This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in


Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Congenital causes of amenorrhoea can be ignored in patients with secondary amenorrhoea but a patient with primary amenorrhoea may have any of the conditions associated with primary or secondary amenorrhoea. Pregnancy must always be excluded.

Basic investigations are:

  • history and physical examination
  • hormone measurements - PRL, FSH, LH, thyroid function, testosterone
  • pelvic ultrasound scan - indicates size of ovaries, presence of follicles and their size, may reveal polycystic ovaries, presence of uterus in cases of vaginal atresia

Other investigations are conducted as indicated:

  • chromosomal studies - if primary amenorrhoea without any obvious basis or if abnormal phenotype
  • progesterone challenge
  • radiologic studies - intravenous urogram if uterine or vaginal malformation to exclude associated renal abnormalities
  • CT or MRI - to visualise pituitary fossa for tumours
  • abdominal or pelvic CT/MRI - haematocolpos, haematometra, or other developmental anomalies (1)
  • laparoscopy and gonadal biopsy - indicated only if the nature of the gonads or the presence of primary oocytes is in dispute
  • hysteroscopy
  • consider serological testing for coeliac disease (2)


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.