What Is Primary Amenorrhea?

Consumptive diseases, such as severe tuberculosis, severe anemia, malnutrition, etc .; endocrine diseases unique, such as "obese reproductive incompetent malnutrition"; the effects of some endocrine glands in the body, such as functional disorders of the adrenal gland, thyroid and pancreas. Because of these factors, menstruation often does not come. In all cases of amenorrhea caused by these conditions, as long as the disease is cured, menstruation will naturally flow.

Primary amenorrhea

Primary amenorrhea refers to those who have reached the age of 18 or whose secondary sexual characteristics have matured for more than 2 years and still have no menstrual cramps. Found in diseases such as uterine hypoplasia or lack of congenital reproductive tract development, congenital ovarian hypoplasia or absence, primary hypopituitar hypogonadism and congenital adrenal hyperplasia and other diseases, a few should be excluded due to lower reproductive tract atresia Pseudo amenorrhea.

Causes of Primary Amenorrhea

Primary amenorrhea

Consumptive diseases, such as severe tuberculosis, severe anemia, malnutrition, etc .; endocrine diseases unique, such as "obese reproductive incompetent malnutrition"; the effects of some endocrine glands in the body, such as functional disorders of the adrenal gland, thyroid and pancreas. Because of these factors, menstruation often does not come. In all cases of amenorrhea caused by these conditions, as long as the disease is cured, menstruation will naturally flow.

Primary amenorrhea

Such as the cervix, vagina, hymen, labia, etc., there is a period of congenital atresia, or acquired attrition caused by adhesion atresia. Although there is menstruation, menstrual blood cannot flow out. This situation is called recessive or pseudomenopause. The lower part of the genital tract is completely curable after treatment by a doctor.

Imperfect primary amenorrhea

Some people have congenital absence of ovaries, or ovarian dysplasia, or ovarian damage. They cannot produce estrogen and progesterone. Therefore, the endometrium cannot undergo periodic changes and endometrial shedding does not occur. Menstrual cramps. There are also congenital absence of the uterus, or endometrial dysplasia, or endometrial damage. Even if the ovaries are healthy and the secretion of estrogen and progesterone is normal, menstruation will not occur.

Primary amenorrhea other

In addition, tuberculous endometritis and abnormal pituitary and hypothalamic functions can also cause amenorrhea. Hypothalamic dysfunction can be caused by many reasons, such as mental stimulation, sadness, anxiety, nervousness, fatigue, environmental changes, and cold stimulation. Amenorrhea caused by the hypothalamus is more common.

Differential diagnosis of primary amenorrhea

Primary amenorrhea uterine vaginal hypoplasia

Uterine and vaginal hypoplasia is mainly caused by hypoplasia of the bilateral mid-renal ducts on both sides. The middle and tail sections of the bilateral midrenal canals are not developed, that is, the pararenal canals have stopped developing before extending to the midline, so they cannot synthesize the uterus. The clinical manifestations are congenital absence of uterus and vagina. If the development of the paramedullary ducts on both sides ceases shortly after meeting, a primordial uterus is formed. This uterus is small, has no endometrium, and therefore does not have menstruation. If the bilateral mesencephalon ducts meet on the two sides to form a uterus, but do not penetrate, a solid uterus is formed without endometrium; or development stops shortly after penetration, forming a naive uterus. Presented as primary amenorrhea, and if part of the endometrium, amenorrhea may be accompanied by periodic abdominal pain. Intellectual, physical and secondary sexual characteristics develop normally. The hypothalamic-pituitary-ovarian axis functions normally with a karyotype of 46, XX.

