The term “amenorrhea” literally means an absence of menstrual bleeding. In medicine, it is used to indicate one of two conditions: the cessation of menstrual cycle in a woman of menstrual age or the failure to develop a menstrual cycle at all in a young woman who has reached the age of 16 years old. This article only addresses the first of these conditions, technically called “secondary amenorrhea.” To avoid using this long term, we will simply refer to the condition here as “amenorrhea.”
There are many causes of amenorrhea. Severe weight loss, such as may occur in a woman with anorexia nervosa, can cause the menstrual period to stop. So can extreme exercise, such as marathon running, bodybuilding, or professional-caliber ballet dancing.
Young women who go to college may develop amenorrhea too, possibly from stress or perhaps as a reflex reaction to what the body considers a “migration.” Pregnancy and nursing stop the menstrual cycle by design. Finally, women who have used oral contraceptives may find that it takes a while for a normal menstrual cycle to return after discontinuing them.
More rarely, amenorrhea may indicate a serious medical condition, such as a disorder of the pituitary gland, the hypothalamus, or the ovaries. For this reason, it’s a good idea to check with your doctor if you miss more than one menstrual period, to see if more evaluation is needed. Medical treatment for amenorrhea depends on the cause. If examination reveals no underlying cause, physicians may recommend a period of oral contraceptive use to start up the cycle.
The hormone progesterone, available (probably inappropriately) as an ingredient in some “natural” creams, may help restore the menstrual cycle. In one double-blind, placebo-controlled trial, oral use of a micronized form of progesterone restored a normal menstrual cycle in women with secondary amenorrhea.1 However, although progesterone is marketed as a “natural hormone,” it is as much a drug as estrogen, and should never be used without medical supervision.
In some women, the pituitary gland produces excess levels of prolactin. Prolactin is a hormone that naturally rises during pregnancy to stimulate milk production; it can also cause amenorrhea. Excessive pituitary prolactin release is a condition that must be investigated medically because it may indicate the presence of a tumor. However, it is possible that slight abnormalities in prolactin level without a dangerous medical cause may trigger amenorrhea in some women. The herb chasteberry is thought to reduce prolactin levels,2–4 and for this reason it has been tried for amenorrhea.5 However, as yet no double-blind, placebo-controlled trials on this potential use of chasteberry have been reported. The herb bugleweed is also thought to reduce prolactin levels,6 but it too has not been tested for amenorrhea.
Other commonly proposed natural treatments for amenorrhea include the supplements vitamin B6 and zinc and the herbs blue cohosh, angelica, asafetida, alfalfa seed, motherwort, parsley, and rue. However, there is no meaningful scientific evidence to indicate whether they are effective.
For reasons that are not entirely clear, women with amenorrhea often have an accelerated rate of bone loss, potentially leading to osteoporosis. Women who have developed amenorrhea due to heavy exercise tend to experience an accelerated rate of bone loss, which may lead to osteoporosis. Unfortunately, calcium and vitamin D supplements are not sufficient to protect bone mass under these circumstances.7 Stronger measures, such as reducing exercise or using medications, may be necessary.
Finally, certain herbs and supplements may interact with oral contraceptive drugs used to treat amenorrhea. For more information, see the Oral Contraceptive article in the Drug Interactions section of this database.
1. Shangold MM, Tomai TP, Cook JD, et al. Factors associated with withdrawal bleeding after administration of oral micronized progesterone in women with secondary amenorrhea. Fertil Steril. 1991;56:1040–1047.
2. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnuscastus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study [translated from German]. Arzneimittelforschung. 1993;43:752–756.
3. Jarry H, Leonhardt S, Gorkow C, et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol. 1994;102:448–454.
4. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res. 1993;25:253–255.
5. Loch EG, Katzorke T. Diagnosis and treatment of dyshormonal menstrual periods in general practice. Gynäkol Praxis. 1990;14:489–495.
6. Sourgens H, Winterhoff H, Gumbinger HG, et al. Antihormonal effects of plant extracts. TSH- and prolactin-suppressing properties of Lithospermum officinale and other plants. Planta Med. 1982;45:78–86.
7. Baer JT, Taper LJ, Gwazdauskas FG, et al. Diet, hormonal, and metabolic factors affecting bone mineral density in adolescent amenorrheic and eumenorrheic female runners. J Sports Med Phys Fitness. 1992;32:51–58.
8. Hutchins AM, Martini MC, Olson BA, et al. Flaxseed consumption influences endogenous hormone concentrations in postmenopausal women. Nutr Cancer. 2001;39:58–65.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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