Initial investigation of amenorrhoea

doi:10.1136/bmj.b2184

Published 4 August 2009, doi:10.1136/bmj.b2184
Cite this as: BMJ 2009;339:b2184

Practice

Rational Testing

Initial investigation of amenorrhoea

E H Dickerson, clinical research fellow¹, A S Raghunath, honorary clinical senior lecturer², S L Atkin, professor of academic endocrinology³

¹ Obstetrics and Gynaecology, University of Hull, Hull HU6 7RX, ² Hull York Medical School, ³ Diabetes and Metabolism, Hull York Medical School, Hull HU3 2RW

Correspondence to: S Atkin Stephen.Atkin@hyms.ac.uk

The first 150 words of the full text of this article appear below.

A 25 year old woman presented to her general practitioner, sayingthat she had not had a period for 10 months since discontinuingthe combined oral contraceptive pill. She had no important gynaecologicalhistory and had never been pregnant. She had had a regular 28day menstrual cycle before taking the contraceptive pill fortwo years. Her body mass index was 19.5. Although she was notcurrently planning a family, she was concerned about the impacton her future fertility and whether there was a serious underlyingproblem.

Primary amenorrhoea is the failure to start menses by the ageof 16 (or absence of secondary sexual characteristics by age14); secondary amenorrhoea is the cessation of established,regular menstruation for six months or longer. Many of the causesof primary and secondary amenorrhoea are the same, so initialinvestigation in primary care is similar for both.

The most common causes . . . [Full text of this article]

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