Step-by-Step: How to Evaluate Primary Amenorrhea
Step-by-Step: How to Evaluate Primary Amenorrhea
The Evaluation Process
Evaluating primary amenorrhea can be complex. Follow this step-by-step guide to understand the essential diagnostic procedures.
Contents
- Initial Assessment
- Hormonal Testing
- Imaging and Genetic Testing
Initial Assessment
The first step is a thorough medical history and physical examination. Look for signs of pubertal development and any abnormalities in internal reproductive structures. These observations guide further diagnostic testing.
Hormonal Testing
Hormonal tests, like measuring follicle-stimulating hormone (FSH), help determine if the cause is central or ovarian. Elevated FSH might suggest ovarian insufficiency, while low levels could indicate central causes.
Imaging and Genetic Testing
If initial tests are inconclusive, imaging studies like ultrasound or MRI can visualize internal structures. Genetic testing may be necessary for conditions like Turner syndrome or gonadal dysgenesis.
FAQs
What's the first step in evaluation?
Conduct a detailed medical history and physical exam.
Why are hormonal tests important?
They help identify if the cause is central or ovarian.
When is imaging needed?
Imaging is used when initial tests are inconclusive.
The Bottom Line
A systematic approach to evaluation ensures accurate diagnosis of primary amenorrhea.
Additional References
- Zhong Q, Layman LC. Fertil Steril 2012; 98:775.
- Quaynor SD, Stradtman EW Jr, Kim HG, et al. N Engl J Med 2013; 369:164.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.