Menstruation - absent

Treatment depends on the cause of the amenorrhea. If it is caused by another systemic disorder, normal menstrual function usually returns after the primary disorder is treated. For example, if the primary disorder is hypothyroidism, then amenorrhea will be cured when the thyroid disorder is treated with thyroid supplements.

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Pituitary tumors are usually treated with bromocriptine, a drug that inhibits prolactin secretion. Surgery removal may also be suggested. Radiation therapy is usually reserved for situations where other medical or surgical treatment regimens are not successful.

A progestin challenge may be used to determine a course of treatment. In this test, daily estrogen supplements are given in conjunction with intermittent progestin for 10 to 14 days per month every 1 to 3 months. Hormonal supplements are commonly utilized for those women who do not bleed in response to the progestin challenge test.

Women who bleed in response to the progestin challenge test are anovulatory -- they do not menstruate because they do not ovulate. This common cause of amenorrhea is treated by inducing ovulation with medication such as clomiphene citrate (Clomid) -- but only if the patient desires pregnancy. In patients who have no immediate plan for pregnancy, on the other hand, oral contraceptive pills may be prescribed to induce cyclic menstruation to prevent uncontrolled growth of the endometrial lining.

Young women with primary amenorrhea, found to be caused by developmental abnormalities, may require hormonal supplementation, surgery, or both. In any case, psychosocial support and counseling for the patient and family is necessary to address specific concerns and provide guidance regarding anticipated sexual development.