The Essential Tests for Diagnosing Secondary Amenorrhea
Published: Sep 13, 2023
Secondary amenorrhea can be confusing, but understanding the tests involved can shine a light on potential causes.
Contents
The First Step: Rule Out Pregnancy
Before diving into more complex tests, it's crucial to rule out pregnancy as a cause of missed periods. This is typically done with a serum hCG test, which is more sensitive than home urine tests. Once pregnancy is excluded, other potential causes can be explored.
Hormonal Tests Unveiled
Key hormonal tests include measuring FSH, prolactin, and TSH levels. High FSH levels suggest ovarian insufficiency, while elevated prolactin can indicate hyperprolactinemia. These tests help doctors determine if the issue lies within the ovaries, pituitary, or thyroid.

When Imaging Comes Into Play
If hormonal tests suggest pituitary issues, an MRI may be needed to look for abnormalities like a pituitary tumor. This imaging helps ensure there's no structural cause for the amenorrhea, such as a tumor affecting hormone production.
Frequently Asked Questions
It's the first step to rule out pregnancy as a cause of missed periods.
FSH, prolactin, and TSH levels are commonly tested.
An MRI is needed if pituitary issues are suspected.
Wrapping Up
Proper testing is key to uncovering the cause of secondary amenorrhea.
References
- Laufer MR, Floor AE, Parsons KE, et al. Hormone testing in women with adult-onset amenorrhea. Gynecol Obstet Invest 1995; 40:200.
- Goel P, Kahkasha, Narang S, et al. Evaluation of serum prolactin level in patients of subclinical and overt hypothyroidism. J Clin Diagn Res 2015; 9:BC15.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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