What is the recommended evaluation for amenorrhea?

The recommended evaluation for amenorrhea involves obtaining a pregnancy test, serum prolactin level, and TSH test. This approach is grounded in clinical practice guidelines and the need to assess the most common and significant causes of amenorrhea early on.

Initially, a pregnancy test is crucial since pregnancy is often the most common reason for amenorrhea in women of reproductive age. If the test is positive, further management will be focused on pregnancy-related care. If negative, next steps involve evaluating hormonal levels, specifically serum prolactin, because elevated prolactin levels can indicate conditions such as prolactinoma or hypothyroidism, both of which can disrupt the menstrual cycle.

Additionally, testing thyroid-stimulating hormone (TSH) is essential, as abnormalities in thyroid function can lead to amenorrhea. Thyroid disorders can either contribute to or be the result of other underlying issues related to menstrual irregularities.

In contrast, while pelvic ultrasound can be useful in certain scenarios to visualize anatomical abnormalities in the reproductive organs, it is not the first line of evaluation for amenorrhea itself. A complete blood count is more relevant for assessing general health and detecting anemia but does not directly correlate with the evaluation of menstrual function. Assessing dietary habits and exercise