What is the first test to perform when a woman presents with amenorrhea?

When a woman presents with amenorrhea, the first test to perform is a beta-HCG test. This test is crucial because amenorrhea can be a sign of pregnancy, and beta-HCG is a hormone produced by the placenta shortly after a fertilized egg attaches to the uterine lining. Therefore, determining whether a woman is pregnant is essential as it influences the direction of further evaluation and management.

If the beta-HCG test is positive, the focus shifts to prenatal care and monitoring of the pregnancy. If it is negative, further investigation is warranted to identify other potential causes of amenorrhea. These could include hormonal imbalances, structural issues, or other conditions, which might require tests like LH and FSH levels or a pelvic ultrasound for further evaluation.

In summary, starting with the beta-HCG test allows healthcare providers to rule out or confirm pregnancy quickly, making it the most logical first step in assessing a patient with amenorrhea.