Amenorrhea - Differential Diagnosis Algorithm
Elevated FSH
• Premature Ovarian Failure
• Menopa use
• Spontaneous
Bleed With Progestin Challenge
• Polycystic Ovarian Syndrome
No Bleed With Progestin Challenge
• Hypothyroidism
• Hyperthyroidism
• Diabetes Mellitus
• Exogenous Androgen Use
• Congenital Structural Abnormalities
High Prolactin
• Hyperprolactinemia
Organic Cause
• Congenital GnRH Deficiency
• Infiltrative or Inflammatory Lesion
• Tumors
• Infarction
• Empty Sella Syndrome
• Apoplexy
Failed Progestin Challenge
• Functional
• Hypothalamic
• Amenorrhea
• Weight Loss, Eating Disorders, Exercise, Stress, Prolonged Illness)
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