PRIMARY AMENORRHEA

A   16-year-old girl    presents    with    her mother, complaining she has never   had

a   menstrual   period. All of  her friends have    menstruated,    and the mother  is

concerned   about   her daughter’s  lack    of  menstruation.   On  examination she

seems   to  be  well-nourished, with    adult   breast  development and pubic   hair

present.    Pelvic  examination reveals a   rudimentary vagina. No  uterus  is

palpable    on  rectal  examination.

Amenorrhea means an absence of menstrual bleeding. Primary means that
menstrual bleeding has never occurred. Primary amenorrhea is diagnosed with
an absence of menses at age 14 without secondary sexual development or at age
16 with secondary sexual development.