/SEX - MENSES - scanty – clotted cocc.

FEMALE GENITALIA/SEX - MENSES - scanty - cold, from a NUX-M.

FEMALE GENITALIA/SEX - MENSES - scanty - convulsions - during – epileptic ART-V. Bufo Caust. Kali-br.

FEMALE GENITALIA/SEX - MENSES - scanty - convulsions – with Glon.

FEMALE GENITALIA/SEX - MENSES - scanty - copious, then choc. Nat-m. ruta tritic-vg.

FEMALE GENITALIA/SEX - MENSES - scanty – daytime Bov. MAG-C. pot-e.

FEMALE GENITALIA/SEX - MENSES - scanty - decreasing until they disappear cocc.

FEMALE GENITALIA/SEX - MENSES - scanty - early; and too alum. brass-n-o. lept. nat-m.

FEMALE GENITALIA/SEX - MENSES - scanty - eruption on face; with bell-p. calc. eug. psor. sang.

FEMALE GENITALIA/SEX - MENSES - scanty – evening mag-c.

FEMALE GENITALIA/SEX - MENSES - scanty - exertion agg.; physical and mental Glon. NUX-M.

FEMALE GENITALIA/SEX - MENSES - scanty - fleshy women; in Kali-br. Kali-i.

FEMALE GENITALIA/SEX - MENSES - scanty - fright agg. NUX-M.

FEMALE GENITALIA/SEX - MENSES - scanty - hysteric women; in NUX-M.

FEMALE GENITALIA/SEX - MENSES - scanty - leukorrhea – after Sep.

FEMALE GENITALIA/SEX - MENSES - scanty - leukorrhea - consisting mostly of leukorrhea cub.

FEMALE GENITALIA/SEX - MENSES - scanty - leukorrhea – with Mez.

FEMALE GENITALIA/SEX - MENSES - scanty - lying down; cease when Cact.

FEMALE GENITALIA/SEX - MENSES - scanty - morning; only carb-an. plut-n. Sep.

FEMALE GENITALIA/SEX - MENSES - scanty - motion agg. Sep.

FEMALE GENITALIA/SEX - MENSES - scanty – night bros-gau.

FEMALE GENITALIA/SEX - MENSES - scanty - plethoric women; in Petros.

FEMALE GENITALIA/SEX - MENSES - scanty - profuse flow; with sensation of lac- cp.

FEMALE GENITALIA/SEX - MENSES - scanty - sexual desire lost Lach.

FEMALE GENITALIA/SEX - MENSES - scanty - sleepiness; with Helon.

FEMALE GENITALIA/SEX - MENSES - scanty - sterility, in Canth.

FEMALE GENITALIA/SEX - MENSES - scanty - three days; first mag-m. nept-m.

FEMALE GENITALIA/SEX - MENSES - scanty - weakness; from NUX-M.

