1)      Exclude pregnancy

2)      Polycystic Ovary Syndrome – PCOS – amenorrhea, hirsutism, acne, alopecia, acanthosis nigricans, moderate elevations of prolactin levels up to 2500 miu/L, Ix – elevated LH levels without FSH elevations,

3)      Premature ovarian failure – Ix = FSH levels greater than 15 iu/L not associated with preovulatory surge seen in impending ovarian failure, levels greater than 40 iu/L irreversible ovarian failure,

4)      Weight-related amenorrhea – underweight for the height

5)      Exercise-related amenorrhea

6)      Spurious secondary amenorrhea – primary amenorrhea treated with hormones and having withdrawal bleeding presenting with secondary amenorrhea

7)      Female Athlete Triad -  FAT consists of amenorrhea, osteoporosis, and disordered eating, other symptoms experienced are fatigue, anemia, depression, cold intolerance, lanugo, eroded tooth enamel, use of laxatives, 

8)      Menopause – see under MMSSC medically unexplained symptoms