Key points for diagnosis
(1) Non-occurrence of menarche after the age of 16 or non-physiological stoppage of menstruation for 3 cycles.
(2) Careful examination is made of the general development, nutrition, mental state and development of the secondary sex characteristic in order to analyze the cause and nature of amenorrhea.
(3) Examination is made to see whether the external and internal genitals are normal and whether there is mass in the pelvis.
(4) Iodized oil roentgenograph is done to see whether there are abnormal development of the uterus, metrosynizesis and tuberculosis of endometrium.
(5) Diagnostic uterine curettage and pathological examination of endometrium are done to examine the functional states of the ovary and to see whether there are tuberculosis of endometrium and severe damage of endometrium.
(6) Sella turcica X-ray examination and CT scan are helpful for excluding pituitary tumor.
(7) Uteroscopy and peritoneoscopy are helpful for detecting organic pathological change of the uterus and pelvis.
(8) Chromosome nuclear analysis can be made in diagnosing primary amenorrhea.
(9) Test of hormones in the blood: FSH has obviously increased and estrin has decreased, suggesting hypofunction of the ovary; low FSH and LH values suggest hypofunction of the pituitary or hypothalamus; increase of LH, FSH and T values indicates amenorrhea due to polycystic ovary syndrome; increase of PRL value indicates amenorrhea due to hyperprolactin hematopathy.
(10) Cares should be taken to differentiate amenorrhea mentioned above from physiological amenorrhea due to pregnancy, breastfeeding and menopause.