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What are the causes of amenorrhea in a 18-year-old?

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Patient's Query

Hi,

I am around 18 years old and have not had a period for nearly two years. There is no specific reason for this, and I am questioning whether I need to consult a doctor. I have had no other symptoms other than frequently feeling tired.

Kindly help.

Answered by Dr. Uzma Arqam

Education:

MBBS

Professional Bio:

Dr. Uzma Arqam is a dedicated Obstetrician and Gynecologist with expertise in prenatal care, high-risk pregnancy management, infertility treatment, menstrual disorders, and minimally invasive gynecological procedures. She provides comprehensive women’s healthcare with a focus on safety, compassion, and personalized treatment. Dr. Arqam is committed to supporting women’s health at every stage of life through evidence-based practices and patient-centered care.

This doctor is not available for online consultations on the platform anymore.

Hi,

Welcome to icliniq.com.

Before two years, if you had periods, it is secondary amenorrhea, but if you have not, it is primary amenorrhea. In both cases, you need urgent investigations. Strictly observe for other abnormal symptoms. Discuss with the laboratory and with the gynecologist like changes in voice, abnormal hair growth, and changes in external genitals. Take healthy precautions along with full investigations. If you have been treated for any disease, try to have the full treatment. Let us see your body's response to periods induction as you need to investigate going for blood tests on day two of menstruation. Discuss with the general practitioner before taking the medication. Take Norethindrone 10 mg twice daily for seven days, then wait for withdrawal bleed for a week after the completion of seven days. On the second day of the period, have blood tests (serum testosterone, serum insulin, prolactin, luteinizing hormone, follicular stimulating hormone, serum progesterone, and thyroid function test). A detailed pelvic scan is needed to exclude any pelvic pathology. One local examination by a gynecologist to see any local pathology like an imperforate hymen. After all laboratory results and scans, discuss them with the gynecologist in detail. You need to consult an endocrinologist as well with all your laboratory reports.

Thank you.

The Probable causes

Hormonal imbalance.

Investigations to be done

Serum Progesterone. Serum luteinizing hormone, follicle-stimulating hormone. Serum prolactin. Serum insulin. Thyroid function test. Detailed pelvic scan.

Differential diagnosis

PCOD (polycystic ovarian syndrome) in case of secondary amenohrea

In the case of primary, lots of causes like congenital adrenal hyperplasia,

androgen insensitivity might need a karyotype in the case of primary amenorrhea.

Treatment plan

After completion, based on the investigation reports.

Regarding follow up

Need endocrinologist to follow up with all laboratory reports. Needs a gynecologist follow-up. I want to see her again after 14 days with laboratory reports.
Answered by Dr. Uzma Arqam
Medically reviewed by iCliniq medical review team
Published At December 23, 2022
Reviewed At June 13, 2023

Education:

MBBS

Professional Bio:

Dr. Uzma Arqam is a dedicated Obstetrician and Gynecologist with expertise in prenatal care, high-risk pregnancy management, infertility treatment, menstrual disorders, and minimally invasive gynecological procedures. She provides comprehensive women’s healthcare with a focus on safety, compassion, and personalized treatment. Dr. Arqam is committed to supporting women’s health at every stage of life through evidence-based practices and patient-centered care.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Uzma Arqam is a dedicated Obstetrician and Gynecologist with expertise in prenatal care, high-risk pregnancy management, infertility treatment, menstrual disorders, and minimally invasive gynecological procedures. She provides comprehensive women’s healthcare with a focus on safety, compassion, and personalized treatment. Dr. Arqam is committed to supporting women’s health at every stage of life through evidence-based practices and patient-centered care.

This doctor is not available for online consultations on the platform anymore.

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