FEMALE GENITALIA/SEX - MENSES – scanty abrom-a-r. abrom-a. acet-ac. acon. agav-t. agn. alet. aln. alum-p. alum-sil. Alum. alumin-s. alumin. alumn. AM-C. amp. anac. ange-s. ant-t. anthraq. Apis aqui. ARG-N. Arist-cl. arn. ARS-MET. Ars. Art-v. Asaf. Atro. aur-ar. aur-s. Aur. bamb-a. Bar-c. bar-m. Bar-s. bell. Berb. Borx. both-ax. Bov. brass-n-o. bros-gau. bry. Bufo buni-o. Buth-a. Cact. cael. Calc-ar. calc-f. calc-p. calc-s. calc-sil. calc. cann-i. canth. Carb-an. Carb-v. CARBN-S. carl. Caul. Caust. chel. chin. chr-m. cic. Cimic. Cocc. colch. Coloc. CON. croc. Crot-h. crot-t. cub. cupr. cur. CYCL. cyclosp. dendr-pol. des-ac. dig. dros. DULC. Elaps erig. euphr. eupi. Ferr-ar. ferr-i. Ferr-p. Ferr. form. Gels. ger-i. gink-b. glycyr-g. goss. GRAPH. guaj. hed. helon. Hep. heroin. hip-ac. hir. hist. hura hydrog. hyos. Ign. iod. Ip. irid-met. iris Kali-ar. Kali-bi. Kali-br. KALI-C. Kali-i. kali-n. Kali-p. Kali-s. kali-sil. kalm. lac-ac. lac-c. lac-d. lac-lup. LACH. lam. laur. lept. Lil-t. lith-c. lob. Lyc. M-arct. Mag-c. mag-m. mag-s. mang-act. mang-i. mang-m. mang-met. mang-n. mang-s. mang-sil. MANG. Meli. merc-i-f. Merc. merl. mez. mill. mosch. Murx. naja Nat-ar. Nat-c. NAT-M. nat-s. nat- sil. nept-m. nicc. Nit-ac. nit-s-d. Nux-m. Nux-v. oena. ol-an. orot-ac. ozone petr-ra. Petr. phel. PHOS. pieri-b. pip-n. pitu. plac-s. Plat. Plb. plut-n. pneu. pot-e. pseuts-m. psor. PULS. rat. rhod. rhus-t. ruta Sabad. sabin. sacch. sal-fr. sang. Sars. sel. SENEC. SENEG. SEP. Sil. sol-ecl. Stann. Staph. stram. stront-c. stront-n. stry-af-cit. suis-em. suis-pan. SULPH. suprar. Syph. tarent. tax. tell. ter. thuj. thymol. thyreotr. til. tong. trios. tritic-vg. ulm-c. ust. valer. vanad. vanil. verat-v. verat. vero-o. Vib. vip. visc. wye. Xan. xanth. zinc-i. zinc-n. zinc-p. Zinc.

FEMALE GENITALIA/SEX - STERILITY - menses - scanty; too Am-c.

FEMALE SEXUAL SYSTEM - Menstruation - type - Scanty flow alet. Alum. apis berb. Borx. canth. Caul. caust. Cimic. Cocc. Con. cycl. dulc. Euphr. Gels. Graph. ign. Kali-c. Kali-p. kali-s. lach. lam. lil-t. Mag-c. mang-act. Meli. merl. Nat-m. nux-v. Ol-an. Phos. plat. Puls. sang. Senec. Sep. sil. stry-af-cit. Sulph. valer. Vib. xan.

FEVER - CHILL absent - menses; before calc.

Fevers - HEAT, absent - internal - menses, during nat-m.

GENERALITIES - CHOREA - menses - absent or difficult puls.

GENERALITIES - PAIN - menses - during – scanty carb-v.

GENERALITIES - PAIN - sore, bruised - bones - menses, during scanty carb-v.

GENERALITIES - PAIN - sore, bruised - menses - during – scanty carb-v.

GENERALS - CHOREA - menses - absent or difficult, with cimic. puls.

GENERALS - CONVULSIONS - epileptic - menses – absent puls.

Generals - SORE, pain - menses, during – scanty carb-v.

GENERALS - WEAKNESS - menses - during - agg. – scanty ip.

HEAD - Internal - aggravation - menses – absent cimic. dulc. Glon. lach. zinc.

HEAD - MENSES - absent agg. cimic. dulc. glon. lach. zinc.

HEAD - PAIN - Occiput - menses - during - agg. - scanty flow, with alum. Carb-v.

HEAD - PAIN - occiput - menses - during - scanty flow, with alum. CARB-V.

HEAD - PAIN, - Occiput - menses, - scanty flow,with alum. Carb-v.

HEAD PAIN - LOCALIZATION - Occiput - menses - during - scanty flow, with alum. Carb-v.

Headaches- OCCIPUT, headaches, pain general - menses, during - scanty flow, with alum. Carb-v.

Hearing - bad, deafness, impaired - menses - absent with nat-c.

HEARING - IMPAIRED - menses - absent, with nat-c.

Hearing - IMPAIRED, hearing - menses, during - absent, with nat-c.

Heart - ENDOCARDITIS, heart, inflammation - menses, with scanty nat-m.