Androgen insensitivity syndrome

Androgen insensitivity syndrome is also known as testicular feminization or male pseudohermaphroditism. The patient's gonads are male and there are testicles in the body. Testosterone is secreted in the early embryo, but due to the lack of androgen receptors in target organ cells, it does not respond to testosterone, which hinders the development of external genitalia and male secondary sexual characteristics. After puberty, the testicles develop, and at the same time, they can secrete estrogen and produce feminization, causing breast development to look like females, so they are called male pseudohermaphroditism. Clinically divided into two types of completely insensitive to androgen and partially insensitive.

l. Patients who are completely insensitive to androgens have normal development, taller bodies, longer arms, huge feet, and breast development, but smaller nipples, pale areolas, and less pubic hair and axillary hair. The external genitalia are female, with poor development of the labia minora, short vagina, blind end, no uterus, and testes may be in the abdominal cavity or groin.

2. External genitalia that are not sensitive to androgens can appear as clitoral hypertrophy or short penis, often accompanied by hypospadias. Therefore, in patients with primary amenorrhea with blind vagina and no uterus, the existence of testicular feminization syndrome should be considered. The karyotype is XY, blood FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are increased, and testosterone is increased or increased in normal men, which is the basis for diagnosis of this disease.

Primary amenorrhea syndrome

Turner syndrome is also called gonadal dysgenesis and short body stature. The normal female karyotype is 46, XX. The normal development of the ovary must have all the genes of the two chromosomes, of which the genes that prevent short stature and residual neck are located on the short arm of the X chromosome. During sex cell division, the chromosomes may not be separated due to certain factors, and the zygote may be formed with only one chromosome; or during the division process, the short arm of the X chromosome is broken or lost, causing abnormalities in the number and structure of sex chromosomes, and the ovary may appear Dysplasia syndrome, clinically referred to as congenital ovarian dysplasia, or Turner syndrome. The ovary is a string-like fibrous tissue without oocytes or follicles, and therefore does not secrete estrogen. Therefore, it appears as primary amenorrhea, short stature, warm neck, barrel chest, elbow valgus, low posterior hairline, and secondary sexual characteristics. The genitalia are usually infantile with aortic stenosis and abnormal urinary system.

Low blood estrogen levels with high levels of blood gonadotropins. The karyotype is 45, XO, the most common chimeric type is 45, XO / 46, XY.

Primary amenorrhea simple gonadal dysgenesis

Those with simple hypogonadism have no chromosomal abnormalities. The karyotype can be divided into 46, XX or 46, XY. The patients are all female.

1. XX simple gonadal dysgenesis is also called true ovarian dysplasia. Because the ovaries are not developed, it appears as a stunted female genitalia, but there is no deformity. The secondary sexual characteristics are poorly developed, but without the characteristics of short stature and other Turner syndrome. The karyotype is 46, XX. Low blood estrogen levels and high blood gonadotropins. No reproductive function.

2. Under normal circumstances of XY simple gonadal dysfunction, male testis secretes ectopic ketones and paranephrosin inhibitory factors in the early stage of male embryos. Testosterone promotes the development of the mesorenal ducts into the male reproductive system, including epididymis, vas deferens, seminal vesicles, prostate and penis and scrotum. Inhibitory factors of the pararenal duct promote degeneration of the pararenal duct. In patients with XY simple gonadal dysgenesis, due to genetic mutations in the chromosomes, the embryonic testes do not develop, secretion of ketone ketones and pararenal tubular inhibitors, so the mesenchymal tube degenerates and no longer develops into male genitalia. The mesenteric duct develops into the female reproductive system; the patient is female in appearance, and often takes over female life. Often due to primary amenorrhea, the body is tall, the hands and feet are thicker and the room is not developed, and the armpit hair and pubic hair are less. The internal and external genitalia are female, but the development is poor. Lack of characteristics of Turner syndrome. The karyotype is 46, XY, low estrogen level, increased blood gonadotropin, and low blood testosterone, which can be distinguished from Hoshimaru feminization syndrome.

Congenital adrenal hyperplasia

Congenital adrenal hyperplasia is also called adrenal reproductive syndrome, or female pseudohermaphroditism.

