Evaluation of secondary amenorrhea

This algorithm offers a stepwise approach to the evaluation of secondary amenorrhea. For further details, refer to additional UpToDate content on the causes, evaluation, and treatment of secondary amenorrhea.

BMI: body mass index; E2: estradiol; FSH: follicle-stimulating hormone; hCG: human chorionic gonadotropin; MRI: magnetic resonance imaging; PCOS: polycystic ovary syndrome; PRL: prolactin; T: testosterone; TSH: thyroid-stimulating hormone.

* Many clinicians also measure serum 17-hydroxyprogesterone at the initial visit to rule out nonclassic 21-hydroxylase deficiency. Some also measure serum dehydroepiandrosterone sulfate (DHEAS).

¶ Mild hyperprolactinemia can sometimes be seen with hypothyroidism. Euthyroidism should be confirmed before performing MRI.

Δ Pituitary MRI not required in those with clear explanation for their hypogonadotropic amenorrhea, eg, eating disorder, excessive exercise, celiac disease, or type 1 diabetes mellitus.

Graphic 109616 Version 3.0

خرید پکیج

Evaluation of secondary amenorrhea