Primary Amenorrhoea

 

Definition: Absent menstrual periods by the age of 16 with normal secondary sexual characteristics.

 

Refer:

Paediatrics - Girls who have no secondary sexual characteristics who have not started menstruating by 13 years of age for ‘Delayed Puberty’.

Paediatric and Adolescent Gynaecology Clinic - Girls with normal secondary sexual characteristics who have not started menstruating by 15 years of age.
 

Information to include:

• Age
• BMI
• Medical history and any Medication
• Abdominal pain (RED FLAG)
• Examination findings:
  • Confirm breast and hair development
  • Abdominal palpation ?mass
  • Appearance of vulva if possible

Investigations:

• FSH/LH, TSH
• Prolactin
• Testosterone, SHBG, DHEAS if no mass and/or hirsute
• Pelvic ultrasound scan (transabdominal)

 

 

References: NICE CKS Ammenorrhoea Revised November 2019

Author: Dr S Burns GP

              Dr M Schick GP

Contributors: Miss S Bates, Consultant Gynaecologist

Version: 1.2

Date:      August 2024                                Review Date: August 2026