Management of Amenorrhoea (Ihtibas-al-Tamth) in Unani System of Medicine: A Review

Menstrual patterns can be an indicator of overall health and self-perception of well-being. Amenorrhoea is the absence of menses in women of reproductive agewhich may be primary or secondary. Primary amenorrhoea refers to the absence of menarche at the age of 16 and secondary amenorrhoea is the cessation of menses for at least 6 months in already cycling women. Secondary amenorrhoea is more common than primary amenorrhea. Ihtibas al-Tamth (amenorrhoea) is defined in the Unani system of medicine as the absence of monthly bleeding for more than 2 months or a decrease in the quantity of menstrual blood. The etiologies of amenorrhoea may be considered categorically as outflow tract abnormalities, primary ovarian insufficiency, hypothalamic or pituitary disorders, other endocrine gland disorders, sequelae of chronic disease, physiologic, or induced. The causes of Ihtibas al-Tamth are related to Quwwat Dafia al-Badan, Madda and Johar Khun-i-Hayd, or Ala Makhraj -i-Hayd. Su’-i-Mizaj Barid, Yabis, Harr or Harr wa Yabis, Su’-i-Mizaj Maddi or Sada can lead to Du’f al-Quwwat-i-Dafia. Abnormality in quality and quantity of Madda in Su’-i-Mizaj Maddi can also lead to ihtibas al-tamth. Amenorrhoea is not a diagnosis but a symptom indicating anatomical, genetic and neuroendocrine abnormalities. It can be determined by two different groups of causes: (a) anatomical defects of the genital organs; (b) endocrine dysfunctions. Both congenital and acquired anomalies in the structure of the uterus and vagina could produce amenorrhoea; nevertheless, in most patients, amenorrhoea is related to an ovarian malfunction. Symptoms usually associated with amenorrhoea are headache, nausea, back ache and lower abdominal pain, tiredness, and some respiratory problems. Main principle of treatment includes Tawleed-i-Dam, Tanqiya-i-Akhlat Ghaleeza, Talteef-i-Khilt, Tafteeh-i-Uruq Raham and Tahzeel if obesity is the cause. Surgical intervention if hymen is imperforated. Some regimenal therapies are also beneficial in amenorrhoea, such as Fasd-i-Safin, Hammam-i-Murattib and Hijama-i-Nariya on calf area. Some Unani drugs, which are beneficial in amenorrhoea, are Habb-i-Mudir, Safoof-i-Baboona, Kushta Faulad, and Safoof Muhazzil. In the present scenario, it is utmost important to educate the patients to live a healthy and hygienic life and to avoid those factors which cause amenorrhoea.