Amenorrhea: A Systematic Approach to Diagnosis and Management

David A. Klein, MD, MPH; Scott L. Paradise, MD; Rachel M. Reeder, MD


Am Fam Physician. 2019;100(1):39-48. 

In This Article

Chronic Disease, Physiologic, and Induced Causes

Patients with chronic disease may experience amenorrhea; however, these conditions are often recognized by individual signs and symptoms. Menopause should be considered in patients older than 40 years.[15,16,54] Pregnancy, lactation, hormonal contraceptives, and exogenous androgens (e.g., transgender care) may also cause amenorrhea.[2,3,6]