Weight Gain Case Study

Translated By: Joe Hing Kwok Chu   

Amenorrhea and Weight

A young Asian woman, age 31, complained that she had not had menses for 2 and a half years.  She was always cold, especially while sleeping. She had to get up to urinate a few times after going to bed. Her pulse reading was weak and heart rate was low. Sometimes the tongue showed water retention. Systolic blood pressure was around 90 mmHg to 100 mmHg and diastolic pressure was around  49 mmHg  to 65 mmHg and heart rate about 49 to 51.  Her past medical history, beside amenorrhea, includes depression, weight fluctuation, binging and purging.

The past blood tests showed that the cortisol level was unstable, TSH was marginally high, low level of estradiol, high level of serum LH and FSH, low aldosterone. One of the 24 hr urine tests showed that the cortisol was high but the urine sample collected was much larger than normal. She complained of chronic back pain, hair loss, coarse hair, difficulty in concentrating, irritability, insomnia, depression with suicidal thought, painful sex with dryness in vagina and low libido.

Clinical reports include: decrease of creases in the wall of vagina, pale labia, vaginal dryness, decrease elasticity of wall of vagina, atrophy of minor, and coarse hair, some edema, cold extremities and scoliosis of spine, and bruises.                      

After 3 months of using chi and herb therapy the menses came back. Then she had to go to Hong Kong to attend her sister's wedding. After that the menses stopped again.  During the time when she was back, her marriage was unstable. She was taking a full load in graduate school and also preparing for her international law exam. Her period stopped for 6 months and then came back again.  She her height is 1.68 meter. During the last 6 months of her visits she gained 27 kilograms and her weight at the time of this report was 77 kg.  Her BMI was 27.3 which is over weight or slightly over the cut off point of 27 BMI for obesity for Asians. Her body became very warm and her heart rate went up from ~50 to 70s to 90s. Clinical examination showed serious flatulence and odor of yeast. She mistakenly thought that over-eating had caused the overly warming of the body and speeding up the heart rate and thought the herb she was taking cause the eating problem.

Discussion:

The clinical observation and lab tests show that there is a risk of premature menopause. The marital situation and her school load caused the extra secretion of cortisol due to stress. This creates the urge to eat and weight gain.  The low level of serotonin also contribute to the craving of carbohydrates. The decreasing E₂ contributes to some degree of osteoporosis and scoliosis of the spine which creates the chronic lower back pain; and also contribute to some extend to the weight problem.  The high level of glucocorticoid increased her heart rate and body temperature and the urge to over eat.

At issue is to control the stress, bone loss, depression, and to reverse the premature ovarian aging.

Her stress caused the increase level of cortisol, epinephrine, and norepinephrine which in turn caused the increase of heart rate, body temperature and the eating appetite. The platelet coagulation caused bruises and the leaching out of serotonin which in turn contributed a big part of the causes of mood swing and craving for carbohydrates. Her over consumption of sugar caused yeast infection of the digestive tract.