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Medical Treatment

Treatment depends on the cause of amenorrhea. Once the cause is determined, treatment is directed at correcting the underlying disease, which should restore menstruation. In case of anatomical abnormalities of the genital tract, surgery may be indicated.

Dopamine agonists, such as bromocriptine (Parlodel) or pergolide (Permax), are effective in treating hyperprolactinemia. In most women, treatment with dopamine agonists restores normal ovarian endocrine function and ovulation.

Hormone replacement therapy, consisting of an estrogen and a progestin, is needed for women in whom estrogen deficiency remains because ovarian function cannot be restored. It is also required to maintain bone density in women whose underlying disease cannot be treated.

In some cases, oral contraceptives may be prescribed to restore the menstrual cycle and to provide estrogen replacement to women with amenorrhea who do not wish to become pregnant. Before administering oral contraceptives, withdrawal bleeding is induced with an injection of progesterone or oral administration of 5-10 mg of medroxyprogesterone (Provera) for 10 days.