Medical Problems: Secondary Amenorrhea


This page is designed to organize content that is relevant to the topic of secondary amenorrhea. This term is used often in medicine, and it is important that we become as familiar as possible with it.


Before going any farther, let us make sure we clearly define secondary amenorrhea. Secondary amenorrhea refers to state in which a woman (who has previously menstruated before) stops menstruating for 3 consecutive cycles, or a time period more than six months.


The differential diagnosis for secondary amenorrhea can be organized in a few different ways:

  • Can’t miss diagnosis
  • Organ systen
  • Disease category
  • Diagnostic modality
  • Most common diagnosis

Now that the possible causes of secondary amenorrhea have been established, the focus can shift to how one would actually “work-up” a patient who presents with secondary amenorrhea

Pregnancy test: pregnancy is the most common causes of secondary amenorrhea and must always be ruled out.

Serum hormone levels: there are a few hormones that can be contributory to secondary amenorrhea. These are routine studies that often are often ordered to workup patients with secondary amenorrhea (as they evaluate for the most common causes of secondary amenorrhea):

  • Prolactin: if this is elevated a brain MRI may be needed to evaluate for the a prolactinoma in the brain.
  • TSH: if elevated the patient may have hypothyroidism which is causing the amenorrhea.
  • FSH: if this si elevated the patient may be experiencing premature ovarian failure.

Hysteroscopy may be done in patients with a prior history of uterine procedures/infection


Page Updated: 10.02.2016