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The most common cause of secondary amenorrhea is pregnancy. Clinical gynecologic endocrinology and infertility.
Treatment of hypothyroidism should restore menses, but this may take several months. Serum dehydroepiandrosterone sulfate normal: Already a member or subscriber?
Androgen exposure during the 1st trimester, possibly indicating Congenital adrenal virilism True hermaphroditism Drug-induced virilization.
Menstrual cyclicity after metformin therapy in polycystic ovary syndrome.
Karyotype analysis should be performed to determine if the patient is genetically female. Obstet Gynecol.
Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency. It is characterized by hyperandrogenism found on clinical or laboratory examination, polycystic ovaries as suggested by ultrasonography, and ovulatory dysfunction.
Symptoms of estrogen deficiency. Prolactin levels should be checked in most patients.
Asherman syndrome intrauterine synechiae. Delayed sexual development: Bone mineral density after resumption of menses in amenorrheic athletes. Rudimentary or absent uterus; pubic hair.
The risk of amenorrhea is lower with subclinical hypothyroidism than with overt disease. Papaioannou S, Tzafettas J. Other laboratory testing should be determined based on the individual patient. Patients should be questioned about contraceptive use, because extended-cycle combined OCs, injectable medroxyprogesterone acetate Depo-Provera , implantable etonogestrel Implanon , and levonorgestrel-releasing intrauterine devices Mirena may cause amenorrhea.