Amenorrhea is the absence of menstruation. When a girl reaches age 16 and has not begun menstruating, she may have primary amenorrhea. When a woman who has had menstrual cycles misses three periods in a row, she is considered to have secondary amenorrhea. A hormone imbalance can cause hypoestrogenemic amenorrhea.

Signs and Symptoms

Symptoms sometimes related to primary amenorrhea include headaches, abnormal blood pressure, vision problems, acne, excessive hair growth, and perhaps either a short, stubby physique or extremely tall stature.

Symptoms sometimes related to secondary amenorrhea include nausea, swollen breasts, headaches, vision problems, unusual thirst, goiter (an enlarged thyroid gland), skin darkening, extreme weight loss, alcoholism, liver disease, and kidney failure. Hot flashes, mood changes, depression, and vaginal dryness are common with estrogen deficiency.

What Causes It?

Generally, the causes of amenorrhea include certain genetic defects, body structure abnormalities, or endocrine disorders. Specific causes include the following.

What to Expect at Your Provider's Office

Your provider will conduct a physical examination, which will include an internal pelvic examination. Laboratory tests may include analysis of mucus from the cervix and uterus, blood tests, computer assisted tomography (CAT) scan, magnetic resonance imaging (MRI), or ultrasound.

Treatment Options

Your healthcare provider will treat your condition based on the underlying cause. Treatments include hormone therapy, psychological counseling and support, and surgery among others.

Drug Therapies

Your provider may suggest the following drugs:

Complementary and Alternative Therapies

Alternative therapies may help the body metabolize hormones while ensuring that the nutritional requirements for hormone production are met.

Eat fewer refined foods and limit animal products. Limit the cruciferous family of vegetables (cabbage, broccoli, brussel sprouts, cauliflower, kale). Eliminate methylxanthines (coffee, chocolate). Eat more whole grains, organic vegetables, and omega-3 fats (cold-water fish, nuts, and seeds). In addition, you may take the following supplements. Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Homeopathy
Homeopathy may be useful as a supportive therapy.

Physical Medicine
The following help increase circulation and relieve pelvic congestion.

Special Considerations

Becoming pregnant may be difficult or impossible. Amenorrhea also may cause pregnancy complications.


Amenorrhea, Diagnosis and treatment. MFMER. Accessed at on February 15, 2018.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Chen B-Y. Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis. Acupunct Electro-Therapeut Res. 1997;22:97-108.

Clomiphene. NMIHI. Accessed at on February 15, 2018.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Menstrual Cycle. Office on Women's Health. Accessed at on February 15, 2018.

Mowrey DB. The Scientific Validation of Herbal Medicine. New Canaan, Conn: Keats Publishing; 1988.

Primary Amenorrhea. NMIHI. Accessed at on February 15, 2018.

Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod. 1996;11(6): 1314-1317.

Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO. Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstet Gyneol Scand. 2000;79:180-188.

Tierney LM, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis & Treatment 1999. 38th ed. Stamford, Conn: Appleton & Lange; 1999.

Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, NY: Pharmaceutical Products Press; 1994.

Ullman D. Discovering Homeopathy. Berkeley, Calif: North Atlantic Books; 1991.

Vardenafil. NMIHI. Accessed at on February 15, 2018.

Xiaoming M, Ding L, Yunxing P, Guifang X, Xiuzhen L, Zhimin F. Clinical studies on the mechanism for acupuncture stimulation of ovulation. J Tradit Chin Med. 1993;13(2):115-119.

What are the treatments for amenorrhea? NIH. Accessed at on February 15, 2018.