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Feature Article

Amenorrhoea. A focus on the four most common causes

SALLY-ANNE DUKE, KIRSTEN NEAL

Figures

© valagrenier/istockphoto.com model used for illustrative purposes only
© valagrenier/istockphoto.com model used for illustrative purposes only

Abstract

Most cases of amenorrhoea can be evaluated by taking a careful history, performing a physical examination and measuring hormone levels. Initial investigations for primary and secondary amenorrhoea are similar, although primary amenorrhoea should prompt an earlier pelvic ultrasound and karyotyping.

 

Key Points

  • Polycystic ovary syndrome, functional hypothalamic amenorrhoea, hyperprolactinaemia and primary ovarian insufficiency are the most common causes of amenorrhoea.
  • Initial investigations should include measurement of beta-human chorionic gonadotropin, thyroid stimulating hormone, follicle stimulating hormone and prolactin levels, and androgen levels if suggestive from the history.
  • Pregnancy should always be ruled out in women presenting with amenorrhoea.
  • Women should be asked about their menses at routine clinic appointments.

Figures

© valagrenier/istockphoto.com model used for illustrative purposes only
© valagrenier/istockphoto.com model used for illustrative purposes only