Your doctor should take a detailed history from you and examine you. This should include a breast examination and a check for other signs of normal sexual development e.g. axillary and pubic hair growth, especially in women who are younger and never had a menses.
The examination may include a check of your visual fields by the doctor. It is usual to examine both the external genitalia and a vaginal examination both with a speculum and a bimanual examination.
Your height and weight should be taken and your body mass index calculated.
A pregnancy test should be offered as this is the commonest cause of secondary amenorrhoea. A range of hormone tests may be ordered depending on the symptoms and signs: • Follicle Stimulating Hormone (FSH) • Luteinising Hormone (LH) • Oestradiol • Prolactin • Testosterone • Sex hormone binding globulin • Thyroid function It is usual to have an ultrasound of the pelvis to assess the uterus and ovaries. In women who have been sexually active or have used tampons during menses, this can be carried out using a small vaginal probe, which should not be painful. Other investigations which rarely may be required are: • CT or MRI to exclude rare tumours of the hypothalamus, pituitary, or adrenal glands. • Blood tests for chromosomes. • A hysteroscopy, an investigation when a small camera is passed into the uterus through the vagina and cervix.
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