History of present illness includes whether menses have ever occurred (to distinguish primary from secondary amenorrhea) and, if so, how old patients were at menarche, whether periods have ever been regular, and when the last normal menstrual period occurred. History should also include duration and flow of menses; presence or absence of cyclic breast tenderness and mood changes; and growth, development, and age at thelarche Levels can be elevated in women with hypothalamic or pituitary dysfunction and are sometimes normal in hirsute women with polycystic ovary syndrome. The cause of elevated levels can sometimes be determined by measuring serum LH. In polycystic ovary syndrome, circulating LH levels are often increased, increasing the ratio of LH to FSH
Clinicians should note vital signs and body composition and build, including height and weight, and should calculate body mass index (BMI). Secondary sexual characteristics are evaluated; breast and pubic hair development are staged using Tanner’s method. Treatments vary based on the underlying condition. Key issues are problems of surgical correction if appropriate and oestrogen therapy if oestrogen levels are low.
In preindustrial societies, menarche typically occurred later than in current industrial societies. After menarche, menstruation was suppressed during much of a woman's reproductive life by either pregnancy or nursing. Reductions in age of menarche and lower fertility rates mean that modern women menstruate far more often than they did under the conditions prevalent for most of human evolutionary history. The term is derived from Greek: a = negative, men = month, rhoia = flow. Derived adjectives are amenorrhoeal and amenorrhoeic. The opposite is the normal menstrual period.