Patient with gonadal female. Due to the lack of 21-hydroxylase or 11-hydroxylase in the congenital adrenal cortex, it is impossible to synthesize adrenocortical hormones, which causes excessive secretion of adrenocorticotropic hormones in the anterior pituitary gland, which causes the adrenal cortex to compensate for hyperplasia. After adrenal hyperplasia, a large amount of 17-hydroxypregnenolone and 17-hydroxyprogesterone are secreted and converted into androgens, so male signs appear. Patients often have a family history through recessive autosomal inheritance. Since the fetus has been affected by too much androgen, at birth, it can be manifested as an enlarged clitoris, fusion of both labia, and incomplete differentiation of the urethra and vagina.

External genital abnormalities have attracted the attention of their parents, often seeing children during childhood. After puberty, there may be hairy, muscular muscles, larynx knots, beards, and bright hair distributed in males. The breasts are not developed, the uterus is small, and there is no menstruation. Patients have male habits.

Karyotype is 46, XX, low estrogen level, blood LH may be elevated, blood androgen is high, urine 17-ketone and 17-hydroxysteroid are high.

Primary amenorrhea check item

1. Gynecological examination: Pay attention to the development of vulva and vaginal distribution, whether there is clitoral hypertrophy, vaginal development, whether the vagina, hymen are obstructed, deformed, atrophied, rich and small, and whether the ovaries are enlarged.

Second, the whole body examination: pay attention to general development and nutritional status, mental nerve type, intelligence level, and whether there is physical deformity. If necessary, measure height, weight, finger distance, and development of secondary sexual characteristics, such as obesity, hairiness, and galactorrhea.

Third, ovarian function test:

(1) Vaginal mucus crystallization examination: understand estrogen levels.

(2) Cervical mucus crystallization examination: to understand the level of estrogen and the effect of progestin.

(3) Basal body temperature measurement: to know whether ovulation and corpus luteum function.

(4) Determination of estrogen and progesterone levels: understand ovarian function.

Fourth, uterine examination:

(1) Official laparoscopy: understand whether the depth, width, and shape of the official cavity are deformed, and whether there is adhesion. Take the endometrium for pathological changes.

(2) Laparoscopy: look directly at the appearance of the uterus and gonads, except for congenital abnormalities, and take ovarian biopsy if necessary.

(3) Uterine axis oviduct iodine oil angiography: understand the uterine cavity shape, whether there is deformity, whether the fallopian tube is unobstructed, except for tuberculosis.

(4) Drug test: Progesterone and estrogen test to observe whether the endometrium is responding.

Primary amenorrhea treatment

Treatment of primary amenorrhea

(1) Hysterectomy:

The hymen "X" incision was made under anesthesia, the edge of the incision was sutured with gut, antibacterial infection was used, and hemorrhage was drained.

(2) Artificial vaginoplasty: Make a transverse incision between the vagina and rectum under anesthesia, bluntly separate 9-10cm, 3-4cm in diameter, and cover the vagina with a thigh flap or amniotic membrane implantation. Put in a vaginal model. Models are changed daily after opening. After half a year, take out the model daily for 1-2 hours to start sex, and then gradually increase the removal time. If you stop sex for a long time, you still need to place a vaginal model. Patients should learn to change models before being discharged. A short vagina can be used without surgery, using a vaginal model from small to large, mechanical expansion, until sexual life is satisfied.

(3) Laparotomy: The purpose of the biopsy is to testify that the gonads are testes or ovaries. The testes are removed in the abdominal cavity to prevent tumors.

(4) Vulvoplasty: first decide to become male or female, if necessary, please consult a urologist. For feminization of the testis, consideration should be given to removing the testicles to create a female vulva. Adrenal hyperplasia is too large and can be removed.

