Materiały źródłowe

• #1 Amenorrhea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/amenorrhea/diagnosis-treatment/drc-20369304

  Treatment depends on the underlying cause of your amenorrhea. In some cases, birth control pills or other hormone therapies can restart your menstrual cycles. Amenorrhea caused by thyroid or pituitary disorders may be treated with medications. If a tumor or structural blockage is causing the problem, surgery may be necessary.

• #2 Amenorrhea: Types, Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/3924-amenorrhea

  Amenorrhea is often a sign of a treatable condition. With treatment, your regular menstrual cycle will usually resume. […] If your period stopped because of menopause, lactation or pregnancy, your provider won’t need to treat it. […] In other cases, your treatment will depend on the cause and may include: Following a diet and exercise plan that help you maintain a weight that’s healthy for you. […] Hormonal treatment (medication), as prescribed by your healthcare provider. […] Most cases of amenorrhea are treatable. With treatment, your periods should start to happen regularly. […] Talk to your healthcare provider if you’re older than 15 and haven’t gotten your period or you’ve had a normal menstrual cycle but now you’re missing periods. Amenorrhea is usually the sign of a treatable condition. Once your provider figures out what’s causing missed periods, you can get care to regulate your cycle. You may need lifestyle changes or hormonal treatment to help resume normal menstrual cycles.

• #3 Amenorrhea in adolescents: a narrative review – Newbery – Pediatric Medicine

  https://pm.amegroups.org/article/view/4922/html

  Amenorrhea warrants deliberate evaluation and potential treatment. […] Understanding where particularly in the menstrual cycle or the affected regulatory process amenorrhea is occurring should lead to more effective treatment specific to the patient’s condition. […] Early detection in adolescent females helps prevent potential future adverse health outcomes. This article provides an overview of the different causes, evaluation and treatment approach of amenorrhea, with special focus on polycystic ovary syndrome (PCOS), eating disorders (EDs), and the female athlete triad (FAT). […] Provision of appropriate care that is safe and evidence-based can prevent future negative health implications such as infertility and compromised bone health. […] Once the diagnosis of PCOS is established, the mainstay of treatment is oral contraceptives. These are effective in regulating menstrual cycles and lowering androgen levels.

• #4 Amenorrhea – Wikipedia

  https://en.wikipedia.org/wiki/Amenorrhea

  Treatment for amenorrhea varies based on the underlying condition. Treatment not only focuses on restoring menstruation, if possible, but also preventing additional complications associated with the underlying cause of amenorrhea. […] In primary amenorrhea, the goal is to continue pubertal development, if possible. For example, most patients with Turner syndrome will be infertile due to gonadal dysgenesis. However, patients are frequently prescribed growth hormone therapy and estrogen supplementation to achieve taller stature and prevent osteoporosis. In other cases, such as MRKH, hormones do not need to be prescribed since the ovaries are able to function normally. Patients with constitutional delay of puberty may be monitored by an endocrinologist, but definitive treatment may not be needed as there will eventually be progression to normal puberty.

• #5 Amenorrhea: Absence of Periods | ACOG

  https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

  Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea: Primary amenorrhea is when a girl does not get her first period by age 15. Secondary amenorrhea is when a woman who already menstruates does not get her period for 3 months or more. […] If primary amenorrhea is caused by the ovaries not producing enough estrogen, you can discuss using hormone therapy to start puberty and your periods. Hormone therapy also can help prevent osteoporosis. […] Treatment for secondary amenorrhea depends on the cause: Primary ovarian insufficiency hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce. PCOS treatment may involve weight loss and hormone therapy. […] Most people with amenorrhea benefit from a healthy diet and exercise. Reducing stress also may help. And it is important to consume enough calcium and vitamin D to help prevent osteoporosis.

• #6 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #7 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #8 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #9 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  The treatment for amenorrhea depends on the underlying cause, as well as the health status and goals of the individual. […] If primary or secondary amenorrhea is caused by lifestyle factors, your health care provider may suggest changes in the areas below: […] Having overweight or severe underweight can affect your menstrual cycle. Attaining and maintaining a healthy weight often helps balance hormone levels and restore your menstrual cycle. […] For primary amenorrhea, depending on your age and the results of the ovary function test, health care providers may recommend watchful waiting. […] Primary amenorrhea caused by chromosomal or genetic problems may require surgery. […] Treatment for secondary amenorrhea, depending on the cause, may include medical or surgical treatments or a combination of the two.

• #10 Amenorrhea: Absence of Periods | ACOG

  https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

  Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea: Primary amenorrhea is when a girl does not get her first period by age 15. Secondary amenorrhea is when a woman who already menstruates does not get her period for 3 months or more. […] If primary amenorrhea is caused by the ovaries not producing enough estrogen, you can discuss using hormone therapy to start puberty and your periods. Hormone therapy also can help prevent osteoporosis. […] Treatment for secondary amenorrhea depends on the cause: Primary ovarian insufficiency hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce. PCOS treatment may involve weight loss and hormone therapy. […] Most people with amenorrhea benefit from a healthy diet and exercise. Reducing stress also may help. And it is important to consume enough calcium and vitamin D to help prevent osteoporosis.

• #11 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  The treatment for amenorrhea depends on the underlying cause, as well as the health status and goals of the individual. […] If primary or secondary amenorrhea is caused by lifestyle factors, your health care provider may suggest changes in the areas below: […] Having overweight or severe underweight can affect your menstrual cycle. Attaining and maintaining a healthy weight often helps balance hormone levels and restore your menstrual cycle. […] For primary amenorrhea, depending on your age and the results of the ovary function test, health care providers may recommend watchful waiting. […] Primary amenorrhea caused by chromosomal or genetic problems may require surgery. […] Treatment for secondary amenorrhea, depending on the cause, may include medical or surgical treatments or a combination of the two.

• #12 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #13 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #14 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Patients with hypothalamic amenorrhea caused by excessive exercise may refuse to correct or change their behavior. […] Symptomatic hyperprolactinemia from a pituitary disorder should first be treated by dopamine agonists such as bromocriptine (Parlodel) and cabergoline (Dostinex). […] Hormone replacement therapy (HRT) should be offered to allow completion of puberty in a controlled fashion, similar to her peers, and should facilitate maximum bone density development. […] Treatment should be decided on an individual basis. Some patients may require estrogen replacement therapy (ERT) for hot flashes and other symptomatic menopausal issues. […] The need for ongoing care is defined by the mechanism disrupting the menstrual cycle and the patient’s desires.

