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Secondary amenorrhoea — DRCOG MCQ

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EasyGynaecologySecondary amenorrhoeaDRCOG

A 24-year-old woman has not had a period for 4 months. Her periods were previously regular. She uses condoms and has mild breast tenderness. What is the most appropriate investigation?

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Correct answer: A — Perform a pregnancy test

Pregnancy is the commonest and most important first diagnosis to exclude in secondary amenorrhoea. MRI, HRT and endometrial biopsy may be relevant in selected later work-up but are not first-line before pregnancy testing. Tranexamic acid treats heavy bleeding, not absent periods. A simple urine hCG test should be done before further endocrine investigation.

Reference: NICE CKS amenorrhoea