Thank you for your query at DoctorSpring.com
May I request you for a few more details ?
Before 16 months, did she always have regular cycles ?
Also, what is her height and weight ?
Has she been having total amenorrhea or is there sporadic spotting in between ?
Can you upload these test results because different labs have different ranges of normal.
Reading typed values provides less information, looking at the actual printed reports is of much more value.
Has any other workup been done so far ?
Mainly, I would be looking at - an internal exam including physical evaluation of secondary sexual characteristics such as axillary hair, pubic hair, breast tissue, mons bud etc, a pelvic ultrasound scan detailing the endometrial thickness ( status of the lining of the uterus ), tests for tuberculosis ( would you mind telling me where you reside also ? ), chromosomal evaluation, estimation of TSH ( thyroid hormones ) and adrenal hormones ?
All the best
Looking forward to hearing from you.
Patient replied :
her height - 153cm weight - 40kg about
no total amenorrhoea sporadic spotting 3 times between 18 months
before 16 months she have regular cycle
axillary hair and pubic hair present normal
breast tender present on nipple no secretion fluid
The lab reports are not abnormal enough to explain the secondary amenorrhea.
HAs she been under undue stress, lost an abnormal amount of weight, changed places , jobs, sleep and diet patterns ?
I would ask you to get the following done -
1. Complete internal exam - per vaginum and per speculum by a qualified gynaecologist.
2. Pelvic ultrasound scan done transvaginally, to assess endometrial thickness.
3. Biopsy of the endometrium ( lining of the uterus ) to rule out any damage or infection.
4. TSH, DHEAS, Free testosterone levels ( thyroid and adrenal hormones )
Once these three are done, the exact reason can be assessed.
Secondary amenorrhoea can occur due to endometrial damage, adhesions , infections etc.
All the best
Please revert once the workup is done.