The poor health, mental and physical, that usually accompanies amenorrhea is often thought by the patient and her friends to be the result, rather than the cause—as it really is—of the arrested bleeding.
Treatment.—The treatment of amenorrhea depends upon the cause of the condition. Little, if any, benefit is to be expected in those cases due to defective development of the uterus or the ovaries. If an attempt at menstruation is made, as shown by periodical local pain and general disturbance, and the uterus is found to be small and sharply anteflexed, benefit may sometimes result from thorough dilatation of the cervix.
Most cases of amenorrhea demand general treatment. The mode of life should be regulated according to strict hygienic principles. Fresh air, sunshine, baths, and suitable exercise should be prescribed. Studious girls should be made to lead more active lives. A change of surroundings is beneficial. A visit to the seashore and salt-water baths are of advantage.
The general health should be improved by the administration of iron, strychnine, or some other tonic. Blaud’s pill and the hypophosphites are useful. Obesity should be relieved by a regulated diet and exercise. The regularity of the bowels should always be carefully attended to. Most of the so-called emmenagogues are of but little, if any, value. Benefit is sometimes derived from the use of potassium permanganate (gr. j-ij three times a day) and the binoxide of manganese (gr. j-ij three times a day). These medicines should be administered in pill form for several weeks.
Oxalic acid in doses of from ⅒ to ¼ of a grain, given in lemon syrup for a period of from one to four months, has been recommended, and is sometimes very useful.
It seems probable that pelvic massage practised for a period of several months may result in benefit.
Acute suppression of menstruation during a menstrual period is a phenomenon to which the term amenorrhea is not properly applicable. It may be caused by exposure to cold or by some sudden emotional disturbance during the menstrual flow.
The condition may be unaccompanied by any subjective symptoms, or there may be present ovarian and pelvic pain.
The treatment consists in rest in bed, the application of warm fomentations to the lower abdomen, and hot foot-baths. Especial care of the general health should be observed at the following menstrual period.
Scanty Menstruation.—Scanty menstruation occurs when the menstrual flow is much less than normal. It must be remembered that individual peculiarities in this respect may be within the limits of health. When one or more periods are missed, and the flow shows a continual tendency to diminish in amount, treatment may be demanded.