Defined as when a girl have never started menstruation and sexual characteristics have not developed by the age of 14 years OR no menstruation by age 16 years when growth and sexual development is normal.
1. Outflow Abnormalities: Mullerian agenesis, transverse vaginal septum, androgen insensitivity, imperforate hymen.
2. Ovarian Disorders: Gonadal dysgenesis due to chromosomal abnormalities e.g Turner’s syndrome
3. Pitutary Disorders: Prolactinoma
4. Hypothalamic disorders: Kallman’s syndrome.
Defined as absence of menses for more than 6 months in a previously menstruating woman.
1. Always consider the possibility of pregnancy.
3. Starvation , anorexia or excessive exercise.
4. Hypo/ Hyperthyroidism
6. Polycystic ovarian syndrome
7. Premature menopause.
History And Physical Examination.
Rule out the possibility of pregnancy.