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A 26-year-old top female athlete (height 157 cm), who took part in competitive sport similar to middle- and long-distance running, became amenorrhoeic in February 2009. In late May 2009, athletic amenorrhoea was diagnosed and a norgestrel–ethinyl estradiol combination (norgestrel 0.5 mg and ethinyl estradiol 0.05 mg three times daily) was prescribed for 2 weeks. She experienced menstrual bleeding on one occasion for 4 days in mid-June before becoming amenorrhoeic again. The athlete visited our centre to try acupuncture treatment. Forty-six acupuncture sessions were given between 1 October 2009 and 2 November 2010. Acupuncture point selection was based on classical acupuncture medicine and included points long used for gynaecological disorders in Japan—namely, CV6, CV12, LR3, LR14, BL17, BL18, BL23, SP6 and SP10. On 7 May 2010, owing to lack of regular normal vaginal bleeding, she again consulted her gynaecologist and was prescribed the same hormone preparation as used previously. She took it for 2 weeks in conjunction with acupuncture treatment. From July, the amount and duration of menstrual flow increased at regular intervals. Throughout July, a biphasic pattern in basal body temperature (BBT) was gradually established. In conclusion, the single hormone replacement therapy in May 2009 without acupuncture treatment was not effective for the amenorrhoea, nor was the single acupuncture treatment between October 2009 and May 2010. However, after hormone replacement therapy was started in May 2010 in conjunction with regular acupuncture treatment, menstrual blood flow restarted and BBT moved close to the biphasic pattern.