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Tests and diagnosis
By Mayo Clinic staffAlthough amenorrhea rarely results from a life-threatening condition, it can encompass a complex set of hormonal problems. Finding the underlying cause can take time and may require more than one kind of testing, including:
- Pregnancy test. This will probably be the first test your doctor does, to rule out or confirm a possible pregnancy.
- Pelvic exam. Your doctor may also perform a pelvic exam to check for any problems with your reproductive organs.
- Physical exam. Your doctor will perform a physical examination and ask about your medical history. In young women, this exam includes checking for signs and symptoms of changes that are normal to puberty.
- Blood tests. Blood tests, such as a thyroid function test or evaluation of your prolactin level, can pinpoint inconsistencies in hormone levels that might be responsible for amenorrhea. In women with increased hair growth, male hormone levels may be checked.
- Progestin challenge test. For this test, you take a hormonal medication (progestogen) for seven to 10 days to trigger menstrual bleeding. Results from this test can tell your doctor whether your periods have stopped due to a lack of estrogen.
- Imaging tests. Depending on your signs and symptoms — and the result of any blood tests you've had — your doctor might recommend an imaging test. Imaging tests, including computerized tomography, magnetic resonance imaging or ultrasound, can reveal pituitary tumors or structural abnormalities in your reproductive organs.
- Laparoscopy or hysteroscopy. As a last resort, when other testing reveals no specific cause, your doctor may recommend a minimally invasive surgery to view your internal organs. Sometimes, any problems detected can be treated at the same time.
References
- Welt CK, et al. Etiology, diagnosis, and treatment of secondary amenorrhea. http://www.uptodate.com/home/index.html. Accessed March 24, 2009.
- Lobo RA. Primary and secondary amenorrhea and precocious puberty: Etiology, diagnostic evaluation, management. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/128045551-2/0/1524/252.html?tocnode=53759937&fromURL=252.html#4-u1.0-B978-0-323-02951-3..50041-8_1217. Accessed March 24, 2009.
- Cohen DP. Amenorrhea. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:648.
- Welt CK, et al. Etiology, diagnosis, and treatment of primary amenorrhea. http://www.uptodate.com/home/index.html. Accessed March 24, 2009.
- Master-Hunter T, et al. Amenorrhea: Evaluation and treatment. American Family Physician. 2006;73:1374.
- Goldberg AB, et al. Injectable contraceptives. In: Hatcher RA, et al. Contraceptive Technology. 19th ed. New York, N.Y.: Ardent Media; 2007:157.
- Kennedy KI, et al. Postpartum contraception and lactation. In: Hatcher RA, et al. Contraceptive Technology. 19th ed. New York, N.Y.: Ardent Media; 2007:403.