Endocrine therapy for primary amenorrhea

a . Supplement of estrogen: (1) For those who have a small uterus or are not sure whether or not they have a uterus, give Premarin, starting from 0.3mg / day, and gradually available to 0.625mg 1-2 times a day according to the situation. B- ultrasound was performed again from January to March to observe the presence of uterus and the size of the uterus. (2) For those without secondary uterine deficiency, ovarian dysplasia in those with testicular resection or those without ovaries will be given a small dose of estrogen supplementation and long-term supplementation.

b . Artificial cycle: Give artificial cycle supplement to those who need estrogen and have uterus. Especially for those who are too tall, those who have not recovered from the epiphysis should take a longer time to supplement (about one year or more) so that their height does not continue to increase.

c . Other hormone supplements: hypothyroidism, congenital adrenal hyperplasia, cooperation with internal medicine endocrinologist, and supplementation with thyroxine and prednisone.

d . Application of estrogen: The epiphysis is not healed and the body is short like Turner Syndrome. Before adding estrogen, a small dose of estrogen androgen should be used to increase the height. 0.625 mg of Levitrax can be used twice a week. It can be used from March to June. Increase 2-3cm. Long time application, can make the body up to more than 150cm.

e . Bromocriptine application: hyperprolactinemia, normal ovarian function, better after healing, bromocriptine can be used to reduce PRL and promote ovulation. Apply 1.25mg gradually to normal PRL, and then slightly reduce the amount for long-term maintenance. Take a small amount of food and medication before going to bed at night, then enter food and then fall asleep to reduce side effects, and measure basal body temperature at the same time to observe menstrual ovulation Happening.

f . Ovulation-promoting: HMG is used to promote ovulation in patients who have been married and who require fertility. Or use GnRH pulse to promote ovulation.

Other treatments for primary amenorrhea: supplement nutrition, improve the environment, psychological treatment, etc.

Primary amenorrhea treated with traditional Chinese medicine

^[1] Primary amenorrhea refers to those who are over 16 years of age (with regional differences), who have developed secondary sexual characteristics, or who have not yet developed secondary sexual characteristics over 14 years of age, and who have no menstrual cramps. Primary amenorrhea is rare, often due to genetic causes or congenital developmental defects, and it is more rare due to trauma.

Chinese medicine for treatment of primary amenorrhea:

(1) Insufficient kidney qi : primary amenorrhea, or late menarche, less amount after menstrual error, pale and dark, gradual amenorrhea, dizziness, tinnitus, soft waist and knees, frequent nocturia, low banding, dull complexion, tongue Light, thin and moss, thin and weak pulse, weak veins.

Governing Law: Bushen Yijing, Tiao Bu Chong Ren.

Recipe: 15 grams each of Cuscuta chinensis, Lycium barbarum, Rare Earth, Raspberry, Codonopsis, Shouwu, Huangjing, Angelica, Ligustrum lucidum, and 10 grams each of Ziheche, Xianlingpi, Cistanche.

Chinese patent medicine: Shenrong Pill.

(2) Liver and kidney loss : Abortion, abortion, prolonged illness or postpartum, menstrual flow gradually decreases, menstruation is delayed, even amenorrhea, dizziness, aching waist, knees, upset, hot flashes, less take-off, dry genitals, even Then the body is thin, pale, the skin is moist, the hair is shedding, the libido is light, the tongue is pale, the fur is thin white or yellow, and the veins are weak.

Governing law: nourish liver and kidney, nourish blood and fill essence.

Recipe: 15 grams each of Shudi, Yam, Ligustrum lucidum, Chinese wolfberry, Shouwu, Angelica and Poria, 12 grams of Mangosteen meat, 10 grams of Eucommia ulmoides, Cuscuta chinensis, Morinda officinalis.

Chinese patent medicine: Gynecological Jin Wan.

(3) Weakness of qi and blood : menstruation gradually delayed, menstrual flow gradually decreased, pale color and thinness, and then stopped, fatigue, fatigue, shortness of breath, dizziness, palpitations, insomnia, less hair, skin moistness, pale tongue The moss is thin and white, and the veins are weak.

Governing law: nourishing Qi and nourishing blood and regulating menstruation.

Recipes: Codonopsis, Astragalus, Atractylodes, Poria, Angelica, Angelica, 15g each, Polygonum chinense, Zhigancao each 10g, Chenpi, Guixin 6g each.

