Differential for secondary amenorrhea = Pregnancy, Menopause, PCOS, hypothyroidism, prolactinoma, primary ovarian insufficiency, Asherman syndrome, functional hypothalamic amenorrhea, etc.
First step in setting of secondary amenorrhea (amenorrhea for >3 months in woman with previously regular menses or >6 months in woman with previously irregular menses) is to obtain a pregnancy test
Presence of withdrawal bleed after progesterone administration confirms that the uterus is undergoing a normal proliferative phase and therefore eliminates estrogen deficiency (primary ovarian failure, menopause, hyperprolactinemia, hypothyroidism, functional hypothalamic amenorrhea), endometrial abnormalities (Ashermanโs) and Outlet tract abnormalities (imperforate hymen) as the cause of secondary amenorrhea
Therefore, secondary amenorrhea with progesterone withdrawal bleed indicates that the cause is anovulation, which is most commonly caused by PCOS
submitted by โstep_prep7(71)
- Differential for secondary amenorrhea = Pregnancy, Menopause, PCOS, hypothyroidism, prolactinoma, primary ovarian insufficiency, Asherman syndrome, functional hypothalamic amenorrhea, etc.
- First step in setting of secondary amenorrhea (amenorrhea for >3 months in woman with previously regular menses or >6 months in woman with previously irregular menses) is to obtain a pregnancy test
- Presence of withdrawal bleed after progesterone administration confirms that the uterus is undergoing a normal proliferative phase and therefore eliminates estrogen deficiency (primary ovarian failure, menopause, hyperprolactinemia, hypothyroidism, functional hypothalamic amenorrhea), endometrial abnormalities (Ashermanโs) and Outlet tract abnormalities (imperforate hymen) as the cause of secondary amenorrhea
- Therefore, secondary amenorrhea with progesterone withdrawal bleed indicates that the cause is anovulation, which is most commonly caused by PCOS
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