Secondary Amenorrhea: Causes, Diagnosis, and Treatment

In 2017, Katherine Pereira and Ann J. Brown reviewed secondary amenorrhea, the cessation of menstruation for at least three months in women with previously normal cycles. They identified various causes, including pregnancy, lactation, functional hypothalamic amenorrhea (FHA), pituitary disorders, ovarian issues like primary ovarian insufficiency (POI) and polycystic ovary syndrome (PCOS), uterine conditions, and other endocrine disorders. FHA, often stress-related, accounts for 35% of cases, while PCOS affects 7% to 10% of young women. The article stressed the importance of detailed patient history and physical exams in diagnosis, including lab tests for pregnancy, thyroid, and pituitary function, and androgen levels. Treatment focuses on restoring menstrual cycles and addressing associated health issues, with nurse practitioners playing a key role in managing care and coordinating with specialists.