Health Condition

Amenorrhea

  • Progesterone

    The oral, micronized form has been shown to successfully induce normal menstrual bleeding in women with secondary amenorrhea. (Use of this natural hormone should always be supervised by a doctor.)

    Dose:

    Consult a qualified healthcare practitioner
    Progesterone
    ×
     

    Oral, micronized progesterone (200 to300 mg per day) has been shown in at least one double-blind trial to successfully induce normal menstrual bleeding in women with secondary amenorrhea.8 Use of this natural hormone should always be supervised by a doctor.

  • Acetyl-L-Carnitine

    Acetyl-L-carnitine may help restore menstruation in some amenorrheic women.

    Dose:

    Refer to label instructions
    Acetyl-L-Carnitine
    ×
     

    Acetyl-L-carnitine is an amino acid that may have effects on brain chemicals and hormones that control female reproductive hormones. In a preliminary trial, 2 grams daily of acetyl-L-carnitine was given to amenorrheic women who had either low or normal blood levels of female hormones. Hormone levels improved in the women with low initial levels, and half of all the women resumed menstruating within three to six months after beginning supplementation.9 Controlled trials are needed to confirm these promising results.

  • Blue Cohosh

    Traditional practitioners consider blue cohosh to be a uterine tonic and an agent that stimulates menstrual blood flow, and it is used as a remedy for lack of menstruation.

    Dose:

    Refer to label instructions
    Blue Cohosh
    ×
     

    Blue cohosh is a traditional remedy for lack of menstruation. It is considered an emmenagogue (agent that stimulates menstrual blood flow) and a uterine tonic. No clinical trials have validated this traditional use.

  • Motherwort

    Motherwort has traditionally been thought to stimulate absent or diminished menses, though it has not been studied clinically.

    Dose:

    Refer to label instructions
    Motherwort
    ×
     

    Herbal emmenagogues traditionally regarded as stimulating absent or diminished menses are motherwort, rue, partridge berry, and yarrow. None of these herbs has undergone modern clinical trials to determine their efficacy. All emmenagogues should be avoided in pregnancy, as they may possibly cause a spontaneous abortion.

  • Partridge Berry

    Partridge berry has traditionally been thought to stimulate absent or diminished menses, though it has not been studied clinically.

    Dose:

    Refer to label instructions
    Partridge Berry
    ×
     

    Herbal emmenagogues traditionally regarded as stimulating absent or diminished menses are motherwort, rue, partridge berry, and yarrow. None of these herbs has undergone modern clinical trials to determine their efficacy. All emmenagogues should be avoided in pregnancy, as they may possibly cause a spontaneous abortion.

  • Rue

    Rue has traditionally been thought to stimulate absent or diminished menses, though it has not been studied clinically.

    Dose:

    Refer to label instructions
    Rue
    ×
     

    Herbal emmenagogues traditionally regarded as stimulating absent or diminished menses are motherwort, rue, partridge berry, and yarrow. None of these herbs has undergone modern clinical trials to determine their efficacy. All emmenagogues should be avoided in pregnancy, as they may possibly cause a spontaneous abortion.

  • Vitamin B6

    Preliminary evidence found that vitamin B6 restored menstruation and normalized hormone levels in three women with amenorrhea who had high prolactin levels.

    Dose:

    Refer to label instructions
    Vitamin B6
    ×
     

    Prolactin is a hormone that may be elevated in some cases of amenorrhea. A preliminary trial of 200 to 600 mg daily of vitamin B6 restored menstruation and normalized prolactin levels in three amenorrheic women with high initial prolactin levels; however, 600 mg daily of vitamin B6 had no effect on amenorrheic women who did not have high prolactin levels.10 A number of other small, preliminary trials have not demonstrated an effect of either oral or injected vitamin B6 on prolactin levels,11,12,13,14,15 and they also have reported inconsistent effects on restoring menstruation.14,13,11 Larger, controlled trials are needed to better determine the usefulness of vitamin B6 in amenorrhea.

  • Vitamin C and Clomiphene

    Vitamin C combined with the drug clomiphene, which affects female hormone levels, is more effective at stimulating ovulation in women with amenorrhea than either substance alone.

