USG pelvis..give progesterone withdrawal, if negative oestrogen plus progesterone withdrawal, then history of Koch's, endometrial sample for TB PCR if sexually active...then D2 or 3 FSH, LH, PRL, AMH, and TSH
Hi...detailed history is important about her previous menstrual cycle whether flow was normal or scanty. any h/ o sudden weight gain or weight loss, loss of appetite, stressful factors, h/o suggestive of hypothyroidism , then if she is needs a local examination of genitilia...to rule out local abnormality( this is to complete our examination as we should not miss anything)
investigations- usg , hormonal profile.d2 or d3 FSH,LH,TSH,PRL.AMH.
pt have previously scanty MC before 1 yr. but after that stop .
she have no history of wt gain or lose.and history of thyroid treatment but she is in stress and have complain of loss of appetite ,lower abdomen discomfort some time pain also.
local examination not done at all....
Hi....go for investigations and then we can review ..as you said no mensus , first get an ultrasound done. we will see the endometrial thickness . according ly we can plan whether to give E+ P if endometrium thin or only progesterone if endometrium is thick...then go for hormonal profile..you can TSH, PRL...no need to mensus to come for this test.
This is a simple case of imbalance of hormones, bcz of low Hb/ blood levels.
So start with-
-Ferrum met 3x- 5 tabs-5-5-5 for 4 months
-Amenorrhea capsules are available in market, use 3 daily for 3-4 days
problem will be over
Further u can consult me if needed