Assessment of primary amenorrhoea

Patients with secondary sexual development should be assessed for pregnancy.
Patients with hyperprolactinaemia or those diagnosed with hypogonadotrophic hypogonadism and neurological symptoms should undergo neuroimaging to rule out an intracranial neoplasm.[13]
Patients with symptoms of rapid virilisation should undergo prompt work-up to rule out adrenal or ovarian tumours.
Patients diagnosed with gonadal dysgenesis (Y chromosome on karyotype) and androgen insensitivity syndrome are at risk for gonadal tumours such as dysgerminoma or gonadoblastoma and should be counselled regarding removal of the gonads.[6][14]
Patients with obstructive anomalies that result in compression of the urethra can lead to urinary retention (e.g., haematometrocolpos, Herlyn-Werner-Wunderlich syndrome).

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Urgent considerations