Secondary amenorrhea

Dx:
1. previous regular: >3 mos
2. irregular: >6 mos

Management:
1. HCG
2. TSH, if high, treat with thyroid replacement
3. Prolactin: medication, tumor, if + then CT to see Kalman syndrome
4. Progensterone Challenge Test: differentiate anovulation and inadequate estrogen priming or anatomic problems
5. E-P Challenge Test: (+) --> inadequate estrogen, use FSH to differentiate ovarian or H-P problems,
(-) --> anatomic or Asherman syndrome, hysterosalpingogram