• #15 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  Hypothalamic amenorrhea is when your hypothalamus causes your period to stop. Common causes include excessive exercise, stress and undereating. […] The main treatment healthcare providers use for hypothalamic amenorrhea is lifestyle changes. Lifestyle changes may include limiting vigorous exercise, gaining weight or finding ways to reduce stress levels. […] Your provider may recommend speaking with a dietitian so you can better understand what nutrients your body needs and how many calories you should be eating each day. […] Some people with hypothalamic amenorrhea see a mental health professional for cognitive behavior therapy. This is especially helpful for people who have eating disorders or who are in denial about the condition. […] In some cases, your provider may recommend hormone treatment, birth control pills or fertility medication to induce menstruation.

• #16 Hypothalamic Amenorrhea Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hypothalamic-amenorrhea

  The 2017 guideline addresses: […] Treating FHA and concomitant conditions with lifestyle changes and hormone therapy, and providing fertility treatments for women with FHA. […] Hypothalamic amenorrhea patients should be evaluated for inpatient treatment if they have an abnormally slow heart rate, low blood pressure, or an electrolyte imbalance. […] In adolescents and women with FHA, we recommend correcting the energy imbalance to improve hypothalamic-pituitary-ovarian (HPO) axis function; this often requires behavioral change. Options for improving energy balance include increased caloric consumption, and/or improved nutrition, and/or decreased exercise activity. This often requires weight gain. […] In patients with FHA wishing to conceive, after a complete fertility workup, we suggest: treatment with pulsatile gonadotropin-releasing hormone (GnRH) as a first line, followed by gonadotropin therapy and induction of ovulation when GnRH is not available.

• #17 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  Hypothalamic amenorrhea is when your hypothalamus causes your period to stop. Common causes include excessive exercise, stress and undereating. […] The main treatment healthcare providers use for hypothalamic amenorrhea is lifestyle changes. Lifestyle changes may include limiting vigorous exercise, gaining weight or finding ways to reduce stress levels. […] Your provider may recommend speaking with a dietitian so you can better understand what nutrients your body needs and how many calories you should be eating each day. […] Some people with hypothalamic amenorrhea see a mental health professional for cognitive behavior therapy. This is especially helpful for people who have eating disorders or who are in denial about the condition. […] In some cases, your provider may recommend hormone treatment, birth control pills or fertility medication to induce menstruation.

• #18 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  Hypothalamic amenorrhea is when your hypothalamus causes your period to stop. Common causes include excessive exercise, stress and undereating. […] The main treatment healthcare providers use for hypothalamic amenorrhea is lifestyle changes. Lifestyle changes may include limiting vigorous exercise, gaining weight or finding ways to reduce stress levels. […] Your provider may recommend speaking with a dietitian so you can better understand what nutrients your body needs and how many calories you should be eating each day. […] Some people with hypothalamic amenorrhea see a mental health professional for cognitive behavior therapy. This is especially helpful for people who have eating disorders or who are in denial about the condition. […] In some cases, your provider may recommend hormone treatment, birth control pills or fertility medication to induce menstruation.

• #19 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  Hypothalamic amenorrhea is when your hypothalamus causes your period to stop. Common causes include excessive exercise, stress and undereating. […] The main treatment healthcare providers use for hypothalamic amenorrhea is lifestyle changes. Lifestyle changes may include limiting vigorous exercise, gaining weight or finding ways to reduce stress levels. […] Your provider may recommend speaking with a dietitian so you can better understand what nutrients your body needs and how many calories you should be eating each day. […] Some people with hypothalamic amenorrhea see a mental health professional for cognitive behavior therapy. This is especially helpful for people who have eating disorders or who are in denial about the condition. […] In some cases, your provider may recommend hormone treatment, birth control pills or fertility medication to induce menstruation.

• #20 Functional Hypothalamic Amenorrhea: A Stress-Based Disease

  https://www.mdpi.com/2673-396X/2/3/20

  The most appropriate and effective treatment for FHA is that of treating the underlying cause of hypogonadotropic hypogonadism. It includes providing the right amount of energy in the form of sufficient calories, stopping excessive sports or reducing stress, or the ability to deal with it. […] First of all, the focus should be on weight gain in patients, which is a broadly understood lifestyle change. The recovery of FHA patients with low body weight is associated with an increase in BMI or fat mass. […] Pharmacological treatment involving the use of replacement doses of hormones should be started after 6–12 months of ineffective non-pharmacological and behavioral lifestyle modifications. The most appropriate therapy that should be administered is transdermal cyclic estrogen-progestogen therapy.

• #21 Functional Hypothalamic Amenorrhea: A Stress-Based Disease

  https://www.mdpi.com/2673-396X/2/3/20

  The most appropriate and effective treatment for FHA is that of treating the underlying cause of hypogonadotropic hypogonadism. It includes providing the right amount of energy in the form of sufficient calories, stopping excessive sports or reducing stress, or the ability to deal with it. […] First of all, the focus should be on weight gain in patients, which is a broadly understood lifestyle change. The recovery of FHA patients with low body weight is associated with an increase in BMI or fat mass. […] Pharmacological treatment involving the use of replacement doses of hormones should be started after 6–12 months of ineffective non-pharmacological and behavioral lifestyle modifications. The most appropriate therapy that should be administered is transdermal cyclic estrogen-progestogen therapy.

• #22 Amenorrhea and Anorexia | The Bulimia Project

  https://bulimia.com/anorexia/anorexia-amenorrhea/

  Amenorrhea is the absence of menstrual periods in biological women. […] Regardless, the disruption of a normal menstrual cycle for women of childbearing age is often an indication of a significant health problem. But if the issue is connected to an eating disorder, there are treatment programs that can help. […] If you’re experiencing amenorrhea, it’s important to contact your doctor. […] There is no official treatment recommended for amenorrhea, but there are some ways to help alleviate the issue. […] For women with anorexia nervosa or others at a low body weight, weight restoration is a crucial aspect of recovering a normal menstrual cycle. Many women see a resumption of menses after returning to a healthy weight. […] Reproductive medicine can also benefit some people with amenorrhea, with some types of birth control or other hormonal therapies sometimes used to help kick-start the process, particularly in cases where pituitary or other hormonal issues are in play.

• #23 Amenorrhea and Anorexia | The Bulimia Project

  https://bulimia.com/anorexia/anorexia-amenorrhea/

  Amenorrhea is the absence of menstrual periods in biological women. […] Regardless, the disruption of a normal menstrual cycle for women of childbearing age is often an indication of a significant health problem. But if the issue is connected to an eating disorder, there are treatment programs that can help. […] If you’re experiencing amenorrhea, it’s important to contact your doctor. […] There is no official treatment recommended for amenorrhea, but there are some ways to help alleviate the issue. […] For women with anorexia nervosa or others at a low body weight, weight restoration is a crucial aspect of recovering a normal menstrual cycle. Many women see a resumption of menses after returning to a healthy weight. […] Reproductive medicine can also benefit some people with amenorrhea, with some types of birth control or other hormonal therapies sometimes used to help kick-start the process, particularly in cases where pituitary or other hormonal issues are in play.

