A 14-year-old girl has failed to menstruate and develop secondary sex characteristics. What term describes this condition?

• A. Primary amenorrhea
• B. Secondary amenorrhea
• C. Delayed puberty
• D. Hypogonadism

Answer: (A)

Primary amenorrhea is the failure of the menstrual period to appear by the age puberty would normally begin. If secondary sexual characteristics are present, lack of menses by age 15 is diagnostic; if secondary sexual characteristics are absent, the threshold is age 13. In this case, a 14-year-old who has not developed secondary sexual characteristics and has not had menses fits primary amenorrhea, since puberty hasn’t progressed to menarche by the appropriate age for her level of pubertal development.