    Dose:

    Refer to label instructions
    Vitamin C and Clomiphene
    ×
    Vitamin C alone, at 400 mg daily, had no effect on amenorrhea in one preliminary trial, although it was associated with the return of ovulation in some women who were menstruating regularly but not ovulating. In a second phase of the trial, the same amount of vitamin C was combined with a drug that affects female hormone levels, and this combination was associated with return of ovulation in almost half of amenorrheic women who had not benefited from the drug alone.16 More studies of the effect of vitamin C on amenorrhea are needed.
  • Vitex

    In herbal medicine, vitex, also known as chaste tree, is sometimes used to treat amenorrhea. Research suggests it may regulate hormones related to menstruation and fertility.

    Dose:

    Refer to label instructions
    Vitex
    ×
     

    In herbal medicine, vitex (Vitex agnus-castus; chaste tree) is sometimes used to treat female infertility and amenorrhea.17 Elevation of prolactin can be a cause of amenorrhea, and vitex has been shown in animals to reduce elevated prolactin levels.18 In a controlled trial, prolactin production was normalized in women with high prolactin levels after three months of treatment with vitex.19 Vitex has also been found to raise levels of luteinizing hormone and subsequent progesterone levels in women with luteal phase defect—a condition that can also lead to menstrual cycle abnormalities, including amenorrhea.20 To date, only one small preliminary trial has studied the effects of vitex on amenorrhea. This study found that ten of fifteen women with amenorrhea began having a normal period after taking 40 drops of a liquid vitex preparation once daily for six months.21 Further research is needed to determine what role vitex may play in the management of amenorrhea.

  • Yarrow

    Yarrow has traditionally been thought to stimulate absent or diminished menses, though it has not been studied clinically.

    Dose:

    Refer to label instructions
    Yarrow
    ×
     

    Herbal emmenagogues traditionally regarded as stimulating absent or diminished menses are motherwort, rue, partridge berry, and yarrow. None of these herbs has undergone modern clinical trials to determine their efficacy. All emmenagogues should be avoided in pregnancy, as they may possibly cause a spontaneous abortion.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Holistic Options

In a number of preliminary trials,22,23,24acupuncture has been shown to induce ovulation in women with disorders involving lack of ovulation. Preliminary studies show that levels of estrogen and progesterone, as well as levels of the related hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone), may all be affected by acupuncture.23,24 Few studies have looked at the use of acupuncture for treatment of amenorrhea, but one preliminary trial found it helpful for women who have widely separated menstrual cycles.27 In one controlled trial, amenorrheic women showed a trend toward normalizing hormone levels following acupuncture.28

References

1. Fagan KM. Pharmacologic management of athletic amenorrhea. Clin Sports Med 1998;17:327-41 [review].

2. Yen SS. Effects of lifestyle and body composition on the ovary. Endocrinol Metab Clin North Am 1998;27:915-26,ix [review].

3. Sanborn CF, Horea M, Siemers BJ, Dieringer KI. Disordered eating and the female athlete triad. Clin Sports Med 2000;19:199-213 [review].

4. Berga SL, Loucks-Daniels TL, Adler LJ, et al. Cerebrospinal fluid levels of corticotropin-releasing hormone in women with functional hypothalamic amenorrhea. Am J Obstet Gynecol 2000;182:776-81.

5. Carmichael KA, Carmichael DH. Bone metabolism and osteopenia in eating disorders. Medicine (Baltimore) 1995;74:254-67 [review].

6. McNeilly AS, Tay CC, Glasier A. Physiological mechanisms underlying lactational amenorrhea. Ann N Y Acad Sci 1994;709:145-55 [review].

7. Kalkwarf HJ. Hormonal and dietary regulation of changes in bone density during lactation and after weaning in women. J Mammary Gland Biol Neoplasia 1999;4:319-29 [review].

8. 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;56:1040-7.

9. Genazzani AD, Petraglia F, Algeri I, et al. Acetyl-l-carnitine as possible drug in the treatment of hypothalamic amenorrhea. Acta Obstet Gynecol Scand 1991;70:487-92.

10. McIntosh EN. Treatment of women with the galactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6). J Clin Endocrinol Metab 1976;42:1192-5.

11. Kidd GS, Dimond R, Kark JA, et al. The effects of pyridoxine on pituitary hormone secretion in amenorrhea-galactorrhea syndromes. J Clin Endocrinol Metab 1982;54:872-5.

12. Spiegel AM, Rosen SW, Weintraub BD, Marynick SP. Effect of intravenous pyridoxine on plasma prolactin in hyperprolactinemic subjects. J Clin Endocrinol Metab 1978;46:686-8.

