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Secondary amenorrhea's most common and most easily diagnosable causes are pregnancy, thyroid disease, and hyperprolactinemia. [50] A pregnancy test is a common first step for diagnosis. [50] Similar to primary amenorrhea, evaluation of secondary amenorrhea also begins with a pregnancy test, prolactin, FSH, LH, and TSH levels. [13]
Exercise amenorrhoea is a diagnosis of exclusion. Girls who exercise at a young age may have primary amenorrhoea. The differential diagnosis are androgen excess, pituitary tumors (rare), tumors of the third ventricle (rare) or other conditions leading to chronic malnutrition. Diet history and bone density investigations should also be done to ...
Amenorrhea, or the absence of menstruation, is subdivided into primary and secondary amenorrhea. In primary amenorrhea, in which there is a failure to menstruate by the age of 16 with normal sexual development or by 14 without normal sexual development, causes can be from developmental abnormalities of the uterus, ovaries, or genital tract, or ...
Evaluation for FHA may include a thorough history and physical exam, laboratory testing, and imaging if appropriate. The Endocrine Society Clinical Practice Guidelines on Functional Hypothalamic Amenorrhea suggests obtaining a baseline bone mineral density measurement by DEXA scan from any patient with 6 or more months of amenorrhea. [9]
However, if no bleeding occurs after progesterone withdrawal, then the patient's amenorrhea is likely to be due to either a) low serum estradiol (i.e. premature ovarian failure), b) hypothalamic-pituitary axis dysfunction (such as low GNRH or low FSH that lead to low estrogen level ), c) a nonreactive endometrium, or d) a problem with the ...
The diagnosis can be made at various ages, from neonates presenting with hydrocolpos to young women presenting with primary amenorrhea and pelvic pain due to the development of hematocolpos. Often, women might have a normal hymeneal opening but this wall of tissue might be blocking the access to the vaginal canal.
Müllerian agenesis (including absence of the uterus, cervix and/or vagina) is the cause in 15% of cases of primary amenorrhoea. [2] Because most of the vagina does not develop from the Müllerian duct, instead developing from the urogenital sinus, along with the bladder and urethra, it is present even when the Müllerian duct is completely absent.
Diagnosis commonly occurs in adolescence due to delayed puberty or amenorrhea. Some individuals may have some breast development, secondary amenorrhea, or ovarian follicles on imaging rather than the expected streak or hypoplastic ovaries.