Amenorrhea.

The evaluation of amenorrhea requires a careful history and physical examination and a systematic, stepwise approach. Pregnancy must be excluded. One or more of the following will help establish the diagnosis: prolactin, T4, lateral skull x-ray or tomograms of the sella, FSH, LH, urinary 17-ketosteroids and 17-hydroxysteroids, bone age, buccal smear for Barr bodies, karyotype and the presence of withdrawal bleeding after a course of progesterone alone or cyclic estrogen plus progesterone.