Secondary amenorrhea

Alternative Names

Symptoms

• Previously had one or more menstrual periods
• No menstrual period for 6 months or longer

Other symptoms associated with secondary amenorrhea depend on the cause. They may include headache, galactorrhea, considerable weight gain or weight loss, dry vagina, increased hair growth in a "male" pattern (hirsutism), voice changes, and breast size changes. If amenorrhea is caused by a pituitary tumor, other symptoms related to the tumor such as visual loss, may be present.

Exams and Tests

The doctor will probably do a pelvic examination. Physical and pelvic examinations must rule out pregnancy before other diagnostic testing begins. The patient may be referred for psychological counseling if anxiety is causing the condition.

Diagnostic tests that may be performed include:

• Endometrial biopsy
• Progestin withdrawal
• Prolactin level
• Serum hormone levels such as testosterone levels
• Pregnancy test (serum HCG)
• Follicle stimulating hormone (FSH level)
• Luteinizing hormone (LH level)
• Thyroid stimulating hormone (TSH)
• Karyotype to rule out the presence of Y chromosome abnormality
• CT scan of the head may be done if a pituitary tumor is suspected

References

Stenchever MA, Droegemueller W, Herbst AR. Comprehensive Gynecology. 4th ed. St. Louis, Mo: Mosby; 2001:1109-1119.

Rakel P, ed. Conn’s Current Therapy 2005. 57th ed. Philadelphia, Pa: WB Saunders; 2005:1291-1293.