# Japanese Traditional Herbal Medicine (Kampo Medicine) Improved Functional Hypothalamic Amenorrhea With Inherited Antithrombin Deficiency

## TL;DR

A Japanese woman with a blood clotting disorder and menstrual issues was successfully treated with traditional herbal medicine instead of hormone therapy.

## Contribution

This case demonstrates the potential of Kampo medicine as a safe alternative for treating amenorrhea in patients with inherited antithrombin deficiency.

## Key findings

- Keishibukuryogan and Shigyakusan restored menstruation in a patient with FHA and AT deficiency.
- Adding Tokakujokito resolved constipation and normalized the menstrual cycle.
- No adverse effects were observed with the Kampo treatment.

## Abstract

We report a case of a 28-year-old Japanese woman diagnosed with functional hypothalamic amenorrhea (FHA). Although oral estrogen-progestin therapy was initially recommended, laboratory tests revealed an inherited antithrombin (AT) deficiency, which is associated with an increased risk of venous thromboembolism (VTE). To mitigate this risk, we selected Kampo medicine (Japanese traditional herbal medicine) as an alternative treatment for amenorrhea. She was prescribed Keishibukuryogan and Shigyakusan, which led to the resumption of menstruation shortly after initiation. Subsequently, Tokakujokito was added to address persistent constipation, resulting in the regularization of her menstrual cycle and resolution of associated symptoms without adverse effects. This case suggests that Kampo medicine may offer a viable therapeutic alternative for managing menstrual disorders in patients predisposed to thrombosis.