primary amenorrhea:

when to evaluate?

lack of menstruation by 15 year of age if secondary sexual characteristics are present and by age 13 if those are absent.

EVALUATION OF PRIMARY AMENORRHOEA

initial tests: beta hcg, TSH, Prolactin, pelvic Usg









I like to mention here one of the cases I had seen in my clinical practice. A mother of a 15-year-old girl brought her daughter for evaluation of primary amenorrhea. on examination, she had developed breasts but no axillary and pubic hair. I sent for usg pelvis which revealed no uterus. Then I sent serum testosterone and FSH. The report revealed normal male levels of serum testosterone and normal FSH. her possibility was androgen insensitivity syndrome because she had an absence of axillary and pubic hair. In addition, she had normal male serum testosterone levels. Due to these reasons, mullerian agenesis was unlikely because in mullerian anomaly, there is a normal female serum testosterone level and there should have been the presence of axillary and pubic hair.







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