[Not to be missed signs of primary amenorrhea]

Primary amenorrhea is defined as the absence of the menarche by the age of 16. Knowledge of the new arrangement of all causes into four pathofysiologic compartments by the NVOG and NVK guideline contributed the diagnostic process. This article present the alarm symptoms of primary amenorrhea in the anamnesis, physical examination and supplementary tests including the interpretation of stages of puberty in relation with length and vaginal examination. In this article, we propose the optimal diagnostic traject for general practitioner, pediatrician and gynaecologist. We describe four cases, one of each compartment, to illustrate the importance of this process.