Chinese patent medicine: Babao Kunshun Pill, Wuji Baifeng Pill.

(4) Qi stagnation and blood stasis : menstruation sequence is uncertain, small amount, gradually to amenorrhea, or sudden amenorrhea after anger , depression, chest pain, breasts, bloating, abdominal pain, dark tongue or stasis , Thin white or thin yellow fur, astringent pulse.

Governing Law: regulating qi and activating blood, removing stasis and passing through menstruation.

Recipe: 15 grams each of angelica, red peony, Sichuan achyranthes bidentata, zedoary rhizome, and cooked land, 12 grams of peach kernel, safflower, coriander husk, vinegar, Chinese bellflower, chuanxiong, licorice each 10 grams.

Chinese patent medicine: Xuefu Zhuyu pills.

(5) Stagnation of phlegm : Delayed menstrual period, menstrual flow gradually decreases to stop, fatigue, fatigue, body fatness, stuffy chest, sputum eating less, more sputum, more volume, thick white, thick tongue Fat, white and greasy, smooth pulse.

Governing law: dryness and phlegm, blood circulation.

Recipe: 15 grams each of Poria, Atractylodes and Angelica, Pinellia oleifera, Chenpi, raw licorice, Zhixiangfu, bile Nanxing, coriander shell, Shenqu, Chuanxiong each Io grams, 3 pieces of ginger.

Chinese patent medicine: Erchen Pill.

Dietary therapy for primary amenorrhea

Primary Amenorrhea Regulating Menstruation and Crust Turtle Soup

Materials:

One soft-shelled turtle (about 500 grams), 25 grams of Zeeland, and a little cooking wine.

Production:

Put soft-shelled turtles in the pot, cover with fresh water, and slowly heat until the water rolls. After the soft-shelled turtles drain their urine, remove them to remove intestinal impurities. Stew in a cup for 2 hours until the turtle is cooked. Eat turtle meat and drink soup.

efficacy:

Activating blood and nourishing yin, softening and dispersing knots, removing stasis and regulating menstruation, suitable for primary amenorrhea, splenomegaly and other symptoms.

Primary Amenorrhea Angelica Egg Soup

Materials:

Angelica 9 grams, 2 eggs

Production:

Wash the angelica, cut into slices, put it into the clay pot with the eggs, and cook in 3 bowls of water. After the eggs are cooked, remove the shells. Use a needle to pierce more than 10 holes around the eggs. Serve in 20 minutes.

efficacy:

Nourishing Qi, nourishing blood and regulating menstruation. For women with blood deficiency and qi stagnation type of primary amenorrhea.

Primary Amenorrhea Tao Ren Niu Xue Tang

Materials:

10-12 grams of peach kernels, 200 grams of fresh beef blood (blood has coagulated).

Production:

Divide the beef blood into pieces, add the right amount of soup with peach kernel and water, and season with salt.

efficacy:

Remove stasis, blood, and menstruation. Indications Qi and blood stasis type amenorrhea, menstruation can not work for several months, lower abdomen pain refused to press, tongue purple dark, pulse astringent.

Primary amenorrhea wudou double red soup

Materials:

Black beans (black beans) 50-100 grams, safflower 5 grams, brown sugar 30-50 grams.

Production:

Place the front 2 flavors in a stew pot, add an appropriate amount of water, and simmer until the black beans are cooked thoroughly, remove the safflower, and mix in brown sugar.

efficacy:

Nourishes liver and kidney, promotes blood circulation, and beauty UFA. Applicable to blood deficiency and qi stagnation type amenorrhea.

Primary Amenorrhea Leonurus Root Sugar Water

Materials:

Motherwort 30 grams, black beans 60 grams, rice wine, brown sugar each amount.

Production:

Add 3 bowls of Motherwort and Black Beans with water, fry to 1 bowl, season with brown sugar, and pour into rice wine.

efficacy:

Activating blood, removing stasis, regulating menstruation, and beauty. Suitable for primary amenorrhea.