13. Lehtovirta P, Ranta T, Seppala M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh) 1978;87:682-6.

14. Tolis G, Laliberte R, Guyda H, Naftolin F. Ineffectiveness of pyridoxine (B6) to alter secretion of growth hormone and prolactin and absence of therapeutic effects on galactorrhea-amenorrhea syndromes. J Clin Endocrinol Metab 1977;44:1197-9.

15. Goodenow TJ, Malarkey WB. Ineffectiveness of pyridoxine in evaluation and treatment of the hyperprolactinemic amenorrhea-galactorrhea syndrome. Am J Obstet Gynecol 1979;133:161-4.

16. Igarashi M. Augmentative effect of ascorbic acid upon induction of human ovulation in clomiphene-ineffective anovulatory women. Int J Fertil 1977;22:168-73.

17. Veal L. Complementary therapy and infertility: an Icelandic perspective. Complement Ther Nurs Midwifery 1998;4:3-6 [review].

18. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res 1993;25:253-5.

19. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993;43:752-6 [in German].

20. Brown DJ. Herbal Prescriptions for Health and Healing. Roseville, CA: Prima Health, 2000, 235-8.

21. Loch EG, Katzorke T. Diagnosis and treatment of dyshormonal menstrual periods in general practice. Gynäkol Praxis 1990;14:489-95.

22. Stener-Victorin E, Waldenstrom U, Tagnfors U, et al. Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome. Acta Obstet Gynecol Scand 2000;79:180-8.

23. Mo X, Li D, Pu Y, et al. Clinical studies on the mechanism for acupuncture stimulation of ovulation. J Tradit Chin Med 1993;13:115-9.

24. Yu J, Zheng HM, Ping SM. Changes in serum FSH, LH and ovarian follicular growth during electroacupuncture for induction of ovulation. Chung Hsi I Chieh Ho Tsa Chih 1989;9:199-202,195 [in Chinese].

25. Gerhard I, Postneek F. Possibilities of therapy by ear acupuncture in female sterility. Geburtshilfe Frauenheilkd 1988;48:165-71 [in German].

26. Kubista E, Boschitsch E, Spona J. Effect of ear-acupuncture on the LH-concentration in serum in patients with secondary amenorrhea. Wien Med Wochenschr 1981;131:123-6 [in German].

27. Koebnick C, Strassner C, Hoffmann I, Leitzmann C. Consequences of a long-term raw food diet on body weight and menstruation: results of a questionnaire survey. Ann Nutr Metab 1999;43:69-79.

28. Barr SI. Vegetarianism and menstrual cycle disturbances: is there an association? Am J Clin Nutr 1999;70:549S-54S [review].

29. Kemmann E, Pasquale SA, Skaf R. Amenorrhea associated with carotenemia. JAMA 1983;249:926-9.

30. Frumar AM, Meldrum DR, Judd HL. Hypercarotenemia in hypothalamic amenorrhea. Fertil Steril 1979;32:261-4.

31. Martin-Du Pan RC, Hermann W, Chardon F. Hypercarotenemia, amenorrhea and a vegetarian diet. J Gynecol Obstet Biol Reprod (Paris) 1990;19(3):290-4 [in French].

32. Cassidy A, Bingham S, Setchell K. Biological effects of isoflavones in young women: importance of the chemical composition of soyabean products. Br J Nutr 1995;74:587-601.

33. Cassidy A, Bingham S, Setchell KD. Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr 1994;60:333-40.

34. Lu LJ, Anderson KE, Grady JJ, et al. Decreased ovarian hormones during a soya diet: implications for breast cancer prevention. Cancer Res 2000;60:4112-21.

35. Wu AH, Stanczyk FZ, Hendrich S, et al. Effects of soy foods on ovarian function in premenopausal women. Br J Cancer 2000;82:1879-86.

36. Xu X, Duncan AM, Merz BE, Kurzer MS. Effects of soy isoflavones on estrogen and phytoestrogen metabolism in premenopausal women. Cancer Epidemiol Biomarkers Prev 1998;7:1101-8.

37. Lu LJ, Anderson KE, Grady JJ, Nagamani M. Effects of soya consumption for one month on steroid hormones in premenopausal women: implications for breast cancer risk reduction. Cancer Epidemiol Biomarkers Prev 1996;5:63-70.

38. Martini MC, Dancisak BB, Haggans CJ, et al. Effects of soy intake on sex hormone metabolism in premenopausal women. Nutr Cancer 1999;34:133-9.

39. Duncan AM, Merz BE, Xu X, et al. Soy isoflavones exert modest hormonal effects in premenopausal women. J Clin Endocrinol Metab 1999;84:192-7.

