Urgent considerations
See Differentials for more details
Patients with secondary sexual development should be assessed for pregnancy.
Patients with hyperprolactinemia or those diagnosed with hypogonadotropic hypogonadism and neurologic symptoms should undergo neuroimaging to rule out an intracranial neoplasm.[13]
Patients with symptoms of rapid virilization should undergo prompt workup to rule out adrenal or ovarian tumors.
Patients diagnosed with gonadal dysgenesis (Y chromosome on karyotype) and androgen insensitivity syndrome are at risk for gonadal tumors such as dysgerminoma or gonadoblastoma and should be counseled 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., hematometrocolpos, Herlyn-Werner-Wunderlich syndrome).
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