• Secondary amenorrhoea is usually considered to be amenorrhoea of 6 or more months duration during reproductive years.
• Aetiology and treatment can be conveniently catago-rized into hypothalamic, pituitary, ovarian, uterine causes or systemic illness, which in essence causes secondary hypothalamic amenorrhoea.
• Correct diagnosis is readily made if a logical protocol is applied.
• The polycystic ovary syndrome is the commonest cause and is the only major cause of amenorrhoea that is not associated with oestrogen deficiency.
• The amenorrhoea of polycystic ovary syndrome should be treated to either enhance fertility or prevent endome-trial hyperplasia/adenocarcinoma.
• Oestrogen deficiency results in the long-term sequelae of osteoporosis and cardiovascular disease and so the cause of amenorrhoea should be corrected early and hormone replacement therapy administered if necessary.
• Fertility can be achieved either after ovulation induction or, in cases of premature ovarian failure with oocyte donation/in vitro fertilization.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.