Amenorrhea: evaluation and treatment

Area of Science:

• Reproductive Endocrinology
• Gynecology

Background:

• Amenorrhea, the absence of menstruation, requires a systematic diagnostic approach.
• Distinguishing between primary and secondary amenorrhea is crucial for targeted evaluation.

Purpose of the Study:

• To outline a diagnostic strategy for primary and secondary amenorrhea.
• To identify common etiologies based on patient presentation.
• To emphasize treatment goals for amenorrhea management.

Main Methods:

• Clinical history and physical examination.
• Laboratory testing, including karyotype analysis.
• Differential diagnosis based on sexual development and uterine anatomy.

Main Results:

• Primary amenorrhea evaluation depends on sexual development: constitutional delay in its absence, outflow tract obstruction with normal development, or müllerian agenesis with abnormal development.
• Secondary amenorrhea necessitates ruling out pregnancy first.
• Treatment is etiology-specific, aiming to prevent complications and preserve fertility.

Conclusions:

• A structured approach to amenorrhea diagnosis is essential.
• Identifying the underlying cause guides effective management and prevents long-term health issues.
• Treatment focuses on hormonal balance, reproductive health, and preventing osteoporosis and cardiovascular disease.