• #24 Amenorrhea and Anorexia | The Bulimia Project

  https://bulimia.com/anorexia/anorexia-amenorrhea/

  Amenorrhea is the absence of menstrual periods in biological women. […] Regardless, the disruption of a normal menstrual cycle for women of childbearing age is often an indication of a significant health problem. But if the issue is connected to an eating disorder, there are treatment programs that can help. […] If you’re experiencing amenorrhea, it’s important to contact your doctor. […] There is no official treatment recommended for amenorrhea, but there are some ways to help alleviate the issue. […] For women with anorexia nervosa or others at a low body weight, weight restoration is a crucial aspect of recovering a normal menstrual cycle. Many women see a resumption of menses after returning to a healthy weight. […] Reproductive medicine can also benefit some people with amenorrhea, with some types of birth control or other hormonal therapies sometimes used to help kick-start the process, particularly in cases where pituitary or other hormonal issues are in play.

• #25 Amenorrhea in adolescents: a narrative review – Newbery – Pediatric Medicine

  https://pm.amegroups.org/article/view/4922/html

  Weight recovery is a therapeutic goal in ED, but there is no consensus concerning target weight. […] The approach to managing females with amenorrhea is dictated by the underlying cause. In most cases, there is plausible treatment for amenorrhea. […] Similar to the management of functional hypothalamic amenorrhea in females with ED, approach to the female adolescent athlete entails a multidisciplinary team, with emphasis on prevention of future lapses as well as treatment of current dysfunction. […] An intake of 1,500 mg/day of calcium and 1,500-2,000 IU/day of vitamin D is plausible. […] Oral contraception including the use of estrogen and cyclic progesterone may return adolescents to a normal state of menstruation, but should absolutely continue to be monitored in terms of loss in bone density prior to medication administration. […] Further investigation is warranted when a young adolescent presents with amenorrhea.

• #26 Amenorrhea in adolescents: a narrative review – Newbery – Pediatric Medicine

  https://pm.amegroups.org/article/view/4922/html

  Weight recovery is a therapeutic goal in ED, but there is no consensus concerning target weight. […] The approach to managing females with amenorrhea is dictated by the underlying cause. In most cases, there is plausible treatment for amenorrhea. […] Similar to the management of functional hypothalamic amenorrhea in females with ED, approach to the female adolescent athlete entails a multidisciplinary team, with emphasis on prevention of future lapses as well as treatment of current dysfunction. […] An intake of 1,500 mg/day of calcium and 1,500-2,000 IU/day of vitamin D is plausible. […] Oral contraception including the use of estrogen and cyclic progesterone may return adolescents to a normal state of menstruation, but should absolutely continue to be monitored in terms of loss in bone density prior to medication administration. […] Further investigation is warranted when a young adolescent presents with amenorrhea.

• #27 Amenorrhea: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0601/p781.html

  Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. […] Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis. […] In patients with functional hypothalamic amenorrhea (especially with the female athlete triad), the primary treatment is weight restoration through nutritional rehabilitation and decreased exercise. […] In patients with functional hypothalamic amenorrhea, combined oral contraceptives do not improve bone density and should not be used solely for this purpose. […] Metformin (Glucophage) may improve abnormal menstruation in patients with polycystic ovary syndrome.

• #28 Amenorrhea: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0601/p781.html

  Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. […] Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis. […] In patients with functional hypothalamic amenorrhea (especially with the female athlete triad), the primary treatment is weight restoration through nutritional rehabilitation and decreased exercise. […] In patients with functional hypothalamic amenorrhea, combined oral contraceptives do not improve bone density and should not be used solely for this purpose. […] Metformin (Glucophage) may improve abnormal menstruation in patients with polycystic ovary syndrome.

• #29 Amenorrhea: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0601/p781.html

  Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. […] Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis. […] In patients with functional hypothalamic amenorrhea (especially with the female athlete triad), the primary treatment is weight restoration through nutritional rehabilitation and decreased exercise. […] In patients with functional hypothalamic amenorrhea, combined oral contraceptives do not improve bone density and should not be used solely for this purpose. […] Metformin (Glucophage) may improve abnormal menstruation in patients with polycystic ovary syndrome.

• #30 Amenorrhea: Causes, Primary vs. Secondary, Symptoms & Treatment

  https://www.emedicinehealth.com/amenorrhea/article_em.htm

  How to Treat Amenorrhea In some women, nutritional deficiencies induced by dieting can cause amenorrhea. Such women should eat a properly balanced diet. […] In some women, excessive body weight can be the cause of amenorrhea. These women should restrict the amount of fat in their diet, and they should exercise moderately to maintain ideal body weight. […] More than 8 hours of vigorous exercise a week may cause amenorrhea. A moderate exercise program may restore normal menstruation. […] In women with anorexia nervosa or excessive weight loss, normal menstrual cycles can often be restored by undergoing treatment to restore and maintain healthy body weight. […] If amenorrhea is caused by emotional stress, finding ways to deal with stress and conflicts may help. […] Maintaining a healthy lifestyle by avoiding alcohol consumption and cigarette smoking is also helpful.

• #31 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #32 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #33 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #34 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Hormone replacement therapy (HRT) may reduce associated vasomotor symptoms, bone mineral density loss, and cardiovascular risk and should be continued until the age of natural menopause (50 to 51 years). […] Treatment should address the underlying cause. […] Amenorrhea can be associated with clinically challenging pathology and may require lifelong treatment.

• #35 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Hormone replacement therapy (HRT) may reduce associated vasomotor symptoms, bone mineral density loss, and cardiovascular risk and should be continued until the age of natural menopause (50 to 51 years). […] Treatment should address the underlying cause. […] Amenorrhea can be associated with clinically challenging pathology and may require lifelong treatment.

• #36 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  Gonadotropin therapy or pulsatile gonadotropin-releasing hormone (GnRH) therapy is indicated in women who desire fertility yet remain anovulatory because of an unresolved hypothalamic/pituitary disorder. […] Once the diagnosis is established, for some women with oligomenorrhea or amenorrhea who do not wish to become pregnant, oral contraceptives may be a good choice to restore menstrual cyclicity and provide estrogen replacement. […] In patients with amenorrhea or oligomenorrhea withdrawal bleeding should be induced with an injection of progesterone or the administration of 5-10 mg of medroxyprogesterone for 10 days. […] Hormone therapy, consisting of an estrogen and a progestin, is needed for women in whom estrogen deficiency remains because ovarian function cannot be restored.

