Understanding Amenorrhea and Its Impact on Fertility
Amenorrhea is when a woman doesn’t get a period, which could mean something’s up with the hormones or reproductive system. Usually, a period means ovulation is happening, which is important for getting pregnant. Not all cases of amenorrhea mean a woman can’t have a baby, but it can make it hard to conceive. When a woman doesn’t ovulate (anovulate), it’s usually because of amenorrhea, and that makes it even harder to get pregnant. Understanding and taking care of these conditions is important for women’s reproductive health.
And guess what? Traditional Chinese Medicine (TCM) can be a great way to support fertility, along with regular treatments.
Types of amenorrhea
Primary amenorrhea
Primary amenorrhea occurs when a woman has not had her first menstrual period by age 15-16 or within three years after puberty begins. Causes include genetic conditions, hormonal imbalances, or structural abnormalities affecting the reproductive organs. Fertility depends on the underlying cause and may require medical intervention.
Secondary amenorrhea
Secondary amenorrhea is the absence of menstruation for three or more cycles or six months in women with previously regular periods. Common causes include:
Addressing the root cause can often restore menstrual cycles and improve fertility.
Causes of Amenorrhea and Non-Ovulation
Hormonal Imbalances
Disruptions in aestrogen, progesterone, or thyroid hormone levels can affect ovulation and menstruation. Anovulation occurs when the ovaries do not release an egg, making conception impossible. Treatment may involve lifestyle adjustments, acupuncture, or hormone therapy.
Polycystic Ovary Syndrome (PCOS)
PCOS often leads to irregular or absent periods and non-ovulation. TCM focuses on balancing hormones naturally through acupuncture, herbal medicine, and lifestyle modifications to support ovulation.
Premature Ovarian Failure (POF)
POF occurs when ovarian function declines before age 40, leading to irregular or absent periods and non-ovulation. While conventional medicine often recommends hormone replacement therapy (HRT), TCM aims to nourish kidney essence, improve ovarian function, and regulate menstruation with acupuncture and herbal medicine.
Stress and Lifestyle Factors
Excessive stress, intense exercise, and poor nutrition can impact reproductive health, leading to amenorrhea and non-ovulation. Managing stress and adopting a balanced lifestyle can help restore menstrual function and improve fertility.
Nutritional Deficiencies
Iron, vitamin D, and essential nutrient deficiencies may contribute to amenorrhea and anovulation. A nutrient-rich diet combined with TCM support can improve menstrual health and ovulatory function.
Medication-Induced Amenorrhea
Some contraceptives and medications can disrupt menstruation and ovulation. If periods do not return after stopping hormonal birth control, a TCM approach may help regulate the cycle naturally.
Post-Pill Amenorrhea
Stopping oral contraceptive pills (OCPs) can temporarily disrupt the menstrual cycle. This condition, known as post-pill amenorrhea, occurs due to:
Hormonal readjustment as the body transitions from synthetic hormones
Withdrawal from continuous hormonal regulation
Individual differences in how quickly the body restores ovulation
If menstruation does not return after several months, acupuncture and Chinese herbal medicine may assist in regulating hormonal balance.
Traditional Chinese Medicine for Amenorrhea and Non-Ovulation
Acupuncture
Acupuncture stimulates blood flow to reproductive organs, supports hormonal balance, and reduces stress, promoting the return of regular cycles and encouraging ovulation.
Chinese Herbal Medicine
TCM practitioners may prescribe customized herbal formulas to nourish blood, regulate hormones, and promote menstrual health. Common herbs include:
Chinese motherwort (Leonurus japonicus) – Promotes blood flow and menstrual regularity
Tribulus terrestris – Supports ovulation and improves ovarian function
Dietary and Lifestyle Recommendations
TCM emphasises a holistic approach, incorporating dietary and lifestyle changes such as:
Nutrient-dense foods to support hormonal health
Stress management techniques like meditation or Tai Chi
Moderate exercise to maintain balance without excessive strain
Menstruation and Fertility Support at Melbourne Clinics
At Almond Wellness Centre (Melbourne Acupuncture & Chinese Medicine Clinics), we provide expert care in reproductive health. Our Coburg and Ringwood clinics provide:
Acupuncture & Chinese herbal medicine for menstrual regulation
A study explored how acupuncture could help manage menopause symptoms in breast cancer patients. It discovered that while acupuncture effectively relieved general menopause symptoms, it didn’t significantly reduce hot flushes in patients undergoing medical menopause due to breast cancer treatments. For those concerned about hormone therapy’s side effects, acupuncture might serve as an alternative.
Method
The study, accessible at this link focused on breast cancer patients experiencing hot flushes due to medical menopause. Instead of traditional hormone therapy, some patients chose acupuncture. The research reviewed various randomised clinical trials involving 844 women, averaging 58 years old, using Cochrane criteria to assess the acupuncture’s effectiveness.
Result
The analysis showed that while acupuncture didn’t notably impact the frequency and severity of hot flushes (p = 0.34; p = 0.33), it did significantly improve overall menopause symptoms (p = 0.009). No severe adverse effects were reported from acupuncture treatment.