Primary amenorrhea walnut wine

Materials:

500 grams of walnuts and 1000 ml of rice wine.

Production:

Break the walnut shell, place the kernel in the container, pour the rice wine, and cover. After sealing for 20 days, filter the wine slurry, add 250 grams of brown sugar, boil and melt, bottle and set aside, 10 ml each time, 2 times a day.

Primary amenorrhea cuttlefish and mushroom winter porridge

Materials:

One cuttlefish, 50 grams each of shiitake mushrooms and winter bamboo shoots, 100 grams each of lean pork and japonica rice, 1 gram of pepper, 10 grams of cooking wine, and appropriate amounts of salt and MSG.

Production:

Cut the cuttlefish boneless, soak the hair with warm water, wash, and shred; pork, shiitake mushrooms, and winter bamboo shoots are also shredded for later use. Wash the japonica rice thoroughly, add the shredded pork, cuttlefish, shiitake mushrooms, winter bamboo shoots, cooking wine to the boil, then add salt, monosodium glutamate and pepper powder.

efficacy:

Replenishes vital energy, regulates menstruation, converges and stops bleeding, and keeps skin beautiful. Applicable to primary amenorrhea, increased vaginal discharge, and complexion.

Primary amenorrhea indica rice lentils porridge

Materials:

30 grams of barley, 15 grams of fried lentils, 15 grams of hawthorn.

Production:

Put indica rice, lentils, and hawthorn together in a casserole and add water to cook the porridge. Season the porridge with brown sugar. Once daily for 7 days.

efficacy:

Spleen and dampness, stasis and pass through.

Primary amenorrhea with peach kernel porridge

Materials:

5 grams of peach kernels, 30 grams of incense sticks, 50 grams of japonica rice, and 30 grams of brown sugar.

Production:

Decoction with Xiangfushui; smash the peach kernels, soak in water, grind the juice to remove residue, enter the casserole with rice, Xiangfujian, brown sugar, add an appropriate amount of water, and cook into thin porridge with gentle heat. Serve warm, 2 times a day for several days.

efficacy:

Qi, blood circulation, menstruation.

Primary Amenorrhea Pigeon Onion and Ginger Porridge

Materials:

150 grams of pigeon meat, 20 grams of minced ginger, 50 grams of minced pork, 100 grams of japonica, 1 grams of ground pepper, 10 grams of cooking wine, sesame oil, salt, and monosodium glutamate.

Production:

Remove the spurs from the pigeon meat, cut into cubes, add pork, green onion ginger, cooking wine and salt, mix well and set aside. Wash the japonica material thoroughly, add 1,000 ml of water to the pot, boil it and add pigeon meat, etc. When cooking the porridge, add sesame oil, monosodium glutamate and pepper powder.

efficacy:

Nourish the kidney and nourish qi, expel wind and detoxify, and blood joy. Suitable for primary amenorrhea and blood deficiency amenorrhea.

Primary amenorrhea longan porridge

Materials:

9 grams of dried longan meat, 30 grams of barley kernels, 1 spoon of brown sugar.

Production:

Boil porridge with dried longan and barley, add 1 spoon of brown sugar and serve. 1 dose daily.

efficacy:

Spleen and nourishing menstruation. Indications of weak amenorrhea of qi and blood, symptoms of less menstrual flow, prolonged menstrual period to amenorrhea, fatigue, lack of complexion, hair loss, pale tongue, and less moss.

Primary amenorrhea black tempeh

Materials:

3 grams of black beans, 15 grams of motherwort, 5 grams of amomum.

Production:

First grind the black beans, wash the motherwort and amomum, and fry the black beans for juice.

efficacy:

Promotes blood circulation and stasis, regulates qi and stagnates, rejuvenates skin. Applicable to blood deficiency and qi stagnation type amenorrhea.