• #37 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  Gonadotropin therapy or pulsatile gonadotropin-releasing hormone (GnRH) therapy is indicated in women who desire fertility yet remain anovulatory because of an unresolved hypothalamic/pituitary disorder. […] Once the diagnosis is established, for some women with oligomenorrhea or amenorrhea who do not wish to become pregnant, oral contraceptives may be a good choice to restore menstrual cyclicity and provide estrogen replacement. […] In patients with amenorrhea or oligomenorrhea withdrawal bleeding should be induced with an injection of progesterone or the administration of 5-10 mg of medroxyprogesterone for 10 days. […] Hormone therapy, consisting of an estrogen and a progestin, is needed for women in whom estrogen deficiency remains because ovarian function cannot be restored.

• #38 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  Gonadotropin therapy or pulsatile gonadotropin-releasing hormone (GnRH) therapy is indicated in women who desire fertility yet remain anovulatory because of an unresolved hypothalamic/pituitary disorder. […] Once the diagnosis is established, for some women with oligomenorrhea or amenorrhea who do not wish to become pregnant, oral contraceptives may be a good choice to restore menstrual cyclicity and provide estrogen replacement. […] In patients with amenorrhea or oligomenorrhea withdrawal bleeding should be induced with an injection of progesterone or the administration of 5-10 mg of medroxyprogesterone for 10 days. […] Hormone therapy, consisting of an estrogen and a progestin, is needed for women in whom estrogen deficiency remains because ovarian function cannot be restored.

• #39 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  Gonadotropin therapy or pulsatile gonadotropin-releasing hormone (GnRH) therapy is indicated in women who desire fertility yet remain anovulatory because of an unresolved hypothalamic/pituitary disorder. […] Once the diagnosis is established, for some women with oligomenorrhea or amenorrhea who do not wish to become pregnant, oral contraceptives may be a good choice to restore menstrual cyclicity and provide estrogen replacement. […] In patients with amenorrhea or oligomenorrhea withdrawal bleeding should be induced with an injection of progesterone or the administration of 5-10 mg of medroxyprogesterone for 10 days. […] Hormone therapy, consisting of an estrogen and a progestin, is needed for women in whom estrogen deficiency remains because ovarian function cannot be restored.

• #40 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Patients with primary ovarian insufficiency should be treated with hormone therapy until the age of natural menopause (50 to 51 years of age) to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy. […] In patients with functional hypothalamic amenorrhea, treatment should correct the underlying cause to restore ovulatory function through behavior change, nutritional repletion (e.g., caloric intake, vitamin D), stress reduction, and weight gain. […] In patients with polycystic ovary syndrome and an elevated body mass index, weight loss and regular exercise are recommended and may restore regular menses and improve metabolic comorbidities. […] In patients with polycystic ovary syndrome and infertility, letrozole (Femara) is a first-line treatment because it confers higher ovulation, pregnancy, and live birth rates than clomiphene.

• #41 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Patients with primary ovarian insufficiency should be treated with hormone therapy until the age of natural menopause (50 to 51 years of age) to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy. […] In patients with functional hypothalamic amenorrhea, treatment should correct the underlying cause to restore ovulatory function through behavior change, nutritional repletion (e.g., caloric intake, vitamin D), stress reduction, and weight gain. […] In patients with polycystic ovary syndrome and an elevated body mass index, weight loss and regular exercise are recommended and may restore regular menses and improve metabolic comorbidities. […] In patients with polycystic ovary syndrome and infertility, letrozole (Femara) is a first-line treatment because it confers higher ovulation, pregnancy, and live birth rates than clomiphene.

• #42 Amenorrhea: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0601/p781.html

  Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. […] Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis. […] In patients with functional hypothalamic amenorrhea (especially with the female athlete triad), the primary treatment is weight restoration through nutritional rehabilitation and decreased exercise. […] In patients with functional hypothalamic amenorrhea, combined oral contraceptives do not improve bone density and should not be used solely for this purpose. […] Metformin (Glucophage) may improve abnormal menstruation in patients with polycystic ovary syndrome.

• #43 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Patients with primary ovarian insufficiency should be treated with hormone therapy until the age of natural menopause (50 to 51 years of age) to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy. […] In patients with functional hypothalamic amenorrhea, treatment should correct the underlying cause to restore ovulatory function through behavior change, nutritional repletion (e.g., caloric intake, vitamin D), stress reduction, and weight gain. […] In patients with polycystic ovary syndrome and an elevated body mass index, weight loss and regular exercise are recommended and may restore regular menses and improve metabolic comorbidities. […] In patients with polycystic ovary syndrome and infertility, letrozole (Femara) is a first-line treatment because it confers higher ovulation, pregnancy, and live birth rates than clomiphene.

• #44 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Treatment is determined by the etiology of the amenorrhea and the desires of the patient. Ideally, treatment should be directed at correcting the underlying pathology. In the case of outflow tract abnormalities (eg, imperforate hymen), surgery may be indicated. In other cases, correcting the underlying pathology should restore normal ovarian endocrine function and prevent the development of osteoporosis. […] Dopamine agonists are effective in treating hyperprolactinemia. In most cases, this treatment restores normal ovarian endocrine function and ovulation. […] Hormone replacement therapy is required to achieve peak bone density in patients whose underlying pathology cannot be reversed to restore normal endocrine function. In conditions leading to estrogen deficiency, hormone replacement therapy is required to maintain bone density, and it may have other possible health benefits in patients whose underlying pathology cannot be reversed to restore normal endocrine function.

• #45 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Treatment is determined by the etiology of the amenorrhea and the desires of the patient. Ideally, treatment should be directed at correcting the underlying pathology. In the case of outflow tract abnormalities (eg, imperforate hymen), surgery may be indicated. In other cases, correcting the underlying pathology should restore normal ovarian endocrine function and prevent the development of osteoporosis. […] Dopamine agonists are effective in treating hyperprolactinemia. In most cases, this treatment restores normal ovarian endocrine function and ovulation. […] Hormone replacement therapy is required to achieve peak bone density in patients whose underlying pathology cannot be reversed to restore normal endocrine function. In conditions leading to estrogen deficiency, hormone replacement therapy is required to maintain bone density, and it may have other possible health benefits in patients whose underlying pathology cannot be reversed to restore normal endocrine function.

• #46 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Treatment is determined by the etiology of the amenorrhea and the desires of the patient. Ideally, treatment should be directed at correcting the underlying pathology. In the case of outflow tract abnormalities (eg, imperforate hymen), surgery may be indicated. In other cases, correcting the underlying pathology should restore normal ovarian endocrine function and prevent the development of osteoporosis. […] Dopamine agonists are effective in treating hyperprolactinemia. In most cases, this treatment restores normal ovarian endocrine function and ovulation. […] Hormone replacement therapy is required to achieve peak bone density in patients whose underlying pathology cannot be reversed to restore normal endocrine function. In conditions leading to estrogen deficiency, hormone replacement therapy is required to maintain bone density, and it may have other possible health benefits in patients whose underlying pathology cannot be reversed to restore normal endocrine function.