Conclusion
Acupuncture emerges as an effective method to alleviate menopause symptoms for breast cancer patients. However, its influence on hot flushes appears limited. For those worried about hormone therapy’s repercussions, considering acupuncture as an alternative is recommended. Further large-scale studies exploring biomarkers or cytokines could deepen our understanding of how acupuncture aids in managing menopause symptoms in breast cancer patients.
31-year-old Sarah came to see me at Almond Wellness Centre, our acupuncture Chinese medicine clinic. Sarah had been trying to get pregnant for over a year without any success, and was concerned that her short menstrual cycles might be hindering her chances.
Sarah’s period was so short that she almost had two periods in one month. Her first period lasts for 5 days, normal flow with mild cramping and some PMS. She then has another period a few days later. The second “period” is light or spotting only, with clear stretching discharge and some cramping or sharp pain on the sides of lower abdomen.
I suggested her to do ovulation test and check her basal body temperature (BBT). From her BBT and ovulation history we discovered that she was not actually having two periods in one month, but was experiencing ovulation bleeding instead.
So, what is ovulation bleeding?
Ovulation bleeding is light bleeding or spotting that occurs during ovulation.
The exact cause of ovulation bleeding is not clear, but it is thought to be related to changes in hormone levels that occur during ovulation. The surge in oestrogen and luteinising hormone that triggers ovulation can cause some women to experience spotting or light bleeding.
Does ovulation bleeding affect fertility?
Ovulation bleeding is generally not a concern; however, it may affect chances of getting pregnant. For instance, Sarah thought that she was having period. She avoided having intercourse during that period time, therefore missed her fertile windows and had difficulty to get pregnant.
Chinese medicine and ovulation bleeding
In Chinese medicine, ovulation bleeding is seen as a sign of disharmony in the body’s energy, or qi. This disharmony can be caused by a variety of factors, including stress, poor diet, and hormonal imbalances. A Chinese medicine practitioner will work to identify the root cause of the problem and develop a customised management plan. In addition, dietary and lifestyle changes may be recommended to support your overall health and improve your chances of getting pregnant.
Because Sarah was avoiding intercourse during her bleeding time, she was actually missing her fertile windows, which made it more difficult for her to conceive. After following her treatment plan and other advice, her period became more regular and her ovulation bleeding stopped. She could “time it right” – having intercourse during her fertile windows. A few months later Sarah successfully became pregnant, much to her delight and relief.
So, if you are experiencing two periods in one month, with light flow or unusual spotting or discharge, you may actually be experiencing ovulation bleeding. Don’t let ovulation bleeding or any other menstrual irregularities get in the way of your dreams of becoming pregnant. With the right treatment and care, you can improve your chances of conception and start your journey towards motherhood.
It’s worth noting that while some people respond positive to Chinese medicine treatment on fertility outcomes, others have found no significant benefits. You should consult with your fertility specialist and registered Chinese medicine practitioner before start any treatment.
broccoli is the star but eating plenty of green vegetables of the cruciferous family help the liver metabolise oestrogen.
Other cruciferous vegetables include: Bok-Choy, Brussels sprouts, Cabbage, Cauliflower, Chinese cabbage, Daikon radish, Horseradish, Kale, Radish, Turnip and Watercress.
Eat high fibre foods to help oestrogen bind in the bowel and assist elimination.
One source suggests that eating 1/2 cup of raw grated carrots can be enough fibre to assist in elimination
Decrease alcohol consumption
Assist the liver by drinking St Mary’s Thistle and Dandelion tea
Avoid soy
Eat a no sugar and no gluten diet
sugar and gluten are both highly inflammatory in susceptible people so should be avoided when possible
Be mindful of too many vitamins, supplements, medications and even caffeine that all need to be processed by the liver, where possible space them out through the day.
Chinese herbal medicine
Some Chinese herbal medicine /formula may help assist in balance your hormone. You may contact us for details.
Natural Ways to Increase Progesterone
Reduce stress
google progesterone steal if you are more interested in how stress affects progesterone levels
Supplements:
750 mg vitamin C per day (increased progesterone 77% and improved fertility)
600 mg vitamin E (increased progesterone in 67% of patients)
6 g L-arginine (increased progesterone in 71% of patients)
Increasing beta carotene in your diet, as found in:
Apricots, Asparagus, Broccoli, Carrots, Chinese cabbage, Chives, Dandelion leaves, Grapefruit, Herbs and spices – chilli powder, oregano, paprika, parsley, Kale, Onions, Peas, Peppers, Plums, Pumpkin, Spinach, Squash, Sweet potatoes. So again, get onto those carrots!
Supplementing with
Vitex Agnus Castus 1000mg daily
Black Cohosh or as we call it in Chinese Medicine ‘Sheng ma’ on days 1 to 12 (increases progesterone and fertility).
Weight loss
Improving insulin sensitivity (for example metformin increases progesterone levels 246%, chromium supplementation can help in regulating blood sugar in combination with a low sugar and low carbohydrate diet)
Replacing saturated fat in the diet with unsaturated fat
Eating a high protein, low carbohydrate diet
Lowering TSH levels in subclinical hypothyroidism
Chinese herbal medicine
Some Chinese herbal medicine /formula may help assist in balance your hormone. Contact us for details.
