Menstruation in a girl is often celebrated as advent of womanhood and some communities even celebrate this by ceremoniously blessing the girl. It empowers the continuum of life and procreation. If there is delay in its onset there is anxiety generated in parents who may seek the advice of a doctor. Women with excessive carotene levels in their blood appear to be at higher risk of amenorrhea than women with normal levels and while research has not shown high carotene levels to directly cause amenorrhea, they may constitute a contributing factor.

Menstruation in a girl is often celebrated as advent of womanhood and some communities even celebrate this by ceremoniously blessing the girl. It empowers the continuum of life and procreation. If there is delay in its onset there is anxiety generated in parents who may seek the advice of a doctor.

Prevention: Maintaining good nutritional habits and a normal weight and avoiding overly strenuous sports can probably be beneficial in preventing secondary amenorrhea. Also
• Get enough nutrients
• Eat more food or choose a high-calorie supplement if you are underweight, have low body fat if you are an athlete.
• Look after your bones
• Protect yourself from amenorrhea-related bone loss by taking 800 to 1,500 of calcium and 400 to 800 IU of vitamin D each day
• Get a checkup
• Visit your healthcare provider to find out if your amenorrhea is the result of a treatable medical problem
• Regulate your workouts
• Balance the hormone function by avoiding intense or excessive exercise

Amenorrhea is the absence of menstruation. There are two categories of this disorder. Primary amenorrhea is the failure to begin menstruating by the age of 16. Secondary amenorrhea, the more common of the two conditions, is the absence of three or more periods in a row in a woman who has been menstruating for some time. Primary amenorrhea is specifically defined at the age of 16 and can go on indefinitely. Secondary amenorrhea is usually a temporary condition; the periods generally resume when the underlying cause for the interruption has been corrected.
Causes of primary amenorrhea can be an endocrine gland disorder such as hyperthyroidism or hypothyroidism; genetic abnormalities; damaged or missing ovaries, uterus, or vagina; or an excessively thick hymen (the membrane that usually covers the vaginal opening in women who have not yet had sexual intercourse), which blocks the outflow of the menstrual discharge. Secondary amenorrhea is most commonly caused by pregnancy. It can also be triggered by strenuous sports training, poor nutrition, drastic weight gain, jet lag, certain medications including corticosteroids, tranquilizers, and birth control pills, major surgery or serious disease, emotional shock, or the loss of a large percentage of body fat.
Symptoms of primary amenorrhea are commonly accompanied by abnormal or inhibited physical development; the young girl may fail to develop breasts or body hair, indicating that a genetic disorder may be preventing her from attaining sexual maturity. These girls are also usually short in height. Secondary amenorrhea has no symptoms other than the absence of menstrual periods.
Diagnostic evaluation of both types of amenorrhea will probably include a test to rule out pregnancy; tests to detect genetic or hormonal disorders, and X rays or ultrasound studies may also be done.
Primary amenorrhea may be treated with extensive hormone therapy to stimulate physical development. If the cause is a thick hymen, a minor surgical procedure may be performed. Some cases of primary amenorrhea, however, are untreatable (for example, those caused by structural abnormalities of the reproductive organs).
Secondary amenorrhea may be better treated with Ayurvedic medicines which triggers ovulation and re-establish the menstrual cycle. However, quite often this condition will reverse itself without treatment, especially if the cause is merely an interruption in the patient’s normal routine, an emotional upset, or pregnancy.
Herbs used for amenorrhoea are Ashok, Kumari, Aloes, Dronpushpi & Suran. Ayurvedic Formulations effective for amenorrhoea are Nashatpushapantak Ras, Rajaparvartini Vati, Pushyanug Churan and Dashmoolarishat. In therapies Uttarvasti can be used.
It has long been known that extreme dietary restriction can cause amenorrhea. When such restriction is due to eating disorders, such as anorexia and bulimia, professional treatment is necessary. Athletic amenorrheic women may have low intakes of calories and other nutrients, and there are reports of some athletes resuming menstruation after adding to their diet a daily nutritional beverage containing additional calories, protein, carbohydrate, fat, vitamins, and minerals. However, these women also decreased their exercise intensity, which likely contributed to normalization of their menstrual function.
Specific diets may be associated with increased risk of amenorrhea. A strict raw foods diet was found in one preliminary study to be strongly associated with weight loss and amenorrhea..Vegetarian diets tend to be rich in the antioxidant nutrients known as carotenes. Women with excessive carotene levels in their blood appear to be at higher risk of amenorrhea than women with normal levels and while research has not shown high carotene levels to directly cause amenorrhea, they may constitute a contributing factor. Women vegetarians often rely heavily on soy foods as sources of protein, and a number of studies have found that increasing dietary intake of soy reduces levels of estrogen and progesterone in premenopausal women thus leading to amenorrhea.
Moderate exercise has many benefits to the overall health of premenopausal women, but intensive or excessive exercise can contribute to amenorrhea and increase the risk of early bone loss due to detrimental effects on hormone balance. The demands placed upon women performers and athletes are believed to contribute to the high incidence of eating disorders among them. This, along with the increased physical and nutritional demands of intensive exercise, can lead to nutrient deficiencies and lowered body-fat percentages .
Hormonal changes associated with breast-feeding prevent menstruation in healthy women. The duration of this interruption in menstruation, known as lactational or postpartum amenorrhea, depends on many factors, including the nutritional health of the mother. Poor maternal nutritional status has been associated with longer periods of lactational amenorrhea in developing
Excessive stress causes the body to produce increased amounts of the adrenal hormone cortisol, and several studies have linked high cortisol levels to low levels of reproductive hormones and to amenorrhea.
Smoking may contribute to amenorrhea. A survey study found that young women smoking one pack or more per day were more likely to be amenorrheic than other women. However, whether smoking cessation will normalize menstrual function in amenorrheic women is unknown.
Yoga for Amenorrhoea: Regular and proper practice of asanas and Pranayama is beneficial in amenorrhoea. However, it should be noted that, during monthly period (menstruation) yoga practices are not advisable for 3-5 days. Yoga helps by correcting and balancing the functioning of the endocrine system, toning up of the nervous system and by relaxing the body and mind and reducing psychological problems. Asanas are helpful to preserve the general health and to reduce the minor complaints regarding menstruation by improving the vigor and strength of the body. Recommended asanas are Viparitakarani, Halasana, Naukasana, Pawanmuktasana, Setubandhasana, Bhujangasana, Shalabhasana (both legs), Vajrasana, Padma~ana, Parvatasana, Vakrasana, Gomukhasana, Chakrasana (sideward bending), Tadasana, Vrikshasana, Shavasana/Makarasana.
Pranayama techniques useful for amenorrhoea are Anuloma Viloma, Shitali & Bhramari