She needs to see a reproductive endocrinologist.
Thanks I will look into this ^
There is a cascade of hormones involved in producing a menstrual period. in order for that cascade to work properly, the hypothalamus in the brain, the pituitary gland, the ovaries, and the uterus have to all be present and working, with a finely tuned set of checks and balances.
OB/GYN said something about the hypo and brain but said she would look at that once the child reach 18 with no sign of mentration.
Although we often think of reproductive endocrinologists in terms of the treatment of infertility, problems like this are also in their bailiwick.
The first step is to make sure there is actually a uterus present and that the vagina is not obstructed in some way, blocking the outflow of menstrual fluid.
That can be done with a simple physical examination and an ultrasound.
Above has been done
If the other secondary sexual characteristics, breast growth and underarm and pubic hair, have developed, then there are probably functioning ovaries. The ovaries will usually be visible on ultrasound, also.
Above has been done
Most of the other tests are done on blood. At some point, an imaging study of the pituitary gland may be suggested, depending on the results of some of the blood tests.
Above has been done
There are some rare chromosomal problems that can present with failure to initiate menstrual periods. Some of these produce physical characteristics that are so typical that the conditions are often diagnosed by pediatricians prior to puberty.
I will check out the below today- thanks so much for your help!
Here is an algorithm for the tests for primary amenorrhea. You can compare the tests your daughter has already had done and see where she is in the scheme:
http://www.arupconsult.com/Algorithm...Amenorrhea.pdf
Amenorrhea - ARUP Consult, Your Online Lab Test Resource
Amenorrhea - primary: MedlinePlus Medical Encyclopedia
Edited to add: Note that ruling out pregnancy is the first step. Do not let that put you off. It is done because doctors who do not do it risk getting burned. Missing a pregnancy would be very embarrassing!
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