Primary Amenorrhea Guiqi Cuttlefish Slices

Materials:

30 grams of shredded ginger, 10 grams of angelica, 20 grams of astragalus and 300 grams of cuttlefish.

Production:

Decoction of Angelica sinensis and Astragalus membranaceus, take 100 ml of medicinal solution, set aside, boneless cuttlefish, and slice. Put the oil in the casserole and cook. Put the cuttlefish slices and ginger shreds in the pan and stir-fry, add a little salt, add a small amount of starch with Gui and Qi medicinal solution, and place in a pan. Serve with a meal.

efficacy:

Yiqi Yangxue, blood circulation and menstruation.

Primary amenorrhea with ginger and garlic

Materials:

250 grams of lamb, 50 grams of tender ginger, 2 bell peppers, and 50 grams of garlic.

Production:

Wash the various flavors and place them in a wok and stir-fry, mix them into the sauce, serve as a dish, and eat at will. Finish the day.

efficacy:

Nourish the kidney yang. Suitable for amenorrhea. Those with weak kidney yang, who have a small amount of symptoms at the later stage of menstruation, gradually go to amenorrhea, who have sour waists, soft legs, dizziness, tinnitus, and cold chills.

Primary amenorrhea squid peach kernel fried

Materials:

1 cuttlefish (about 250 grams), 6 grams of peach kernels.

Production:

Wash the fish and cook the soup with peach kernel. Take 1 dose daily for 1 week per month.

efficacy:

Replenish qi and blood, pass through menstruation. Applicable to amenorrhea, a type of weakness of qi and blood, symptoms of menstrual gradual delay, a small amount of light color, and gradually no menopause, dizziness, gloomy look, pale tongue, few mosses, pulse weakness.

Primary amenorrhea steamed cypress seed pork liver

Materials:

10 grams of Bo Ziren, 150 grams of pork liver.

Production:

The pork liver was washed, the incision was filled with cypress kernels, and the pan was steamed. Take 1 dose daily in 2 divided doses. Take 25 ml rice wine warm each time.

efficacy;

Tonic, nourish blood, pass through menstruation. Applicable to amenorrhea, a type of weakness of qi and blood, with less complex symptoms, palpitations, shortness of breath, unfavorable hair color, easy to fall off, loss of appetite, and less red tongue coating.

Primary amenorrhea chicken blood rattan stew

Materials:

10 grams of hellebore and 150 grams of lean pork.

Production:

Add the above two flavors with water and stew until the meat is rotten and season. Eat meat and drink soup once a day for 5 days as a course of treatment.

efficacy:

Activating blood and regulating menstruation.

Primary amenorrhea chicken blood rattan pot eggs

Materials:

30 grams of hellebore, 2 eggs, a little white sugar.

Production:

Boil the chicken blood rattan and eggs with 2 bowls of water, boil the eggs after they are cooked and cook for a while. Add 1 bit of white sugar after cooking.

efficacy:

Activating blood and replenishing blood, shujing and activating collaterals, and beauty. For irregular menstruation, amenorrhea, anemia, pale complexion, etc.

Primary amenorrhea stewed white pigeon

Materials:

30 grams of pangolin, 1 white pigeon, a little rice wine.

Production:

Smash the snails into the belly of a cleaned white pigeon, add an appropriate amount of water, a little rice wine, stew in a tiled cup and simmer in water, season and eat.

efficacy:

Nourishes the kidney and nourishes qi, disperses and clears the menstruation, and brightens the skin. For amenorrhea caused by physical weakness.

Primary amenorrhea braised knee trotters

Materials:

15 grams of Sichuan achyranthes, 2 trotters, 50 ml of rice wine.

Production:

Shave the trotters clean and hairless. Cut off the two sides and cut into small pieces. Put them into a large stew pot with the knees, add 500 ml of water, and simmer until the trotters are cooked. Remove the knees, and eat the remaining trotters and soup.

efficacy:

Huoxuetongjing and skin beauty. Applicable to women with qi stagnation and blood stasis type amenorrhea.