The first step in determining the cause of amenorrhea is usually to rule out pregnancy and to check for any problems with a woman’s reproductive organs. This usually involves a pregnancy test along with a pelvic examination typically conducted by an obstetrician-gynecologist (ObGyn).

If pregnancy is ruled out, a physician will collect a thorough medical history, including a menstrual history, and ask questions about accompanying symptoms. Blood tests and/or urine tests may be performed to determine if hormone levels may be interfering with menstruation.

Depending on the signs and symptoms accompanying amenorrhea, further tests may be needed. For example, imaging tests such as an ultrasound can reveal tumors or structural abnormalities in a woman’s reproductive organs, as well as measure and monitor the endometrial lining. In addition, minimally invasive procedures, such as a laparoscopy or hysteroscopy, may sometimes be performed for a more thorough examination of the reproductive structures.

The treatment of amenorrhea depends on its cause. Treatments may include:

• Lifestyle changes. Changes to diet, exercise and stress management may help resolve some causes of amenorrhea or may be an integral part of the overall treatment plan.
  
  
• Medications. These include drugs primarily used to correct hormone disorders. For example, estrogen, progesterone or other hormone replacement therapy may be administered to restore a woman’s menstrual periods. Sometimes birth control pills are prescribed to help with irregular or absent periods.
  
  
• Surgery. Various procedures may be used to remove tumors or cysts in the ovaries, uterus or pituitary gland that is causing the lack of menstruation. Most tumors or cysts are noncancerous, but if cancer is present radiation therapy and/or chemotherapy may be necessary.

Most cases of amenorrhea are caused by a treatable medical condition, and once treated, a woman usually resumes menstruation.