Many women experience missed periods (amenorrhea) or less menstrual flow after drastic weight loss. Sudden weight reduction, inadequate nutrition, emotional stress, and excessively vigorous exercise can disrupt hormonal balance. This endocrine disturbance interferes with ovulation patterns, ultimately affecting menstrual cycles. How can Traditional Chinese Medicine help address these consequences after weight loss and dieting?
Real Case Study: Chinese Medicine(TCM) therapy to missed/stopped period after weight loss
Ms. Wong, 33 years old: “Doctor, I haven’t had my period for over half a year. I wonder if it’s related to my dieting and weight loss back then…”
Patient’s background: Ms. Wong noticed her metabolism slowing down in recent years, leading to easier weight gain. She began dieting strictly—starting with intermittent fasting (16:8 method), then progressing to skip meals frequently. Some days she ate only once or replaced proper meals with fruits/smoothies.
How it get worse: Month 2 of dieting: Menstrual flow of Ms. Wong began decreasing. Month 3: Periods lasted only 1–2 days. After 6 months: Stopped menstrual period. Even after resuming normal eating habits, her menstrual cycle failed to return.
Patient’s symptoms：Amenorrhea: Missed period for >6 months. Digestive issues: Bloating, indigestion, constipation (bowel movements every 2–3 days with dry, hard stools). Constitutional symptoms: Chills and wind intolerance, spontaneous sweating, chronic fatigue. Menstrual history: Past periods accompanied by diarrhea and lumbar soreness.
Why Does Chinese Medical(TCM) Gynecology Link Extreme Dieting to Amenorrhea (Irregular/Missed Periods)?
Ms. Wong’s case is identified as “Spleen-Kidney Qi Deficiency” (脾腎氣虛)-type amenorrhea. Here’s the TCM pathophysiology:
1. Initial Stage: Qi-Blood Depletion & Thin Endometrium
Without sufficient nourishment, the uterine lining fails to thicken, leading to lighter or shorter periods. Disordered eating (e.g., skipping meals, inadequate nutrition) weakens Qi and Blood production.The Liver and Kidneys (which store reproductive essence in TCM) become deficient.
2. Prolonged Starvation: Body Enters “Survival Mode”
Severe deficiencies in iron, protein, and healthy fats further deplete Qi-Blood reserves. The body prioritizes vital functions over reproduction, triggering:
- Hormonal imbalance: Low estrogen and luteinizing hormone (LH) disrupt ovulation.
- “Blood Exhaustion” (血枯) Amenorrhea: Ovarian function halts; periods stop completely.
Even after resuming normal eating, the hypothalamic-pituitary-ovarian axis (HPO axis) may remain dysregulated, delaying recovery.
3. Systemic Damage of the whole body
Ms. Wong’s case exemplifies how extreme dieting weakens the Spleen-Stomach (digestive system):
Poor Nourishment of Tissues: Cold limbs, lumbar weakness, and spontaneous sweating reflect insufficient Qi-Blood to warm and energize the body.
Qi Deficiency → Digestive Dysfunction: Bloating, constipation (due to weak peristalsis), and fatigue.
Chinese Medicine (TCM) Herbal Treatment Restored Menstruation in 2 Months
After 6+ months of missed period(amenorrhea), Ms. Wong began a tailored TCM herbal regimen focused on tonifying Qi-Blood and Nourishing the Kidneys (補益氣血養腎)
Month 1: Signs of Recovery
Ms. Wong experienced increased clear vaginal discharge which indicates ovarian function revival (TCM: 腎氣充盛, “Kidney Qi replenishment”) and alao improved digestion and energy levels.
Month 2: Menstrual Return
Premenstrual symptoms appeared on Ms. Wong (mild lower abdominal soreness/bloating), signaling blood flow activation. After adding blood-moving herbs (e.g., Chuan Xiong (川芎)) to promote menstrual onset. There is light red menses for 2–3 days (initial scanty flow expected after prolonged amenorrhea).
Long-Term Regulation
After that, we continued with Spleen-Kidney tonic herbs to consolidate results. Ms. Wong kept on achieving regular cycles (30–35 days) with normal flow and color within 3–4 months after her first consultation.
Potential Risks of Untreated Amenorrhea (Stopped Periods)
1. Endometrial Hyperplasia & Cancer Risk
The endometrium (uterine lining) normally sheds monthly to prevent abnormal cell buildup. If retained >3 months without shedding, it increases the risk of endometrial hyperplasia (precancerous thickening). Long-term may progress to endometrial cancer (especially with unopposed estrogen exposure).
Take Action: Women with missed periods exceeding 3 months should seek treatment (TCM or Western medicine) as soon as possible
2. Infertility & Premature Ovarian Failure (POF)
Stopped periods = stopped ovulation: Chronic amenorrhea signals ovarian dysfunction, reducing natural pregnancy chances.
Key markers of declining ovarian reserve:
- AMH <2 ng/mL (in women under 40) suggests diminished ovarian function. Often requires IVF + TCM support (e.g., Kidney-tonifying herbs) to improve egg quality.
3. Early Menopause Symptoms & Systemic Health Impacts
Even for women not planning for pregnancy, low estrogen from POF leads to:
- Early aging (linked to hormonal imbalance).
- menopause symptoms: Hot flashes, night sweats.
- Urogenital atrophy: Vaginal dryness, painful intercourse.
- Osteoporosis (due to accelerated bone loss).
- Cardiovascular disease (loss of estrogen’s protective effects).
Chinese Medicine(TCM) Dietary Guidelines for Blood-Deficiency Amenorrhea/Missed Periods
1. Foundational Nutrition: The “211 Balanced Plate” Rule
- 2 parts vegetables: Dark leafy greens (e.g., spinach, kale) rich in iron and folate.
- 1 part high-quality protein: Eggs, lean meat, or legumes (e.g., black beans) to support blood production.
- 1 part whole grains: Brown rice, quinoa, or oats for sustained energy and B vitamins.
- Avoid: Drastic diet changes (e.g., keto, fasting) that disrupt Qi-Blood balance.
2. Foods to Avoid
- Processed sweets: Refined sugar depletes spleen Qi, worsening dampness and fatigue.
- Raw/cold foods: Ice drinks, salads, or sushi weaken digestive fire (脾陽), impairing nutrient absorption.
3. Caution Against Self-Prescribed “Tonics”
- Avoid unverified herbs or excessive estrogen-boosting supplements (e.g., unchecked soy isoflavones), which may trigger fibroids or endometrial hyperplasia.
4. TCM-Recommended Blood-Nourishing Foods
- Daily additions:
- Goji berries (杞子): Steep in warm water or add to soups; supports Liver-Blood.
- Red dates (紅棗): Cook with rice porridge for iron and sweetness.
- Black sesame (黑芝麻): Sprinkle on oatmeal; rich in omega-3s and calcium.
5. Lifestyle Synergy
- Warm meals: Prioritize cooked, warm foods to aid Spleen function.
- Timing: Eat at fixed intervals to stabilize blood sugar and Qi flow.
Eat warm, iron-rich foods like red dates and black sesame, avoid cold salads and sugary snacks. Consistency beats quick fixes! If you have any questions, you can consult a Chinese Medicine Practitoner.
