Causes and management of amenorrhoea

This course is part of the RCOG Core Knowledge series.

The occurrence of regular monthly periods in women of reproductive age is the most obvious manifestation of cyclical ovarian activity and it is only over the last century, as family size has declined, that women have experienced monthly periods for a substantial part of their lives.

Amenorrhoea is a physiological process that can occur in childhood, during pregnancy, during lactation and after the menopause.

All the physiological causes of amenorrhoea have pathological equivalents and, indeed, amenorrhoea may be the presenting symptom of underlying disease.

Primary amenorrhoea refers to a failure of menstruation by the age of 15 years in the presence of normal secondary sexual characteristics, or 13 years in the absence of other evidence of puberty. Secondary amenorrhoea is defined as absent periods for at least 6 months in a woman who has previously had regular periods, or 12 months if she has previously had oligomenorrhoea (bleeds less frequently than 6-weekly).

This course gives an analysis on the approach to diagnosis of the different types of amenorrhoea.

Course overview Authors Audience Capabilities in Practice (CiPs) Related guidelines

Welcome to this Core Knowledge course on Causes and management of amenorrhoea.

When you have completed this course, you will be able to:

use a systematic approach to investigate and diagnose a complaint of amenorrhoea
manage common problems relating to amenorrhoea
select appropriate patients for referral to tertiary care or allied specialties
recognise that adolescent gynaecology patients benefit from specifically tailored care.

Dr Sheethal Madari (2016, 2022)

Consultant Gynaecologist, Aberdeen Royal Infirmary

Dr Prachi Risbud (2022)

Clinical Fellow, Aberdeen Royal Infirmary

This course is intended to help clinicians gain core knowledge for O&G training and the MRCOG examinations. It can also be used by O&G consultants to refresh their knowledge of the area or for teaching.

The content of this course relates to the following Capabilities in Practice (CiPs) and key skills:

CiP 1: Clinical skills and patient care
All

CiP 6: Developing self & others
Commits to continued learning

CiP 11: Non-emergency gynaecology and early pregnancy
Manages subfertility

Further details about each CiP can be found within the O&G Core Curriculum 2024 Definitive Document, available here.

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