What is the workup of delayed menarche?
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In all cases of delayed menarche, a comprehensive history and physical exam should be completed. Serum studies for follicle-stimulating hormone (FSH), leuteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin are recommended. In patients who have developed secondary sexual characteristics, a pregnancy test and progesterone challenge are also warranted. For patients without secondary sexual characteristics, a complete blood count (CBC) and karyotype are advised. Additional tests may be required. (SOR C, based on expert opinion and extrapolation from cohort studies.)
Evidence Based Practice 11(11): 07.