• #47 Amenorrhea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17439

  The dopamine agonist cabergoline is considered first-line therapy in patients with a prolactin-secreting tumor. […] In patients with other endocrine abnormalities resulting in amenorrhea, lifestyle interventions promoting a healthy diet and exercise program are the most beneficial therapy for some conditions (eg, PCOS, diabetes). […] In patients with these underlying etiologies, amenorrhea typically resolves after discontinuation of the contributing physiologic event or medication.

• #48 Amenorrhea: View Causes, Symptoms and Treatments | 1mg

  https://www.1mg.com/diseases/amenorrhea-467?srsltid=AfmBOorb269M6TYR9_evcq2-TzB2zGkED0O6Mqe41tdj5T7IG3vsFucf

  Birth control pills or other types of hormonal medication, including oral contraceptives may be prescribed to restore the menstrual cycle and to provide estrogen replacement to women with amenorrhea. […] Estrogen replacement therapy (ERT) helps in balancing hormonal levels and restarting the menstrual cycle in women with primary ovarian insufficiency (POI). Hormone replacement therapy works by replacing estrogen hormone that is no longer being made by the body. […] Treatment of hypo or hyperthyroidism: Replacement therapy with levothyroxine to correct hypothyroidism and antithyroid drugs like methimazole to correct the underlying hyperthyroidism. […] In the case of pituitary tumor, medications may be recommended to shrink the tumor. If medication does not work, surgery may be necessary to remove the tumor. […] Women with intrauterine adhesions require dissolution of the scar tissue. Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle.

• #49 Amenorrhea: View Causes, Symptoms and Treatments | 1mg

  https://www.1mg.com/diseases/amenorrhea-467?srsltid=AfmBOorb269M6TYR9_evcq2-TzB2zGkED0O6Mqe41tdj5T7IG3vsFucf

  Birth control pills or other types of hormonal medication, including oral contraceptives may be prescribed to restore the menstrual cycle and to provide estrogen replacement to women with amenorrhea. […] Estrogen replacement therapy (ERT) helps in balancing hormonal levels and restarting the menstrual cycle in women with primary ovarian insufficiency (POI). Hormone replacement therapy works by replacing estrogen hormone that is no longer being made by the body. […] Treatment of hypo or hyperthyroidism: Replacement therapy with levothyroxine to correct hypothyroidism and antithyroid drugs like methimazole to correct the underlying hyperthyroidism. […] In the case of pituitary tumor, medications may be recommended to shrink the tumor. If medication does not work, surgery may be necessary to remove the tumor. […] Women with intrauterine adhesions require dissolution of the scar tissue. Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle.

• #50 Amenorrhea: View Causes, Symptoms and Treatments | 1mg

  https://www.1mg.com/diseases/amenorrhea-467?srsltid=AfmBOorb269M6TYR9_evcq2-TzB2zGkED0O6Mqe41tdj5T7IG3vsFucf

  Birth control pills or other types of hormonal medication, including oral contraceptives may be prescribed to restore the menstrual cycle and to provide estrogen replacement to women with amenorrhea. […] Estrogen replacement therapy (ERT) helps in balancing hormonal levels and restarting the menstrual cycle in women with primary ovarian insufficiency (POI). Hormone replacement therapy works by replacing estrogen hormone that is no longer being made by the body. […] Treatment of hypo or hyperthyroidism: Replacement therapy with levothyroxine to correct hypothyroidism and antithyroid drugs like methimazole to correct the underlying hyperthyroidism. […] In the case of pituitary tumor, medications may be recommended to shrink the tumor. If medication does not work, surgery may be necessary to remove the tumor. […] Women with intrauterine adhesions require dissolution of the scar tissue. Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle.

• #51 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #52 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #53 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #54 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #55 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  The treatment for amenorrhea depends on the underlying cause, as well as the health status and goals of the individual. […] If primary or secondary amenorrhea is caused by lifestyle factors, your health care provider may suggest changes in the areas below: […] Having overweight or severe underweight can affect your menstrual cycle. Attaining and maintaining a healthy weight often helps balance hormone levels and restore your menstrual cycle. […] For primary amenorrhea, depending on your age and the results of the ovary function test, health care providers may recommend watchful waiting. […] Primary amenorrhea caused by chromosomal or genetic problems may require surgery. […] Treatment for secondary amenorrhea, depending on the cause, may include medical or surgical treatments or a combination of the two.

• #56 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  The treatment for amenorrhea depends on the underlying cause, as well as the health status and goals of the individual. […] If primary or secondary amenorrhea is caused by lifestyle factors, your health care provider may suggest changes in the areas below: […] Having overweight or severe underweight can affect your menstrual cycle. Attaining and maintaining a healthy weight often helps balance hormone levels and restore your menstrual cycle. […] For primary amenorrhea, depending on your age and the results of the ovary function test, health care providers may recommend watchful waiting. […] Primary amenorrhea caused by chromosomal or genetic problems may require surgery. […] Treatment for secondary amenorrhea, depending on the cause, may include medical or surgical treatments or a combination of the two.

• #57 Amenorrhea: Absence of Periods | ACOG

  https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

  Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea: Primary amenorrhea is when a girl does not get her first period by age 15. Secondary amenorrhea is when a woman who already menstruates does not get her period for 3 months or more. […] If primary amenorrhea is caused by the ovaries not producing enough estrogen, you can discuss using hormone therapy to start puberty and your periods. Hormone therapy also can help prevent osteoporosis. […] Treatment for secondary amenorrhea depends on the cause: Primary ovarian insufficiency hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce. PCOS treatment may involve weight loss and hormone therapy. […] Most people with amenorrhea benefit from a healthy diet and exercise. Reducing stress also may help. And it is important to consume enough calcium and vitamin D to help prevent osteoporosis.

• #58 Amenorrhea: Absence of Periods | ACOG

  https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

  Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea: Primary amenorrhea is when a girl does not get her first period by age 15. Secondary amenorrhea is when a woman who already menstruates does not get her period for 3 months or more. […] If primary amenorrhea is caused by the ovaries not producing enough estrogen, you can discuss using hormone therapy to start puberty and your periods. Hormone therapy also can help prevent osteoporosis. […] Treatment for secondary amenorrhea depends on the cause: Primary ovarian insufficiency hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce. PCOS treatment may involve weight loss and hormone therapy. […] Most people with amenorrhea benefit from a healthy diet and exercise. Reducing stress also may help. And it is important to consume enough calcium and vitamin D to help prevent osteoporosis.

