16. Amenorrhea
r- Check TSH, Prl, hCG,
estrogen status
IHypogonadal
I
I
I Checlc FSH, LH
f I
t
t
Chronic
anovulation
Outflow tract
obstruction
IHmrgonadotropic I IHypogonadotropic
I
โข MU
-IIenananomolies
โขPCO I
Check karyotype
I
IAbnormal
Check MAl
I
I
INormal IIGenetic IIAbnormal I
I
โข Androgen insensitivity
โข Gonadal dysgenesis
agenes
i
s
โข
Stress
โข
Ma
lnutrition
โข
t exerc
i
se
โข
Kallman's
โข CNS lesions
syndrome
โข
Physiologic delay
Clinical evaluation of amenorrhea. CNS, central nervous system; FSH, follicle-stimulating hormone;
hCG, human chorionic gonadotropin; LH, luteinizing hormone; MRI, magnetic resonance imaging;
PCO, polycystic ovary syndrome; POF, premature ovary failure: TSH, thyroid-stimulating hormone_
Eugonadal