To recognize amenorrhea it is necessary to know what would be considered normal menstruation. The duration of a period is 28 +/- 3 days 65% of women, with a range of 18 to 40 days; once a menstrual pattern has been established the variation does not normally exceed 5 days. The average duration of flow is 5 +/- 2 days with a blood loss averaging 130 ml, usually heavier on the second day.

Amenorrhea can be of three broad types:

• Primary amenorrhoea where menstruation has never happened. Such a wide variation in normal onset times of periods occurs that applying this diagnosis is problematic. Usually primary amenorrhoea implies that menstruation has not started by the age of 16. With the safe and effective herbs available to the phytotherapist, treatment could start at the age of 15 if called for. However competent diagnosis is called for as there are a number of diverse cause to consider, including imperforate hymen, ovarian dysfunction or hormonal imbalance. Obviously the treatment will be dictated by the diagnoses cause.
  
• Secondary amenorrhoea when menstruation stops after at leastone period. This is a common occurrence with causes including pregnancy, stress, loss or gain of weight, menopause, breast-feeding, anaemia, excessive exercise, stopping contraceptive pill intake, some drugs, ovarian cysts or tumors etc.etc..
  
• Erratic or irregular menstruation. There may be 3 or 4 periods in a year, or 3 close together followed by none for a few months. A similar range of cause is possible

Emmenagogues are the classic treatment as they are triggers for the menstrual process.
Hormonal Normalizers will help the body regulate the levels of the various hormonal factors involved.
Uterine Tonics will contribute the nourishing, toning power they have.
Other Actions will be indicated by the associated symptom picture or case history. For example if anxiety and stress are an issue consider appropriate nervines, or cramp is present anti-spasmodics.