In cases in which the function has never appeared, the difficulty is generally due to morbid development, or some form of obstruction. For the first condition, such measures should be adopted as will improve the patient's general health, and secure proper development. In these cases, the hips are generally narrow and the breasts small, and the patient has in many cases something of a masculine appearance. When the difficulty has existed for a long time, its removal may be impossible; hence the importance of giving attention to the matter in time. When obstruction exists, as indicated by the periodical occurrence of the usual symptoms of menstruation, but without the menstrual flow, and with enlargement of the lower part of the abdomen, surgical measures should be resorted to, to allow the accumulated fluid to escape. This should be done gradually, however, and in such a way as to prevent the entrance of air, as otherwise decomposition would occur, which might result in poisoning of the blood. This class of persons often suffer much mental annoyance through suspicion of pregnancy.

In cases in which suppression occurs suddenly during the menstrual period, the patient should take a hot foot or sitz-bath, or better still, a hot blanket pack, and should be made to sweat profusely by this means combined with hot drinks. Hot fomentations should be applied across the lower part of the bowels, bricks, hot bags, and other similar applications to the limbs and inside of the thighs. Ice bags or compresses should be applied over the lower portion of the spine, and the patient should be kept quiet in bed.

When amenorrhoea exists in consequence of debility or anaemia, as in consumption and other prostrating diseases, attention should be given to the improvement of the general health by nutritious food, daily exercise in the open air, daily massage, with inunctions, electricity and other tonic measures. In these cases, the amenorrhoea is not to be considered as the cause of the existing debility or general disease, as is usually thought to be the case. It is simply the result of general depression of the system which will disappear with the removal of the cause. In these cases, warm sitz-baths, hot fomentations over the bowels, and daily application of the ice compress to the lower portion of the spine for an hour or two, are useful measures. The local application of electricity by a competent person is also of very great advantage.