Clinical recommendation	Evidence rating	References
Pregnancy should be excluded in all patients presenting with amenorrhea.	C	1, 2, 6, 7, 11
In the evaluation of amenorrhea, hormone-induced withdrawal bleeding has poor sensitivity and specificity for ovarian function.	C	1, 6, 13, 16, 17
In patients with functional hypothalamic amenorrhea (especially with the female athlete triad), the primary treatment is weight restoration through nutritional rehabilitation and decreased exercise.	C	7, 31, 32
In patients with functional hypothalamic amenorrhea, combined oral contraceptives do not improve bone density and should not be used solely for this purpose.	C	7, 31–36
Patients with polycystic ovary syndrome who are overweight should be evaluated for glucose intolerance, dyslipidemia, and overall cardiovascular risk.	C	1, 44
Metformin (Glucophage) may improve abnormal menstruation in patients with polycystic ovary syndrome.	A	44, 48–53