Secondary amenorrhea

• Facts:
  Absence of menses for three months in a woman with previously normal menstruation
• Diagnosis:
  1) Pregnancy test
  2) Check prolactin levels
  3) Check TSH, T4/T3 levels
  4) Check estrogen status (progesterone challenge test)
• Notes:
  No history of menstruation ( primary amenorrhea )
• Differential Diagnosis:
  Asherman's syndrome
  Premature ovarian failure
  Hormonal imbalances