In women presenting with amenorrhea, what is the first step in evaluation?

In the evaluation of women presenting with amenorrhea, the first step should be a pregnancy test. This is crucial because pregnancy is the most common cause of secondary amenorrhea in women of reproductive age. By confirming or ruling out pregnancy right at the outset, healthcare providers can appropriately direct subsequent evaluations and management strategies.

If the pregnancy test is positive, the healthcare provider can proceed to prenatal care or a discussion regarding the pregnancy. If it is negative, it allows for further investigation into other potential causes of amenorrhea. Immediate testing for other hormonal abnormalities or structural issues, such as with pelvic ultrasound or thyroid function tests, would be less prudent before addressing the possibility of pregnancy, which is a straightforward and critical consideration in this context.