Infertility pp 303-327 | Cite as

Primary Amenorrhea

  • James Aiman
Part of the Clinical Perspectives in Obstetrics and Gynecology book series (CPOG)


Menarche occurs at a mean age of 12.8 to 13.5 years (1,2) and 95% of normal women have begun to menstruate by the age of 15.5 to 16 years. After 16 years of age, women who have never menstruated may be normal but are more likely to have a genetic, developmental, or endocrinologic abnormality that warrants a careful evaluation. A comprehensive evaluation is not necessary for most women under the age of 16 years, but is for women over 16 years, especially if there is a family history of primary amenorrhea, ambiguous genitalia, or evidence of an endocrinopathy that may affect menstrual function. An abbreviated evaluation without extensive hormonal studies or karyotype is often sufficient to relieve the adolescent’s or her parents’ concern that something other than delayed puberty is the cause of primary amenorrhea. Thus, there are 3 indications to evaluate a woman who has never menstruated—age over 16 years, a positive family history of amenorrhea or genital abnormality, and patient or parental concern.


Luteinizing Hormone Anorexia Nervosa Congenital Adrenal Hyperplasia Gonadal Dysgenesis Androgen Excess 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag New York, Inc. 1984

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  • James Aiman

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