Amenorrhea not due to pregnancy, lactation, or menopause is a relatively common abnormality of the reproductive years and indicative of a defect somewhere in the hypothalamic-pituitary-ovarian-uterine axis. It also considers the diagnosis and treatment of abnormal uterine bleeding at all stages of life.The prevalence of amenorrhea that is not due to pregnancy, lactation, or menopause is 3 to 4% . Amenorrhea indicates failure of the hypothalamic-pituitary-gonadal axis to induce cyclic changes in the endometrium that normally result in menses and also may result from the absence of end organs or from obstruction of the outflow tract. It is important to remember that amenorrhea may result from an abnormality at any level of the reproductive tract.