40. Miller KK, Parulekar MS, Schoenfeld E, et al. Decreased leptin levels in normal weight women with hypothalamic amenorrhea: the effects of body composition and nutritional intake. J Clin Endocrinol Metab 1998;83:2309-12.

41. Snow RC, Schneider JL, Barbieri RL. High dietary fiber and low saturated fat intake among oligomenorrheic undergraduates. Fertil Steril 1990;54:632-7.

42. Warren MP, Holderness CC, Lesobre V, et al. Hypothalamic amenorrhea and hidden nutritional insults. J Soc Gynecol Investig 1994;1:84-8.

43. Couzinet B, Young J, Brailly S, et al. Functional hypothalamic amenorrhoea: a partial and reversible gonadotrophin deficiency of nutritional origin. Clin Endocrinol (Oxf) 1999;50:229-35.

44. Laughlin GA, Dominguez CE, Yen SS. Nutritional and endocrine-metabolic aberrations in women with functional hypothalamic amenorrhea. J Clin Endocrinol Metab 1998;83:25-32.

45. Koebnick C, Strassner C, Hoffmann I, Leitzmann C. Consequences of a long-term raw food diet on body weight and menstruation: results of a questionnaire survey. Ann Nutr Metab 1999;43:69-79.

46. Barr SI. Vegetarianism and menstrual cycle disturbances: is there an association? Am J Clin Nutr 1999;70:549S-54S [review].

47. Kemmann E, Pasquale SA, Skaf R. Amenorrhea associated with carotenemia. JAMA 1983;249:926-9.

48. Frumar AM, Meldrum DR, Judd HL. Hypercarotenemia in hypothalamic amenorrhea. Fertil Steril 1979;32:261-4.

49. Martin-Du Pan RC, Hermann W, Chardon F. Hypercarotenemia, amenorrhea and a vegetarian diet. J Gynecol Obstet Biol Reprod (Paris) 1990;19(3):290-4 [in French].

50. Cassidy A, Bingham S, Setchell K. Biological effects of isoflavones in young women: importance of the chemical composition of soyabean products. Br J Nutr 1995;74:587-601.

51. Cassidy A, Bingham S, Setchell KD. Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr 1994;60:333-40.

52. Lu LJ, Anderson KE, Grady JJ, et al. Decreased ovarian hormones during a soya diet: implications for breast cancer prevention. Cancer Res 2000;60:4112-21.

53. Wu AH, Stanczyk FZ, Hendrich S, et al. Effects of soy foods on ovarian function in premenopausal women. Br J Cancer 2000;82:1879-86.

54. Xu X, Duncan AM, Merz BE, Kurzer MS. Effects of soy isoflavones on estrogen and phytoestrogen metabolism in premenopausal women. Cancer Epidemiol Biomarkers Prev 1998;7:1101-8.

55. Lu LJ, Anderson KE, Grady JJ, Nagamani M. Effects of soya consumption for one month on steroid hormones in premenopausal women: implications for breast cancer risk reduction. Cancer Epidemiol Biomarkers Prev 1996;5:63-70.

56. Martini MC, Dancisak BB, Haggans CJ, et al. Effects of soy intake on sex hormone metabolism in premenopausal women. Nutr Cancer 1999;34:133-9.

57. Duncan AM, Merz BE, Xu X, et al. Soy isoflavones exert modest hormonal effects in premenopausal women. J Clin Endocrinol Metab 1999;84:192-7.

58. Bringer J, Lefebvre P, Renard E. Nutritional hypogonadism. Rev Prat 1999;49:1291-6 [review, in French].

59. Yen SS. Effects of lifestyle and body composition on the ovary. Endocrinol Metab Clin North Am 1998;27:915-26,ix [review].

60. Dueck CA, Matt KS, Manore MM, Skinner JS. Treatment of athletic amenorrhea with a diet and training intervention program. Int J Sport Nutr 1996;6:24-40.

61. Kopp-Woodroffe SA, Manore MM, Dueck CA, et al. Energy and nutrient status of amenorrheic athletes participating in a diet and exercise training intervention program. Int J Sport Nutr 1999;9:70-88.

62. Warren MP, Stiehl AL. Exercise and female adolescents: effects on the reproductive and skeletal systems. J Am Med Womens Assoc 1999;54:115-20, 138 [review].

63. Jonnavithula S, Warren MP, Fox RP, Lazaro MI. Bone density is compromised in amenorrheic women despite return of menses: a 2-year study. Obstet Gynecol 1993;81:669-74.

