Where Have the Periods Gone? The Evaluation and Management of Functional Hypothalamic Amenorrhea

Amenorrhea, or the absence of periods, should be evaluated by age 15 or within five years of early breast development, and is most commonly caused by conditions like polycystic ovary syndrome and hypothalamic amenorrhea.

Amenorrhea is when a woman doesn't have periods, with primary amenorrhea starting by age 15 or within five years of breast development, and secondary amenorrhea when periods stop for three months. It affects 3-4% of women not pregnant, breastfeeding, or in menopause, mainly due to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, and ovarian failure.

This article discusses the systematic diagnostic evaluation of secondary amenorrhea and provides guidance for referral considerations; it reports no new research findings.

Amenorrhea is relatively rare and initial testing should check FSH, TSH, and prolactin levels.

This source provides a comprehensive overview of amenorrhea, detailing its classification, potential causes such as hormonal imbalances and structural abnormalities, and the various management strategies including hormone therapy and lifestyle modifications tailored to its underlying causes.