• #59 Amenorrhea: Absence of Periods | ACOG

  https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

  Amenorrhea is the absence of menstrual periods. There are two types of amenorrhea: Primary amenorrhea is when a girl does not get her first period by age 15. Secondary amenorrhea is when a woman who already menstruates does not get her period for 3 months or more. […] If primary amenorrhea is caused by the ovaries not producing enough estrogen, you can discuss using hormone therapy to start puberty and your periods. Hormone therapy also can help prevent osteoporosis. […] Treatment for secondary amenorrhea depends on the cause: Primary ovarian insufficiency hormone therapy can replace estrogen and progesterone, which the ovaries are not able to produce. PCOS treatment may involve weight loss and hormone therapy. […] Most people with amenorrhea benefit from a healthy diet and exercise. Reducing stress also may help. And it is important to consume enough calcium and vitamin D to help prevent osteoporosis.

• #60 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  It varies. Factors like your age, weight, activity level and genetics can play a role in how long it takes for your periods to come back. It most likely will take three to six months of consistent treatment to begin menstruating again. […] You can prevent hypothalamic amenorrhea by avoiding the common causes of the condition. This includes eating enough food for your activity level, not restricting your caloric intake, finding ways to reduce and manage your stress levels, and limiting extremely vigorous exercise. […] Hypothalamic amenorrhea can lead to low estrogen levels. Estrogen is an important hormone in your body. One function of estrogen is to maintain healthy, strong bones. Without estrogen, females are at risk for osteoporosis and heart disease. […] If you haven’t had your period in three months or longer, talk to a healthcare provider. They can order tests to determine why you aren’t having a regular period and get you the treatment you need to begin menstruating again.

• #61 Functional Hypothalamic Amenorrhea: A Stress-Based Disease

  https://www.mdpi.com/2673-396X/2/3/20

  In patients who want to become pregnant, also before starting pharmacological treatment, we initially suggest returning to normal body weight. Increasing the energy supply is a highly effective method in restoring normal estradiol levels and returning ovulatory cycles. […] Due to the dangerous complication of FHA, which is the loss of bone mineral density, supplementing with vitamin D and calcium should be borne in mind. According to the recommendations of the Endocrine Society from 2017, the use of transdermal cyclic estrogen-progesterone therapy has an effect on bone protection and reduction of the risk of fractures in women with FHA.

• #62 Amenorrhea: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0601/p781.html

  Hormone therapy (e.g., 100 mcg of daily transdermal estradiol or 0.625 mg of daily conjugated equine estrogen [Premarin] on days 1 through 26 of the menstrual cycle, and 10 mg of cyclic medroxyprogesterone acetate for 12 days [e.g., days 14 through 26] of the menstrual cycle) until the average age of natural menopause is usually recommended to decrease the likelihood of osteoporosis, ischemic heart disease, and vasomotor symptoms. […] Patients with primary ovarian insufficiency should be counseled about possible fertility, because up to 10% of such patients may achieve temporary and unpredictable remission. […] Treatment of functional hypothalamic amenorrhea involves nutritional rehabilitation as well as reductions in stress and exercise levels. […] Combined OCs will restore menses, but will not correct bone density. […] Leptin administration has been reported to restore pulsatility of gonadotropin-releasing hormone and ovulation in these patients, but its effect on bone health is unknown.

• #63 Amenorrhea in adolescents: a narrative review – Newbery – Pediatric Medicine

  https://pm.amegroups.org/article/view/4922/html

  Weight recovery is a therapeutic goal in ED, but there is no consensus concerning target weight. […] The approach to managing females with amenorrhea is dictated by the underlying cause. In most cases, there is plausible treatment for amenorrhea. […] Similar to the management of functional hypothalamic amenorrhea in females with ED, approach to the female adolescent athlete entails a multidisciplinary team, with emphasis on prevention of future lapses as well as treatment of current dysfunction. […] An intake of 1,500 mg/day of calcium and 1,500-2,000 IU/day of vitamin D is plausible. […] Oral contraception including the use of estrogen and cyclic progesterone may return adolescents to a normal state of menstruation, but should absolutely continue to be monitored in terms of loss in bone density prior to medication administration. […] Further investigation is warranted when a young adolescent presents with amenorrhea.

• #64 Hypothalamic Amenorrhea Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hypothalamic-amenorrhea

  The 2017 guideline addresses: […] Treating FHA and concomitant conditions with lifestyle changes and hormone therapy, and providing fertility treatments for women with FHA. […] Hypothalamic amenorrhea patients should be evaluated for inpatient treatment if they have an abnormally slow heart rate, low blood pressure, or an electrolyte imbalance. […] In adolescents and women with FHA, we recommend correcting the energy imbalance to improve hypothalamic-pituitary-ovarian (HPO) axis function; this often requires behavioral change. Options for improving energy balance include increased caloric consumption, and/or improved nutrition, and/or decreased exercise activity. This often requires weight gain. […] In patients with FHA wishing to conceive, after a complete fertility workup, we suggest: treatment with pulsatile gonadotropin-releasing hormone (GnRH) as a first line, followed by gonadotropin therapy and induction of ovulation when GnRH is not available.

• #65 Hypothalamic Amenorrhea Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hypothalamic-amenorrhea

  The 2017 guideline addresses: […] Treating FHA and concomitant conditions with lifestyle changes and hormone therapy, and providing fertility treatments for women with FHA. […] Hypothalamic amenorrhea patients should be evaluated for inpatient treatment if they have an abnormally slow heart rate, low blood pressure, or an electrolyte imbalance. […] In adolescents and women with FHA, we recommend correcting the energy imbalance to improve hypothalamic-pituitary-ovarian (HPO) axis function; this often requires behavioral change. Options for improving energy balance include increased caloric consumption, and/or improved nutrition, and/or decreased exercise activity. This often requires weight gain. […] In patients with FHA wishing to conceive, after a complete fertility workup, we suggest: treatment with pulsatile gonadotropin-releasing hormone (GnRH) as a first line, followed by gonadotropin therapy and induction of ovulation when GnRH is not available.

• #66 Hypothalamic Amenorrhea Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hypothalamic-amenorrhea

  We suggest that clinicians should only induce ovulation in women with FHA that have a body mass index (BMI) of at least 18.5 kg/m2 and only after attempts to normalize energy balance, due to the increased risk for fetal loss, small-for-gestational-age babies, preterm labor, and delivery by Cesarean section for extreme low weight.

• #67 Amenorrhea: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0601/p781.html

  Hormone therapy (e.g., 100 mcg of daily transdermal estradiol or 0.625 mg of daily conjugated equine estrogen [Premarin] on days 1 through 26 of the menstrual cycle, and 10 mg of cyclic medroxyprogesterone acetate for 12 days [e.g., days 14 through 26] of the menstrual cycle) until the average age of natural menopause is usually recommended to decrease the likelihood of osteoporosis, ischemic heart disease, and vasomotor symptoms. […] Patients with primary ovarian insufficiency should be counseled about possible fertility, because up to 10% of such patients may achieve temporary and unpredictable remission. […] Treatment of functional hypothalamic amenorrhea involves nutritional rehabilitation as well as reductions in stress and exercise levels. […] Combined OCs will restore menses, but will not correct bone density. […] Leptin administration has been reported to restore pulsatility of gonadotropin-releasing hormone and ovulation in these patients, but its effect on bone health is unknown.

