Clinical Pearls

The most common cause of secondary amenorrhea after uterine curettage is intrauterine adhesions.

Intrauterine adhesions are diagnosed by hysterosalpingogram and confirmed by hysteroscopy.

Hysteroscopic resection is the best treatment of intrauterine adhesions.

Uterine curettage, especially associated with pregnancy, is a risk factor for intrauterine adhesions.


Mishell DR. Primary and secondary amenorrhea. In: Stenchever MA. Droegemueller W, Herbst AL, Mishell DR, eds. Comprehensive gynecology, 4th ed. St. Louis: Mosby-Year Book, 2001:1099-1124. Laufer LR. Patel KS. Amenorrhea, oligomenorrhea, and hyperandrogenic disorders. In: Hacker NF, Moore JG. Gambone JC, eds. Essentials of obstetrics and gynecology, 4th ed. Philadelphia: Saunders, 2004:398408.

A 59-year-old woman comes into the doctor's office for a health maintenance examination. Her medical history is remarkable for mild hypertension controlled with an oral thiazide diuretic agent. Her surgical history is unremarkable. On examination, her blood pressure is 140/84, heart rate 70 bpm, and she is afebrile. The thyroid is normal to palpation. The breasts are nontender and without masses. Pelvic examination is unremarkable. Mammography revealed a small cluster of calcifications around a small mass.

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