Evaluation of amenorrhea
- PMID: 8629565
Evaluation of amenorrhea
Abstract
Pregnancy is the most common cause of amenorrhea and must be ruled out before proceeding with diagnostic evaluation. A careful history and physical examination may reveal evidence of androgen excess, estrogen deficiency or other endocrinopathies. Serum prolactin and thyroid-stimulating hormone (TSH) levels should be checked in all women who are not pregnant. Galactorrhea by history or on examination and/or an elevated prolactin level should be investigated with an imaging study to rule out a pituitary adenoma. If serum prolactin and TSH levels are normal, a progesterone challenge test should be performed to determine outflow tract patency and estrogen status. In women with hypoestrogenic amenorrhea, indicated by a negative challenge test and a competent outflow tract, serum gonadotropin, follicle-stimulating hormone and luteinizing hormone levels may be measured to determine whether amenorrhea represents ovarian failure or pituitary or hypothalamic dysfunction. Hypothalamic amenorrhea is common in women with a history of weight loss, stress or vigorous exercise. Amenorrheic women with adequate estrogen levels should receive cyclic progesterone. Hormonal therapy and calcium supplementation in hypoestrogenic amenorrhea.
Similar articles
-
[Hypothalamo-hypophyseal amenorrhea. I. The clinical and laboratory manifestations].Ginecol Obstet Mex. 1990 Dec;58:346-53. Ginecol Obstet Mex. 1990. PMID: 2127582 Spanish.
-
[Arginine-GnRH-TRH test in patients with primary hypothalamic amenorrhea].Zentralbl Gynakol. 1985;107(16):996-1002. Zentralbl Gynakol. 1985. PMID: 3931389 German.
-
Significance of hyperprolactinemia in 70 women with amenorrhea.Isr J Med Sci. 1978 Jul;14(7):753-61. Isr J Med Sci. 1978. PMID: 681167
-
Adolescent menstrual irregularity.J Reprod Med. 1984 Jun;29(6):399-410. J Reprod Med. 1984. PMID: 6379175 Review.
-
Evaluation and management of adolescent amenorrhea.Ann N Y Acad Sci. 2010 Sep;1205:23-32. doi: 10.1111/j.1749-6632.2010.05669.x. Ann N Y Acad Sci. 2010. PMID: 20840249 Review.
Cited by
-
Progesterone: A Steroid with Wide Range of Effects in Physiology as Well as Human Medicine.Int J Mol Sci. 2022 Jul 20;23(14):7989. doi: 10.3390/ijms23147989. Int J Mol Sci. 2022. PMID: 35887338 Free PMC article. Review.
-
Best practice in primary care pathology: review 4.J Clin Pathol. 2006 Sep;59(9):893-902. doi: 10.1136/jcp.2005.035212. Epub 2006 May 19. J Clin Pathol. 2006. PMID: 16714397 Free PMC article. Review.
-
High risk of hypogonadism after traumatic brain injury: clinical implications.Pituitary. 2005;8(3-4):245-9. doi: 10.1007/s11102-005-3463-4. Pituitary. 2005. PMID: 16470352 Review.