Amenorrhea Diagnostic Pathway

Primary vs secondary amenorrhea workup — congenital anatomy versus acquired stress, weight, and endocrine causes.

Current Stage

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Congenital likelihood

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Acquired likelihood

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Endocrine priority

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Next test

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Amenorrhea TypePrimary

Cause Severity / Complexity0

Primary amenorrhea branch

Secondary amenorrhea branch

Workup checklist node (active)

Workup checklist node (pending)

Diagnostic conclusion

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Primary vs Secondary — the First Branch in the Amenorrhea Algorithm

Placeholder: classification splits workup into congenital versus acquired pathways.

Age 15: Primary defined by (Placeholder threshold note)
3+ months: Secondary defined by (Placeholder cycle gap)
~0.1%: Prevalence primary (Placeholder stat)
~3-4%: Prevalence secondary (Placeholder stat)

Initial classification step

Placeholder text describing the first branch decision.

Congenital Anatomy and Genetic Screening for Primary Amenorrhea

Placeholder: pelvic imaging and karyotype rule out anatomic and genetic causes.

Step 1: Pelvic ultrasound (Placeholder note)
If needed: Karyotype (Placeholder note)
~15%: Mullerian anomaly (Placeholder stat)
~5%: Turner syndrome (Placeholder stat)

Congenital checklist items

Placeholder text on imaging and karyotype workup order.

Hypothalamic Suppression — Stress, Weight, and Exercise in Secondary Amenorrhea

Placeholder: functional hypothalamic amenorrhea from energy deficit or stress.

<18.5: Low BMI cutoff (Placeholder note)
~35%: FHA share of cases (Placeholder stat)
Common: Exercise-linked (Placeholder note)
Often yes: Reversible (Placeholder note)

Lifestyle and stress checklist

Placeholder text on weight, exercise, and stress history intake.

Hormone Panel Screening Across Both Diagnostic Branches

Placeholder: TSH, prolactin, FSH, and androgens screen for endocrine causes.

Thyroid: TSH (Placeholder note)
Pituitary: Prolactin (Placeholder note)
Ovarian: FSH/LH (Placeholder note)
~30%: PCOS share (Placeholder stat)

Endocrine panel checklist

Placeholder text describing hormone panel interpretation.

Converging on a Diagnostic Conclusion and Next Steps

Placeholder: findings combine into a final recommended pathway.

Refer genetics: Congenital path (Placeholder note)
Lifestyle/endocrine tx: Acquired path (Placeholder note)
MRI/US: Imaging confirm (Placeholder note)
3-6 months: Follow-up (Placeholder note)

Final pathway summary

Placeholder text on concluding the diagnostic algorithm.

Placeholder key insight sentence for stage five conclusion.