Urgent considerations

See Differentials for more details
  • Any patient of reproductive age should be assessed for pregnancy.[1]

  • A patient who was previously amenorrheic due to a chronic anovulatory state can present with acute menorrhagia and resultant symptomatic anemia.

  • Patients with hyperprolactinemia or those diagnosed with hypogonadotropic hypogonadism and neurologic symptoms should undergo neuroimaging to rule out an intracranial neoplasm.[14]

  • Patients with symptoms of rapid virilization should undergo prompt workup to rule out adrenal or ovarian tumors or virilizing Cushing syndrome.

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