Secondary amenorrhoea: prevalence and medical contact—a cross–sectional study from a Danish county

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Abstract
Objective To examine the prevalence of secondary amenorrhoea and the patterns of seeking medical advice for secondary amenorrhoea in an unselected population.Design Cross‐sectional postal questionnaire study.Setting County of Copenhagen, Denmark.Subjects 3743 women, aged 15–44, selected at random from a Danish county who were asked to provide information on menstrual patterns for the preceding year, 1988. The response rate was 78%. Information from non‐responders was obtained via telephone interviews.Results One‐year period prevalence of secondary amenorrhoea of more than 3 months duration was 4.6% and was 7.6%, 3.0%, and 3.7% in women aged 15–24, 25–34, and 35–44 respectively. The duration of secondary amenorrhoea was 6 months or less in 75% aged 15–34 years, but longer than 6 months in 55% of those aged 35–44 years. A social gradient was found of the prevalence of secondary amenorrhoea (odds ratio 3.3, 95% CI 1.5–8.3) in the lowest social group compared with the highest social group; controlled by age. Only 39% of women with secondary amenorrhoea had contacted a doctor. Educational level or social status did not seem to influence the frequency of medical contact in women with amenorrhoea.Conclusion Spontaneous return of the menstrual cycle occurs within 6 months in many amenorrheic women below the age of 35. The detailed investigation of secondary amenorrhoea in this age group can be postponed until it is of 6 months duration, unless there is clinical suspicion of disease. The relative infrequency with which women with secondary amenorrhoea seek medical advice constitutes an important source of selection bias in hospital‐based clinical research on this topic.

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