Secondary amenorrhea

Alternative names:

amenorrhea - secondary

Symptoms:

• previously had one or more menstrual periods
• no menstrual period for 6 months or longer

Note: Other symptoms associated with amenorrhea depend on the cause. They may include headache, galactorrhea (breasts produce milk in woman who is not pregnant or breast feeding an infant), visual loss, marked weight gain or weight loss, dry vagina, increased hair growth in a "male" pattern (hirsutism), voice changes, and breast size changes.

Signs and tests:

The physical examination will probably include a pelvic examination. Physical and pelvic examinations must rule out pregnancy before other diagnostic testing begins. The patient may be encouraged to discuss her fears and, if indicated, may be referred for psychological counseling.

Diagnostic tests that may be performed include:

• endometrial biopsy
• progestin withdrawal
• prolactin level
• serum hormone levels such as testosterone levels
• thyroid function studies
• pregnancy test (serum HCG)
• FSH (follicle stimulating hormone level)
• LH (luteinizing hormone level)
• TSH (thyroid stimulating hormone; other thyroid function tests)
• karyotype to rule out the presence of Y chromosome abnormality
• CT scan of the head may be done if a pituitary tumor is suspected