The treatment is dependent on the cause.
For women who are underweight resulting in amenorrhoea, lifestyle and dietary advice is the mainstay. However, if their oestrogen levels are very low they may benefit from hormone therapy to prevent osteoporosis.
For women with polycystic ovarian syndrome there is no cure as the exact cause for it is still not completely known. However, weight loss in women with high BMI can help the return of more regular menses.
Women not wishing to conceive
who are not seeing their menses are
usually advised to start hormonal
treatment. This is especially important
if the menses come less frequently
than three-monthly, as this in the
longer-term increases the chance
of endometrial abnormalities and
over the years can increase the risk
of endometrial cancer. Therefore, the
combined pill or progesterones every
three months can be used to provoke
a bleed to shed the endometrium.
Metformin is a non-hormonal daily
treatment which can sometimes be
considered. It is important to stress that
there are many treatments to help if
you are trying to conceive.
Problems with excess facial or body
hair are experienced by many women
with PCOS. Creams which can be used
to slow the growth of the hair, along
with laser treatment can help with this.
A specific type of the combined pill can
also be helpful for symptoms of excess
hair growth or acne.
High levels of prolactin normally just
requires treatment with medication,
rarely is surgery required. A referral
to a Specialist in this area, an
Endocrinologist, is usual.
Premature ovarian failure is not
normally reversible, and this can cause
women to consider oocyte donation
with fertility treatment if pregnancy
is desired. This can be a very difficult
diagnosis and extra psychological
support may be needed.
Hormone replacement therapy is
normally advised either in the form
of the combined oral contraceptive
pill or hormone replacement therapy
to prevent osteoporosis in the long
term, which has significant morbidity
and mortality compared to the risks of
Surgery may be required for tumours
in the hypothalamus, ovary or adrenal
gland, as well as for intrauterine
adhesions or problems with cervical
If the cause of the amenorrhoea is due
to other disease then optimising the
control of these medical problems is
the key to treatment.
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