Patient's question:
Detailed medical history and consultation purpose: Since the second induced abortion in July 2003, my body has been very weak, and I often feel cold. Since March this year, my menstrual period has not come regularly. In June and August, I took two courses of progesterone and had two menstrual periods. On August 20th, I haven't had a period until now. On December 10th, I took a dose of Weng Jing Tang and took it for five days, but I still haven't had a period. Since June, I have had left lower abdominal pain, and pressing the area causes pain. What specific tests should I undergo? If I want to have a baby now, what should I do?Doctor's answer:
Hello: According to your description of symptoms, it is recommended to first undergo an estrogen six-item test.Tests for Amenorrhea
I. Basic Tests
1. Ovarian Function Tests
① Endometrial biopsy;
② Vaginal smear examination;
③ Cervical mucus crystallization test;
④ Serum E(2) and P determination;
⑤ Basal body temperature measurement.
2. Pituitary Function Tests
(1) Direct measurement of blood LH, FSH, and PRL levels: If FSH > 40 IU/L indicates ovarian failure; if PRL > 25 μg/L suggests hyperprolactinemia; if LH and FSH are normal or low, further pituitary stimulation tests are needed.
(2) Pituitary stimulation test: If the LH released 15–45 minutes after LHRH injection increases more than 3-fold compared to pre-injection levels, it is (+), indicating that the pituitary responds well to exogenous LHRH, suggesting the cause of amenorrhea is the hypothalamus. If post-injection LH levels do not rise or increase insignificantly, the pituitary stimulation test is (?), indicating the lesion is in the pituitary.
3. CT scan of the sella turcica to check for pituitary adenomas.
4. Chromosome testing to rule out genetic developmental abnormalities.
5. Ultrasound examination to assess for polycystic changes in the ovaries.
II. Further Tests
1. Laparoscopic examination to evaluate the status of the gonads, including whether there are abnormalities such as hypoplasia, polycystic ovaries, or premature ovarian failure.
2. Magnetic resonance imaging to rule out pituitary microadenomas.