Primary and secondary amenorrhoea.

Amenorrhoea, which is usually defined as no periods for six months or more, occurs in 10-20% of patients complaining of infertility and is one of the commonest reasons for referral to a gynaecological endocrine clinic. It usually implies an endocrine abnormality of ovarian function. In many women a preliminary diagnosis may be made from clinical evaluation at the initial visit to the clinic, and in almost all cases the diagnosis can be established as a result of simple endocrine tests.' Although often straightforward, investigation and management of patients with amenorrhoea are best performed in gynaecological endocrine clinics with direct access to an endocrine laboratory and facilities to select, initiate, and monitor programmes for induction of ovulation.