Amenorrhea Questions & Answers

Updated: Oct 14, 2019
  • Author: Kristi A Tough DeSapri, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Questions & Answers

Overview

What is amenorrhea?

What is primary amenorrhea?

What is secondary amenorrhea?

At what point does oligomenorrhea become amenorrhea?

What is the pathophysiology of the menstrual cycle?

What are the three physiologic phases of the menstrual cycle?

What is the follicular phase of the menstrual cycle?

What is the ovulatory phase of the menstrual cycle?

What is the luteal phase of the menstrual cycle?

What is the normal progression of puberty and the start of menstruation?

What is the pathogenesis of hypothalamic amenorrhea?

What causes hypothalamic amenorrhea?

What is the pathogenesis of Kallmann syndrome?

What is the role of body fat in the pathogenesis of amenorrhea?

What are functional causes of amenorrhea?

What is the pathogenesis of pituitary amenorrhea?

What is the pathogenesis of Turner syndrome?

What is the pathogenesis of spontaneous 46,XX primary ovarian insufficiency?

Which genetic syndromes cause amenorrhea?

What is the pathogenesis of Swyer syndrome?

Does PCOS present as primary or secondary amenorrhea?

Which anatomical abnormalities cause amenorrhea?

Which receptor and enzyme defects cause amenorrhea?

How is amenorrhea after puberty classified?

How is primary amenorrhea categorized?

What are the underlying etiologies of hypergonadotropic hypogonadism amenorrhea?

What are the underlying etiologies of hypogonadotropic hypogonadism amenorrhea?

Which congenital abnormalities cause hypogonadotropic hypogonadism amenorrhea?

Which endocrine disorders cause hypogonadotropic hypogonadism amenorrhea?

Which tumors cause hypogonadotropic hypogonadism amenorrhea?

What anatomic abnormalities cause eugonadism amenorrhea?

Which disorders with are the most prevalent causes of secondary amenorrhea?

Which disorders with high FSH levels cause secondary amenorrhea?

How prevalent are anatomic disorder and high prolactin level etiologies in secondary amenorrhea?

Which hyperandrogenic states cause secondary amenorrhea?

What is the incidence of amenorrhea in the US?

How does the incidence of amenorrhea vary by race or ethnicity?

What are the risk factors for amenorrhea?

What is the role of bone density in amenorrhea?

What does a finding of amenorrhea suggest?

What is the prognosis of polycystic ovarian syndrome (PCOS)–caused amenorrhea?

What education about amenorrhea should patients receive?

Presentation

What should be the focus of the patient history in women with secondary amenorrhea?

How should adolescents with amenorrhea be examined?

What is the focus of history in suspected primary amenorrhea?

Why is a history of sexual activity needed when evaluating a patient for amenorrhea?

What does menstrual cycle irregularity suggest?

What are causes of secondary amenorrhea?

How can a detailed patient history be obtained in the evaluation of amenorrhea?

Which outflow tract disorders can cause primary amenorrhea?

Which ovarian disorders can cause secondary amenorrhea?

Which hypothalamic and pituitary disorders are possible causes of amenorrhea?

What dieting restrictions can cause amenorrhea?

Which psychiatric disorders can cause amenorrhea?

Which autoimmune disorders can cause amenorrhea?

Which types of exercise activity can cause amenorrhea?

What are possible metabolic causes of amenorrhea?

Which types of drugs cause amenorrhea?

Which chronic diseases can cause amenorrhea?

When is a pelvic exam performed in an adolescent with amenorrhea?

What is the role of a general physical exam in the evaluation of amenorrhea?

What should be included in the physical exam for amenorrhea?

How should breasts be examined in the evaluation of amenorrhea?

How should the pelvic exam be performed in the evaluation of amenorrhea?

DDX

What is the difference between primary and secondary amenorrhea?

What should be included in the differential diagnoses of amenorrhea with delayed puberty?

What should be included in the differential diagnoses of amenorrhea with normal puberty?

How is amenorrhea diagnosed?

What are the differential diagnoses for Amenorrhea?

Workup

What is the role of lab testing in the diagnosis of amenorrhea?

Which lab tests are performed in the evaluation of secondary amenorrhea?

Which hormonal studies may be performed in the workup of amenorrhea?

What is the role of prolactin measurements in the evaluation of amenorrhea?

What is the role of FSH measurements in the evaluation of amenorrhea?

What is the role of luteinizing hormone measurement in the evaluation of amenorrhea?

What is the role of estradiol measurement in the evaluation of amenorrhea?

What is the role of thyroid hormones measurement in the evaluation of amenorrhea?

What is the role of androgens measurement in the evaluation of amenorrhea?

What is the role of ultrasonography in the evaluation of amenorrhea?

What is the role of MRI in the evaluation of amenorrhea?

Which assessment tools have been validated for the measure of dietary intake, mood disorder, and eating disorders in evaluation of amenorrhea?

What is the role of progesterone withdrawal testing in the evaluation of amenorrhea?

What is the algorithm for diagnosing amenorrhea with delayed puberty?

What is the algorithm for diagnosing amenorrhea with normal puberty and uterus present?

What is the algorithm for diagnosing amenorrhea with genital tract abnormalities?

Treatment

What are the treatment options for amenorrhea?

How is the complication of osteoporosis prevented during the treatment of amenorrhea?

How does amenorrhea affect self-esteem and body image?

What are the most common causes of amenorrhea?

What are the treatment options for PCOS-related amenorrhea?

What are the treatment options for hypothalamic amenorrhea?

What are the treatment options for hyperprolactinemia-related amenorrhea?

What are the treatment options for hypogonadotropic hypogonadism amenorrhea?

How is thyroid dysfunction-related amenorrhea treated?

How are diet and activity modified during the treatment for amenorrhea?

What specialist consultations are needed for the treatment of amenorrhea?

What long-term monitoring is required following treatment for amenorrhea?

Guidelines

What are the Endocrine Society treatment guidelines for hypothalamic amenorrhea?

Medications

Which medications are used for treatment of amenorrhea?

Which medications in the drug class Progestins are used in the treatment of Amenorrhea?

Which medications in the drug class Estrogens are used in the treatment of Amenorrhea?