Modern medicine explains amenorrhea through an imbalance in the hypothalamic-pituitary-ovarian axis. This HPO axis is a core system where the brain (hypothalamus and pituitary gland), acting as our body's control tower, gives commands to the ovaries, and the ovaries send feedback back to the brain, precisely regulating hormones to maintain the menstrual cycle. It is just like an orchestra's conductor and musicians achieving perfect harmony.
However, stress, excessive dieting, over-exercising, and irregular lifestyle habits are major culprits that disrupt the balance of this HPO axis. For instance, extreme stress increases the secretion of the stress hormone cortisol, which disrupts the regular secretion pattern of gonadotropin-releasing hormone released by the hypothalamus. This disturbance in gonadotropin-releasing hormone reduces the secretion of follicle-stimulating hormone and luteinizing hormone from the pituitary gland, consequently suppressing ovarian follicle development in the ovaries and preventing ovulation from occurring. Without ovulation, progesterone is not sufficiently secreted, and the process of the endometrium properly forming and shedding (menstruation) comes to a halt. This is one of the most common mechanisms leading to amenorrhea.
In addition, excessive dieting that rapidly depletes body fat drops levels of leptin secreted by adipocytes, suppressing gonadotropin-releasing hormone secretion. Endocrine diseases such as thyroid gland dysfunction or polycystic ovary syndrome can also directly impact this HPO axis and disrupt the menstrual cycle. Just as uterine coldness in the Donguibogam went beyond mere temperature to signify a decline in the body's energy and circulation, amenorrhea in modern medicine is not merely the absence of a period, but a warning that our body's most delicate hormonal control system is experiencing serious imbalance due to external environments and internal factors. If this state persists, it can lead to long-term health problems such as reduced bone mineral density, increased cardiovascular disease risk, and endometrial hyperplasia, making it crucial to seek professional help for an accurate diagnosis and treatment. While our bodies possess wise systems to protect themselves, they sometimes need our attention and care.
