Primary Amenorrhea - is when an adolescent fails to have her first period by the age of 18.
Narrowing or obstruction of the cervix
Secondary Amenorrhea - is when after having normal menstruation a woman's period stops for reasons other than natural physiological changes such as; pregnancy, breast feeding, or menopause. It's considered amenorrhea when there is absense of a period for 6 months or more.
In Eastern medicine the three most important organ systems that play a role in gynecological disorders are the Spleen, Liver and Kidney. The reason for this is due to their important roles within the reproductive system. The Spleen is responsible for producing Qi and blood; the Liver stores blood, disseminates Qi and blood and ensures the smooth flow of both Qi and Blood; while the Kidneys are responsible for conception, reproduction, and growth & development.
Amenorrhea can be divided into two categories, that of deficiency or excess. Under deficiency you will see signs of Qi and blood deficiency, or signs of deficiency in the organ systems themselves. In the excess type of amenorrhea you will see patterns of Qi stagnation and blood stasis, which can occur due to Liver congestion, or there can be phlegm-damp which obstructs the uterus, and / or the Chong and Ren meridians.
Any given etiology can disrupt the functions of the organ systems, which creates a systemic imbalance. One major disruptor in gynecology is stress or emotional distress, especially anger, frustration and depression. These emotions greatly affect the Liver causing it to become congested, leading to Qi stagnation and blood stasis.
In terms of congenital defects, these fall under Kidney deficiency, in which the patient would have signs of constitutional deficiencies. The Kidneys can also be effected by over-exertion in the case of exercising too much, and if there is a propensity for mental exertion this will also involve the Spleen. When there is an improper diet the Spleen and the Stomach are involved, and this can lead to Qi and blood deficiency, or an accumulation of dampness, which can turn into phlegm-damp that can obstruct the uterus.
After blood chemistry has been assessed and any physiological causes have been ruled out, a precise treatment plan can be decided. When the etiology involves hormonal imbalances, then Eastern medicine is the best choice for the most effective and side-effect free patient outcome. Herbs have been shown to outperform many drugs in diverse gynecological scenarios. In the case of amenorrhea, herbs would be the primary treatment, and acupuncture would be the adjunctive therapy. Of course, lifestyle changes are always recommended where needed.