Heart - HEARTBEATS, general - tumultuous - menses absent two and a half months Cycl.

HEART & CIRCULATION - NFLAMMATION - heart, carditis - endocardium, endocarditis - menses, with scanty nat-m.

Intestines - DISTENTION, from flatus - tympanitic - menses, with absent aral.

Lens - cataract - menses absent, with lyc.

Leucorrhoea - menses - scanty, with calc-p. Caust.

Limbs - SORE, pain, bruised - bones - menses, during scanty carb-v.

Limbs - SORE, pain, bruised - menses, during - scanty menses carb-v. puls.

Lungs - ASTHMA, general - menses, during – scanty arg-n.

Mammae - hard, indurated - menses, absent, with dulc.

Mammae - milk present - absent menses with bell. bry. calc. lyc. phos. puls. rhus-t. sabin. stram.

Mammae - sore, painful - menses - absent, with dulc. zinc.

Menses - absent, suppressed, amenorrhoea - abdomen, bloated, with apoc.

Menses - absent, suppressed, amenorrhoea - asthma, with spong.

Menses - absent, suppressed, amenorrhoea - bath, from nux-m.

Menses - absent, suppressed, amenorrhoea - careworn, tired, women, in ars.

Menses - absent, suppressed, amenorrhoea - cause without ust.

Menses - absent, suppressed, amenorrhoea - chagrin, from coloc.

Menses - absent, suppressed, amenorrhoea - cold, from hell. senec.

Menses - absent, suppressed, amenorrhoea - concomitants, with senec. ust.

Menses - absent, suppressed, amenorrhoea - dancing, excessive, from cycl.

Menses - absent, suppressed, amenorrhoea - deafness, with nat-c.

Menses - absent, suppressed, amenorrhoea - diabetes, in uran-n.

Menses - absent, suppressed, amenorrhoea - dropsy, with apis apoc. kali-c. senec.

Menses - absent, suppressed, amenorrhoea - emigrants, in bry. Plat.

Menses - absent, suppressed, amenorrhoea - emotions, from cimic.

Menses - absent, suppressed, amenorrhoea - foot sweat, suppressed, from Menses - absent, suppressed, amenorrhoea - fright, from  op.

Menses - absent, suppressed, amenorrhoea – functional senec.

Menses - absent, suppressed, amenorrhoea - girls, young senec.

Menses - absent, suppressed, amenorrhoea - grief, from Ign.

Menses - absent, suppressed, amenorrhoea - hands putting in cold water from lac-d.

Menses - absent, suppressed, amenorrhoea - indignation, from staph.

Menses - absent, suppressed, amenorrhoea - jaundice, with chion. 

Menses - absent, suppressed, amenorrhoea - liver, affections, with lept.

Menses - absent, suppressed, amenorrhoea - love, disappointed, from hell.

Menses - absent, suppressed, amenorrhoea - mammae, scirrhus of, with brom.

Menses - absent, suppressed, amenorrhoea - milk in breast, with phos. rhus-t.

Menses - absent, suppressed, amenorrhoea - months, for lyc. sil.

Menses - absent, suppressed, amenorrhoea - neuralgic pain, in body with kalm.

Menses - absent, suppressed, amenorrhoea - neuralgic pain, in body with - ophthalmic, with euphr.

Menses - absent, suppressed, amenorrhoea - puberty of apis sep.

Menses - absent, suppressed, amenorrhoea - rheumatism, with bry. cimic. lach. rhus-t.

Menses - absent, suppressed, amenorrhoea – suddenly acon.

Menses - absent, suppressed, amenorrhoea - tuberculosis, in solid. ust.

Menses - absent, suppressed, amenorrhoea - weaning, after sep.

Menses - absent, suppressed, amenorrhoea - wet getting feet, from puls. rhus-t.

Menses - absent, suppressed, amenorrhoea aur. bell. cimic. Con. cupr. cycl. Dulc. Graph. hell. helon. Kali-c. lac-d. lach. Lyc. nat-s. phos. PULS. Senec. sep. Sil. Sulph. tub. xan.

