Amenorrhea

 

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 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 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.

 

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.

 

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.

 

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.

 

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 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.

 

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.

 

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.