Iron plays a crucial role in fetal development. It supporting blood, brain, and bone formation, as well as overall growth. It’s also vital for a healthy immune system and fertility. Low iron levels can lead to anovulation, hindering fertility. In a Harvard University study of 18,500 women, those supplementing iron were 40% less likely to have fertility problems.
During pregnancy, iron requirements increase due to greater blood volume. It’s essential to boost iron intake in the 2nd and 3rd trimesters as the fetus relies on maternal iron stores. Deficiency raises the risk of anemia, preterm delivery, and low birth weight.
Women with low iron are advised to supplement 10-20mcg daily. Liquid supplements are gentler on the stomach. Organic iron supplements are preferable as they’re better absorbed. Vitamin C aids iron absorption.
Natural sources of iron
Natural sources include green leafy vegetables, dried beans, black strap molasses, lean meat (organic/chemical free), dried apricots, almonds, egg yolk, seaweed, wheat germ, parsley, pumpkin, sesame and sunflower seeds.
Folic acid (B9) and B vitamins
Folic acid (B9) and B vitamins are essential for DNA formation, crucial for preconception and early pregnancy. Supplementation is recommended, especially for women on birth control pills. Deficiency can lead to infertility and birth defects.
Natural sources of B9
Natural sources include dark green leafy vegetables, i.e., uncooked spinach, kale, beet greens; asparagus, broccoli, corn, lima beans, parsnip, mung beans, soy beans; wheat germ; oranges, pineapple, banana. It’s best to consume these foods fresh and raw to preserve B9, as it’s heat-sensitive.
Vitamin D – The sunshine vitamin
Vitamin D, known as the sunshine vitamin, is crucial for fertility. Testing vitamin D levels is recommended, as deficiency is common, affecting 23-49% of Australians. Supplements are advised for levels under 50.
Omega 3 fatty acids
Omega-3 fatty acids are essential for hormonal balance, ovulation, and fetal development, supporting both fertility and healthy pregnancies. In a study, couples receiving 1000mg of omega-3 had a fertilization rate of 76.5%, significantly higher than the 50.4% rate in those without omega-3.
During pregnancy, a deficiency in DHA, a type of omega-3, may lead to various complications, including premature birth, low birth weight, chromosomal defects, spontaneous abortion, hyperactivity, and childhood asthma. We recommend 500-1000mg of DHA daily to support a healthy pregnancy.
Natural Sources of Opmega 3
Natural Sources include deep sea ocean/cold water fish (ie. salmon, cod, herring, trout), mono-unsaturated cold-pressed oils (flaxseed especially, walnuts, hemp and chia seeds.
Vitamin E
Vitamin E supports conception, regulates estrogen levels, and aids circulation. Deficiency can lead to complications like spontaneous abortion.
Natural Sources
Sources include sunflower seeds, almonds, organic cold-pressed wheat germ oil, cold-pressed vegetable, seed and nut oils. Best not heated or cooked, i.e., use in salad dressing.
Protein/Amino Acids
Vital for the number and quality of the ovum (eggs) produced the fertilisation process, and the early development of the embryo.
Natural sources
include deep sea fish, tofu, legumes ie. lentils, soy beans, kidney beans, eggs (free range), lean organic chemical-free meat and poultry, nuts and seeds, sprouted grains.
Calcium
Calcium is essential for fetal bone development, nerve function, and muscle tone. Deficiency can lead to complications like hypertension and bone loss.
Natural Sources
Natural sources include leafy greens, nuts, and seeds.
Dairy foods are another source of calcium; however, since they are not as easily absorbed, it is best to vary your sources of calcium as widely as possible.
Royal jelly
Royal jelly is rich in amino acids, vitamins, and minerals, beneficial for hormone balance and reproductive health. Some evidence exists that royal jelly might also:
Improve egg and sperm health
Increase libido
Reduce inflammation
Support the immune system
Decrease signs of aging
Helps women with irregular cycles
PLEASE DO NOT TAKE IF ASTHMATIC OR ALLERGIES TO BEE’S
Co Q10
CoQ10 supports energy production and cellular health. Supplementation may enhance egg quality and IVF success rates.
Managing PCOS
Chromium and magnesium supplementation, along with a low-GI diet, can help manage PCOS symptoms and improve glycemic control.
31-year-old Sarah came to see me at Almond Wellness Centre, our acupuncture Chinese medicine clinic. Sarah had been trying to get pregnant for over a year without any success, and was concerned that her short menstrual cycles might be hindering her chances.
In Chinese medicine, ovulation bleeding is seen as a sign of disharmony in the body’s energy, or qi. This disharmony can be caused by a variety of factors, including stress, poor diet, and hormonal imbalances. A Chinese medicine practitioner will work to identify the root cause of the problem and develop a customised management plan. In addition, dietary and lifestyle changes may be recommended to support your overall health and improve your chances of getting pregnant.
Iron