Menses - early - scanty, and alum. lept. nat-m.

Menses - late - scanty, and kali-c. sep. vib.

Menses - painful, dysmenorrhoea - flow - scanty, with caul. gnaph. graph.

Menses - scanty - dyspnoea, with arg-n.

Menses – scanty Am-c. calc-p. Con. cycl. Dulc. Graph. Kali-c. Lach. mag-c. mang. nat-m. phos. PULS. seneg. sep. SULPH.

MENSTRUATION - Menses - absent, amenorrhoea - cold bathing ant-c.

MENSTRUATION - Menses - absent, amenorrhoea Apis asar. brom. Bry. calc-p. calc. caul. chel. Chin. Cimic. con. Dulc. ferr. gels. glon. Graph. Helo. hyper. iod. Kali-c. lach. lyc. mag-c. Nat-m. ol-an. Phos. plb. PULS. sang. sec. SENEC. sep. sil. staph. Sulph. urt-u. valer. verat-v. verat. zinc.

MENSTRUATION - Menses - early; too - and scanty alum. lept. nat-m.

MENSTRUATION - Menses - scanty; too Acon. Agn. ALUM. AM-C. arn. asaf. aur. BAR-C. bov. bry. calc. canth. carb-an. CARB-V. CAUST. chel. Cic. COCC. colch. CON. croc. crot-h. Cupr. Dig. Dros. DULC. Euphr. FERR. GRAPH. Guaj. hep. hyos. Ign. iod. ip. Kali-c. Lac-d. LACH. laur. Lyc. MAG-C. Mag-m. Mang. Merc. mosch. NAT-M. nux-m. Nux-v. ol-an. Petr. PHOS. plat. PULS. rhod. rhus-t. RUTA Sabad. sabin. Sars. SENEC. SEP. SIL. Staph. stram. stront-c. SULPH. Thuj. Valer. verat. vib. xanth. Zinc.

Mind - ABSENT-minded - menses, during calc. mur-ac.

MIND - Aggravation - menses – absent cocc. puls.

MIND - FEAR - menses - suppressed or scanty, from NUX-M.

Mind - FEARS, phobias,general - menses, during - scanty, from NUX-M.

MIND - HYSTERIA - menses - after – scanty NUX-M.

MIND -  HYSTERIA - menses -  scanty or  suppressed caust.  CHAM. cocc. con. CROC. hell. hyos. ign. ip. mag-m. nux-m. phos. PLAT. PULS. sep. sulph. zinc.

MIND - HYSTERIA - menses - scanty or suppressed caust. Cham. cocc. con. Croc. hyos. ign. ip. mag-m. nux-m. phos. Plat. Puls. sep. sulph. zinc.

Mind - HYSTERICAL, behavior - menses, during – scanty ign. NUX-M.

MIND - MENSES - absent agg. cocc. puls.

MOUTH - DISCHARGE - offensive, scanty, thick from gums, during menses but-ac.

MOUTH - DISCHARGE - offensive, scanty, thick from gums, during menses but-ac. Nat-m.

NOSE - Bleeding - menses – absent BRY. cact. dulc. phos. Puls. sep.

NOSE - Bleeding - menses – scanty Bry. PULS. Sec. sep.

Nose - BLEEDING, nosebleed, epistaxis - menses, during – scanty bry. corn. graph. Phos. puls. sep.

NOSE - EPISTAXIS - general - menses - during – scanty bry. corn. graph. PHOS. PULS. sec. sep.

NOSE - EPISTAXIS - menses - during - agg. – scanty Bry. corn. graph. Phos. puls. sec. sep.

NOSE - EPISTAXIS - menses - during – scanty bry. corn. graph. Phos. Puls. sec. sep.

NOSE - EPISTAXIS - menses, - scanty Phos.

NOSE - Internal nose - Bleeding - Cause - Menses, absent Bry. Ham. lach. nat-s. Phos. Puls. sep.

NOSE - MENSES - absent agg. sep.

