What is an appropriate initial diagnostic workup for primary amenorrhea?

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Evidence-based answer

The initial evaluation should start with a history, including sexual development, accompanied by a physical examination including assessment of secondary sexual characteristics and genital examination. Initial laboratory studies should include urine pregnancy test, folliclestimulating hormone (FSH), prolactin, and thyroid-stimulating hormone (TSH). The presence or absence of breast development and FSH levels can guide further evaluation (SOR: C, expert consensus based on guideline and case series).

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