For women who are experiencing amenorrhea, it is recommended to be evaluated by gynecologist for proper diagnosis. The doctor will perform a pelvic examination to evaluate for abnormalities related to reproductive organs. If the patient never had a period, the doctor would evaluate their genitalia and breasts to see if they are going through the typical puberty changes.
Amenorrhea may indicate a wide range of hormonal issues. It may take some time and involve doing several different types of tests to determine the main reason.
Several tests may be required to aid in the diagnosis, these are:
- Pregnancy test. The doctor will likely recommend preliminary with this test to eliminate or confirm a potential pregnancy. If it turns out to be negative, the doctor will proceed with examining the patient and looking through the medical history.
- Thyroid function test. This test will evaluate to see if the thyroid is functioning properly by counting the quantity of thyroid-stimulating hormone (TSH) in the blood.
- Ovary function test. Follicle-stimulating hormone (FSH) levels in the blood can be used to assess the health of the ovaries.
- Prolactin test. Prolactin is a hormone released by the pituitary gland. This test measures the prolactin levels in the blood. Low level can be an indicator of pituitary gland malignancy (tumor).
- Androgen test. The level of male hormones or androgen are normally higher on men. High levels of this on women may indicate a health issue. The doctor might want to evaluate the blood testosterone levels if the patient has lowered voice and increased facial hair.
Hormone challenge test
The doctor can determine from this test whether the absence of estrogen is the cause amenorrhea. The patient must take a hormonal drug for seven to ten days prior to the test whether a hormone induce menstrual bleeding.
The doctor may suggest imaging tests, such as the following, depending on the exhibited signs and symptoms and the results of the patient’s blood tests:
- Ultrasound. Allows the doctor to view the internal organs through images from sound waves and to see whether all the organs are of normal shape. It will help determine any irregularities that may have caused the amenorrhea.
- Magnetic resonance imaging (MRI). Used to analyze the cause in the pituitary gland. Radio waves with strong magnetic field are used in MRI to provide incredibly comprehensive images of any tumor or to check the reproductive organs.
The doctor could advise a hysteroscopy, a procedure that involves passing a tiny camera into the patient’s vagina and cervix to view the interior of the uterus. This procedure is done if other testing method fails to determine the cause of the amenorrhea.
The cause of the condition will determine the course of treatment. Medical treatment are provided for amenorrhea originating from thyroid or pituitary abnormalities. Surgical treatment may be recommended if a tumor or structural blockage is the root of the issue. For hormone-related issues, birth control tablets or other hormone treatments are usually recommended to regain normal menstrual cycle.