Pain - bruised, soreness - menses, during - scanty, with carb-v.

Rectum - BLEEDING, from anus and rectum - menses, during - scanty, during lach.

RECTUM - HEMORRHAGE from anus - menses - scanty, during lach.

RESPIRATION - ASTHMATIC - accompanied by - menses; scanty arg-n.

RESPIRATION - ASTHMATIC - menses – scanty arg-n.

RESPIRATION - ASTHMATIC - menses - scanty, with arg-n.

RESPIRATION - DIFFICULT - accompanied by - menses; absent ars-i.

SKIN - MENSES - absent - agg. kali-m. sulph.

Skin - menses - scanty agg con.

Skin - MENSES, during, agg. the skin - scanty, agg. con.

SKIN AND EXTERIOR BODY - Aggravation - menses – absent kali-m. Sulph.

Sleepiness, by day - menses - absent, with senec.

STOMACH - COMPLAINTS of the stomach - accompanied by  - menses – scanty cocc. puls.

STOMACH - Concomitants - menses – scanty cocc. puls.

STOMACH - ULCERS - menses, with scanty calc-ar.

URINE - SCANTY - menses - before - agg. Apis sil.

Urine - scanty - menses – before Apis sil.

URINE - SCANTY - menses - during - agg. nat-m. sabin.

URINE - SCANTY - menses – during nat-m. sabin.

VERTIGO - MENSES - absent; with gels.

Weakness, enervation, prostration - menses - scanty, with ip.

References

 Chapter 10. Physical Activity in Adolescents > Female Athlete Triad CURRENT Diagnosis & Treatment in Family Medicine, 3e

 Chapter 11. The Female Genitalia and Reproductive System >  SECONDARY AMENORRHEA—CLINICAL OCCURRENCE DeGowin's Diagnostic Examination, 9e

 Chapter 13. Female Reproductive Endocrinology and Infertility > Endocrine Causes Greenspan’s Basic & Clinical Endocrinology, 9e

 Chapter 13. Menstrual Disorders > Primary Amenorrhea CURRENT Diagnosis & Treatment in Family Medicine, 3e

 Chapter 16. Amenorrhea > Exercise-Induced Amenorrhea Williams Gynecology, 2e

 Chapter 26. Endocrine Disorders > Hypothalamic-Pituitary Causes (With Low or Normal FSH) CURRENT Medical Diagnosis & Treatment 2014

 Chapter 4. Adolescence > Amenorrhea CURRENT Diagnosis & Treatment: Pediatrics, 21e

 Chapter 4. Adolescence > Evaluation of Primary and Secondary Amenorrhea CURRENT Diagnosis & Treatment: Pediatrics, 21e

 Chapter 54. Amenorrhea > Diagnosis of Primary Amenorrhea CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e

 Encyclopedia Homoeopathica

Radar 10

 

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Comment by Dr Rajneesh Kumar Sharma MD(Hom) on April 22, 2014 at 12:25am

Thanks Dr. Sarang. Regards

Comment by SARANG on April 21, 2014 at 10:48am

Wonderful description covering all the practical aspects. Loved it . Real practical implementation of the knowledge. Repertorial analysis will be very handy. Keep it up.

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on April 16, 2014 at 11:59pm

Thanks Kavitha, regards

Comment by Kavitha Kukunoor on April 16, 2014 at 11:20pm

Thank you for sharing wonderful article - elaborated Information on Amenorrhea with insights of homeopathy is very helpful.

Best wishes

Kavitha

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on April 11, 2014 at 11:45pm

Thanks Dr. Mittu

Comment by Dr. Meakin Mittu M.D.(Hom.) on April 11, 2014 at 9:01am

Nice Elaboration Dr.Rajneesh.

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on April 10, 2014 at 11:45pm

Thanks a lot Sir.

I shall try on infertility too.

Regards

Comment by Dr. Wequar Ali Khan on April 10, 2014 at 6:13pm

A wonderful and in sightly presentation.Has lot of practical information.Can we expect similar article on infertility? Best wishes

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