64. Sanborn CF, Horea M, Siemers BJ, Dieringer KI. Disordered eating and the female athlete triad. Clin Sports Med 2000;19:199-213 [review].

65. Manore MM. Nutritional needs of the female athlete. Clin Sports Med 1999;18:549-63 [review].

66. Benson JE, Engelbert-Fenton KA, Eisenman PA. Nutritional aspects of amenorrhea in the female athlete triad. Int J Sport Nutr 1996;6:134-45 [review].

67. Frederick L, Hawkins ST. A comparison of nutrition knowledge and attitudes, dietary practices, and bone densities of postmenopausal women, female college athletes, and nonathletic college women. J Am Diet Assoc 1992;92:299-305.

68. Hirschberg AL, Hagenfeldt K. Athletic amenorrhea and its consequences. Hard physical training at an early age can cause serious bone damage. Lakartidningen 1998;95:5765-70 [review, in Swedish].

69. Kleiner SM, Bazzarre TL, Ainsworth BE. Nutritional status of nationally ranked elite bodybuilders. Int J Sport Nutr 1994;4:54-69.

70. Dueck CA, Matt KS, Manore MM, Skinner JS. Treatment of athletic amenorrhea with a diet and training intervention program. Int J Sport Nutr 1996;6:24-40.

71. Kopp-Woodroffe SA, Manore MM, Dueck CA, et al. Energy and nutrient status of amenorrheic athletes participating in a diet and exercise training intervention program. Int J Sport Nutr 1999;9:70-88.

72. McNeilly AS, Tay CC, Glasier A. Physiological mechanisms underlying lactational amenorrhea. Ann N Y Acad Sci 1994;709:145-55 [review].

73. Peng YK, Hight-Laukaran V, Peterson AE, Perez-Escamilla R. Maternal nutritional status is inversely associated with lactational amenorrhea in Sub-Saharan Africa: results from demographic and health surveys II and III. J Nutr 1998;128:1672-80.

74. Delgado HL, Martorell R, Klein RE. Nutrition, lactation, and birth interval components in rural Guatemala. Am J Clin Nutr 1982;35:1468-76.

75. Lunn PG, Austin S, Prentice AM, Whitehead RG. The effect of improved nutrition on plasma prolactin concentrations and postpartum infertility in lactating Gambian women. Am J Clin Nutr 1984;39:227-35.

76. Tracer DP. Lactation, nutrition, and postpartum amenorrhea in lowland Papua New Guinea. Hum Biol 1996;68:277-92.

77. Prema K, Naidu AN, Neelakumari S, Ramalakshmi BA. Nutrition—fertility interaction in lactating women of low income groups. Br J Nutr 1981;45:461-7.

78. Heinig MJ, Nommsen-Rivers LA, Peerson JM, Dewey KG. Factors related to duration of postpartum amenorrhoea among USA women with prolonged lactation. J Biosoc Sci 1994;26:517-27.

79. Lunn PG, Prentice AM, Austin S, Whitehead RG. Influence of maternal diet on plasma-prolactin levels during lactation. Lancet 1980 Mar 22;1(8169):623-5 [review].

80. Tennekoon KH, Karunanayake EH, Seneviratne HR. Effect of skim milk supplementation of the maternal diet on lactational amenorrhea, maternal prolactin, and lactational behavior. Am J Clin Nutr 1996;64:283-90.

81. Kalkwarf HJ. Hormonal and dietary regulation of changes in bone density during lactation and after weaning in women. J Mammary Gland Biol Neoplasia 1999;4:319-29 [review].

82. Berga SL, Loucks-Daniels TL, Adler LJ, et al. Cerebrospinal fluid levels of corticotropin-releasing hormone in women with functional hypothalamic amenorrhea. Am J Obstet Gynecol 2000;182:776-81.

83. Gallinelli A, Matteo ML, Volpe A, Facchinetti F. Autonomic and neuroendocrine responses to stress in patients with functional hypothalamic secondary amenorrhea. Fertil Steril 2000;73:812-6.

84. Meczekalski B, Tonetti A, Monteleone P, et al. Hypothalamic amenorrhea with normal body weight: ACTH, allopregnanolone and cortisol responses to corticotropin-releasing hormone test. Eur J Endocrinol 2000;142:280-5.

85. Johnson J, Whitaker AH. Adolescent smoking, weight changes, and binge-purge behavior: associations with secondary amenorrhea. Am J Public Health 1992;82:47-54.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.