Your doctor will ask you about:
The date of your last menstrual period
Whether you are sexually active
Your birth control methods
Your pregnancy history
Your eating habits
Rapid weight changes
Obesity or extreme underweight
Your typical monthly menstrual patterns
The age when your mother entered menopause. (Many mothers and daughters enter menopause at about the same age.)
The amount of stress in your life, and how you deal with it
Your exercise regimen
The types of medications you are taking
Your doctor will review your medical history. He or she will do a general physical examination, followed by a thorough pelvic exam. Your doctor will check whether you are pregnant.
If your doctor suspects a specific cause, he or she will ask additional questions. For example, if your doctor suspects a hormonal abnormality, he or she may ask about:
Increased body hair
Extreme sensitivity to cold temperatures
Unusual breast secretions
If you are an athlete, your doctor will ask about your training program. This is particularly likely if you are underweight or have a low percentage of body fat.
The following tests may be done to identify the underlying cause of your absent periods:
Blood and urine tests. These can detect imbalances of female hormones. Imbalances may be caused by problems with the pituitary gland or ovaries. If problems are found, additional tests can be done. These will check whether your levels of thyroid and adrenal hormones are normal.
Pelvic ultrasound. This painless test uses sound waves. It can identify structural problems in your uterus and ovaries.
Progesterone challenge test. Your doctor may treat you with progesterone to see whether this initiates a menstrual period. If menstrual bleeding occurs, you are probably not releasing a mature egg in the middle of your menstrual cycle.
If bleeding does not occur, your doctor will order blood tests to check your FSH levels. FSH levels can help to determine whether your problem is in the ovaries or hypothalamus.
Additional testing may be necessary to pinpoint the cause of your missed periods. Diagnosing amenorrhea can be complicated. There are many potential causes.