AMENORRHEA: Secondary

AMENORRHEA: Secondary Amenorrhea Secondary Absence of menses for more than 3 cycles or 6 months in women who were previously menstruating Primary No onset of menarche by age 16 Ovarian Hypothalamic Negative progesterone challenge, Low FSH, Low estrogen Pituitary Outflow Tract Obstruction Asherman's syndrome Cervical stenosis Functional (e.g. eating disorder, weight loss, stress, excessive exercise, illness) Infiltrative lesions (e.g. lymphoma, Langerhans cell histiocytosis, sarcoidosis) Rule out pregnancy (?-hCG) Normal FSH High FSHHigh ProlactinOther Polycystic ovarian syndrome (positive progesterone challenge, normal prolactin, chaotic menstruation history) Menopause Premature ovarian failure