• #68 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  It varies. Factors like your age, weight, activity level and genetics can play a role in how long it takes for your periods to come back. It most likely will take three to six months of consistent treatment to begin menstruating again. […] You can prevent hypothalamic amenorrhea by avoiding the common causes of the condition. This includes eating enough food for your activity level, not restricting your caloric intake, finding ways to reduce and manage your stress levels, and limiting extremely vigorous exercise. […] Hypothalamic amenorrhea can lead to low estrogen levels. Estrogen is an important hormone in your body. One function of estrogen is to maintain healthy, strong bones. Without estrogen, females are at risk for osteoporosis and heart disease. […] If you haven’t had your period in three months or longer, talk to a healthcare provider. They can order tests to determine why you aren’t having a regular period and get you the treatment you need to begin menstruating again.

• #69 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  It varies. Factors like your age, weight, activity level and genetics can play a role in how long it takes for your periods to come back. It most likely will take three to six months of consistent treatment to begin menstruating again. […] You can prevent hypothalamic amenorrhea by avoiding the common causes of the condition. This includes eating enough food for your activity level, not restricting your caloric intake, finding ways to reduce and manage your stress levels, and limiting extremely vigorous exercise. […] Hypothalamic amenorrhea can lead to low estrogen levels. Estrogen is an important hormone in your body. One function of estrogen is to maintain healthy, strong bones. Without estrogen, females are at risk for osteoporosis and heart disease. […] If you haven’t had your period in three months or longer, talk to a healthcare provider. They can order tests to determine why you aren’t having a regular period and get you the treatment you need to begin menstruating again.

• #70 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  It varies. Factors like your age, weight, activity level and genetics can play a role in how long it takes for your periods to come back. It most likely will take three to six months of consistent treatment to begin menstruating again. […] You can prevent hypothalamic amenorrhea by avoiding the common causes of the condition. This includes eating enough food for your activity level, not restricting your caloric intake, finding ways to reduce and manage your stress levels, and limiting extremely vigorous exercise. […] Hypothalamic amenorrhea can lead to low estrogen levels. Estrogen is an important hormone in your body. One function of estrogen is to maintain healthy, strong bones. Without estrogen, females are at risk for osteoporosis and heart disease. […] If you haven’t had your period in three months or longer, talk to a healthcare provider. They can order tests to determine why you aren’t having a regular period and get you the treatment you need to begin menstruating again.

• #71 Amenorrhea: Types, Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/3924-amenorrhea

  Amenorrhea is often a sign of a treatable condition. With treatment, your regular menstrual cycle will usually resume. […] If your period stopped because of menopause, lactation or pregnancy, your provider won’t need to treat it. […] In other cases, your treatment will depend on the cause and may include: Following a diet and exercise plan that help you maintain a weight that’s healthy for you. […] Hormonal treatment (medication), as prescribed by your healthcare provider. […] Most cases of amenorrhea are treatable. With treatment, your periods should start to happen regularly. […] Talk to your healthcare provider if you’re older than 15 and haven’t gotten your period or you’ve had a normal menstrual cycle but now you’re missing periods. Amenorrhea is usually the sign of a treatable condition. Once your provider figures out what’s causing missed periods, you can get care to regulate your cycle. You may need lifestyle changes or hormonal treatment to help resume normal menstrual cycles.

• #72 Hypothalamic Amenorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea

  It varies. Factors like your age, weight, activity level and genetics can play a role in how long it takes for your periods to come back. It most likely will take three to six months of consistent treatment to begin menstruating again. […] You can prevent hypothalamic amenorrhea by avoiding the common causes of the condition. This includes eating enough food for your activity level, not restricting your caloric intake, finding ways to reduce and manage your stress levels, and limiting extremely vigorous exercise. […] Hypothalamic amenorrhea can lead to low estrogen levels. Estrogen is an important hormone in your body. One function of estrogen is to maintain healthy, strong bones. Without estrogen, females are at risk for osteoporosis and heart disease. […] If you haven’t had your period in three months or longer, talk to a healthcare provider. They can order tests to determine why you aren’t having a regular period and get you the treatment you need to begin menstruating again.

• #73 Amenorrhea Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/amenorrhea

  Maintaining a healthy weight and exercising regularly can keep your body healthy. Other alternative therapies may help your body make and use hormones properly. […] Be sure to eat a healthy diet. Limit processed foods, and eat foods with heart-healthy fats (unsaturated fats) rather than saturated fats. Avoid caffeine and alcohol. Eat more whole grains, vegetables, and omega-3 fatty acids found in cold-water fish, nuts, and seeds. […] Acupuncture may improve hormonal imbalances that can go along with amenorrhea and related conditions, such as polycystic ovary syndrome (PCOS). A few small studies of women with fertility problems, which are sometimes connected with amenorrhea, suggest that acupuncture may help promote ovulation.

• #74 Amenorrhea Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/amenorrhea

  Maintaining a healthy weight and exercising regularly can keep your body healthy. Other alternative therapies may help your body make and use hormones properly. […] Be sure to eat a healthy diet. Limit processed foods, and eat foods with heart-healthy fats (unsaturated fats) rather than saturated fats. Avoid caffeine and alcohol. Eat more whole grains, vegetables, and omega-3 fatty acids found in cold-water fish, nuts, and seeds. […] Acupuncture may improve hormonal imbalances that can go along with amenorrhea and related conditions, such as polycystic ovary syndrome (PCOS). A few small studies of women with fertility problems, which are sometimes connected with amenorrhea, suggest that acupuncture may help promote ovulation.

• #75 Natural treatments for amenorrhea | EBSCO Research Starters

  https://www.ebsco.com/research-starters/complementary-and-alternative-medicine/natural-treatments-amenorrhea

  The hormone progesterone, available (probably inappropriately) as an ingredient in some natural creams, may help restore the menstrual cycle. […] The herb chasteberry is thought to reduce prolactin levels, so it has been tried for amenorrhea. […] Other commonly proposed natural treatments for amenorrhea include the supplements vitamin B6 and zinc and the herbs black cohosh, angelica, asafetida, alfalfa seed, mugwort, parsley, and rue. However, no meaningful scientific evidence indicates whether they are effective. […] Diet and exercise can play a key role in treating amenorrhea as well. […] Acupuncture, yoga, meditation, and massage have been offered as a natural treatment for amenorrhea.

