What lab evaluations are advised for someone under 40 years old who misses 3 or more consecutive cycles?

In women under 40 who miss three or more consecutive menstrual cycles, it's essential to perform a comprehensive evaluation to assess for underlying causes of amenorrhea. The recommended tests include checking prolactin levels to rule out prolactinomas or other conditions that may elevate prolactin, which can interfere with normal menstrual function. Evaluating FSH (Follicle Stimulating Hormone) and estradiol levels helps to assess ovarian function and determine if the individual has diminished ovarian reserve or is experiencing premature ovarian insufficiency.

Additionally, testing thyroid-stimulating hormone (TSH) is important to evaluate thyroid function, as hypo- or hyperthyroidism can significantly impact menstrual cycles. Finally, a pregnancy test is also crucial to confirm whether the missed cycles may be due to pregnancy, which is a common and important consideration in women of reproductive age experiencing amenorrhea.

This approach encompasses a thorough evaluation of the hormonal axes involved in the menstrual cycle, ensuring that both pituitary and ovarian function, as well as other endocrine influences, are considered. Other options may cover some parameters but do not provide the comprehensive assessment needed in this situation for evaluating amenorrhea in younger women.