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Evaluation of amenorrhea
1Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Comprehensive Therapy
|October 1, 1995
Summary
Evaluating amenorrhea, both primary and secondary, involves excluding pregnancy. Primary amenorrhea requires endocrinologist consultation, while secondary amenorrhea evaluation focuses on central nervous system and gynecological causes like chronic anovulation.
Area of Science:
- Reproductive Endocrinology
- Gynecology
- Clinical Medicine
Background:
- Amenorrhea, the absence of menstruation, presents as either primary or secondary.
- Both types share initial diagnostic considerations, notably excluding pregnancy.
- Secondary amenorrhea is a frequent clinical concern requiring a structured diagnostic approach.
Purpose of the Study:
- To outline an evaluation strategy for primary and secondary amenorrhea.
- To guide physicians in diagnosing the causes of amenorrhea.
- To highlight key differential diagnoses including central nervous system pathology and chronic anovulation.
Main Methods:
- Review of diagnostic considerations for primary and secondary amenorrhea.
- Proposal of a diagnostic algorithm for secondary amenorrhea.
- Brief discussion of Polycystic Ovary Syndrome (PCOS) and hyperprolactinemia.
Main Results:
- Exclusion of pregnancy is a critical first step for both types of amenorrhea.
- Primary amenorrhea necessitates referral to an endocrinologist.
- Secondary amenorrhea evaluation targets central nervous system disorders and chronic anovulation.
Conclusions:
- A systematic approach is essential for evaluating amenorrhea.
- Identifying significant pathology in the central nervous system and addressing chronic anovulation are key.
- Further information on specific conditions like PCOS and hyperprolactinemia is available through referenced authors.