• #76 Natural treatments for amenorrhea | EBSCO Research Starters

  https://www.ebsco.com/research-starters/complementary-and-alternative-medicine/natural-treatments-amenorrhea

  The hormone progesterone, available (probably inappropriately) as an ingredient in some natural creams, may help restore the menstrual cycle. […] The herb chasteberry is thought to reduce prolactin levels, so it has been tried for amenorrhea. […] Other commonly proposed natural treatments for amenorrhea include the supplements vitamin B6 and zinc and the herbs black cohosh, angelica, asafetida, alfalfa seed, mugwort, parsley, and rue. However, no meaningful scientific evidence indicates whether they are effective. […] Diet and exercise can play a key role in treating amenorrhea as well. […] Acupuncture, yoga, meditation, and massage have been offered as a natural treatment for amenorrhea.

• #77 Amenorrhea Definition, Symptoms, Causes, and Treatment

  https://www.medicinenet.com/amenorrhea/article.htm

  While many companies and individuals have marketed herbal therapies as a treatment for amenorrhea, none of these have been conclusively proven to be of benefit. These therapies are not regulated by the U.S. FDA and the quality of herbal preparations is not tested. Herbal remedies have been associated with serious and even fatal side effects in rare cases, and some preparations have been shown to contain high levels of toxins. Before deciding to take a natural or alternative remedy for amenorrhea, it is wise to seek the advice of your healthcare practitioner.

• #78 Amenorrhea: A Systematic Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p39.html

  Hormone replacement therapy (HRT) may reduce associated vasomotor symptoms, bone mineral density loss, and cardiovascular risk and should be continued until the age of natural menopause (50 to 51 years). […] Treatment should address the underlying cause. […] Amenorrhea can be associated with clinically challenging pathology and may require lifelong treatment.

• #79 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  The treatment for amenorrhea depends on the underlying cause, as well as the health status and goals of the individual. […] If primary or secondary amenorrhea is caused by lifestyle factors, your health care provider may suggest changes in the areas below: […] Having overweight or severe underweight can affect your menstrual cycle. Attaining and maintaining a healthy weight often helps balance hormone levels and restore your menstrual cycle. […] For primary amenorrhea, depending on your age and the results of the ovary function test, health care providers may recommend watchful waiting. […] Primary amenorrhea caused by chromosomal or genetic problems may require surgery. […] Treatment for secondary amenorrhea, depending on the cause, may include medical or surgical treatments or a combination of the two.

• #80 Amenorrhea Medication: Estrogens, Progestins

  https://emedicine.medscape.com/article/252928-medication

  For primary amenorrhea, hormone therapy, consisting of an estrogen and a progestin, is recommended for women with estrogen deficiency. […] Young women in whom secondary sex characteristics have failed to develop fully should be exposed initially to very low doses of estrogen in an attempt to mimic the gradual pubertal maturation process. […] Gradual dose escalation allows time to balance estrogen supplementation with need to grow in height, develop secondary sexual characters, and often results in optimal breast development. […] Cyclic progesterone therapy, given 12-14 days per month, should be instituted once vaginal bleeding begins. […] Parenteral estrogen (transdermal or vaginal) is the preferred route of administration because it avoids first-pass liver metabolism. […] For secondary amenorrhea, dopamine agonists are the only medical therapy specifically approved to reverse an underlying pathology that leads to amenorrhea.

• #81 Amenorrhea Treatment & Management: Approach Considerations, Treatment of Common Causes, Diet and Activity

  https://emedicine.medscape.com/article/252928-treatment

  Treatment is determined by the etiology of the amenorrhea and the desires of the patient. Ideally, treatment should be directed at correcting the underlying pathology. In the case of outflow tract abnormalities (eg, imperforate hymen), surgery may be indicated. In other cases, correcting the underlying pathology should restore normal ovarian endocrine function and prevent the development of osteoporosis. […] Dopamine agonists are effective in treating hyperprolactinemia. In most cases, this treatment restores normal ovarian endocrine function and ovulation. […] Hormone replacement therapy is required to achieve peak bone density in patients whose underlying pathology cannot be reversed to restore normal endocrine function. In conditions leading to estrogen deficiency, hormone replacement therapy is required to maintain bone density, and it may have other possible health benefits in patients whose underlying pathology cannot be reversed to restore normal endocrine function.

• #82 What are the treatments for amenorrhea? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

  Common medical treatments for secondary amenorrhea include: Birth control pills or other types of hormonal medication. Certain oral contraceptives may help restart the menstrual cycle. […] Estrogen replacement therapy (ERT) may help balance hormonal levels and restart the menstrual cycle in women with primary ovarian insufficiency (POI) or Fragile X-associated primary ovarian insufficiency (FXPOI). […] Surgical treatment for amenorrhea is not common, but may be recommended in certain conditions. […] Removal of the scar tissue during a procedure called a hysteroscopic resection can help restore the menstrual cycle. […] Medications may be recommended to shrink the tumor. If this does not work, surgery may be necessary to remove the tumor.

• #83 Amenorrhea in adolescents: a narrative review – Newbery – Pediatric Medicine

  https://pm.amegroups.org/article/view/4922/html

  Amenorrhea warrants deliberate evaluation and potential treatment. […] Understanding where particularly in the menstrual cycle or the affected regulatory process amenorrhea is occurring should lead to more effective treatment specific to the patient’s condition. […] Early detection in adolescent females helps prevent potential future adverse health outcomes. This article provides an overview of the different causes, evaluation and treatment approach of amenorrhea, with special focus on polycystic ovary syndrome (PCOS), eating disorders (EDs), and the female athlete triad (FAT). […] Provision of appropriate care that is safe and evidence-based can prevent future negative health implications such as infertility and compromised bone health. […] Once the diagnosis of PCOS is established, the mainstay of treatment is oral contraceptives. These are effective in regulating menstrual cycles and lowering androgen levels.

• #84 General Approaches to Medical Management of Menstrual Suppression | ACOG

  https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2022/09/general-approaches-to-medical-management-of-menstrual-suppression

  Gynecologists should be familiar with the use of hormonal therapy for menstrual suppression (including combined oral contraceptive pills, combined hormonal patches, vaginal rings, progestin-only pills, depot medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine device, and the etonogestrel implant). The choice of method should be individualized based on patient preferences and goals, average treatment effectiveness, and contraindications or risk factors for adverse events. Because complete amenorrhea may be difficult to achieve, gynecologists should counsel patients about realistic expectations. […] Menstrual suppression refers to the use of hormonal medications to decrease the frequency and volume of physiologic menses and, in some cases, achieving amenorrhea. […] Counseling regarding the choice of hormonal medication for menstrual suppression should be approached with the utmost respect for patient autonomy and be free of coercion. Gynecologists should engage in shared decision making with patients, and evidence-based counseling should include menstrual-management options and the benefits and limitations of the different methods, as well as realistic expectations about complete amenorrhea.

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