The efficacy of hormone assays in the differential diagnosis of amenorrhea and menopause.

The differential diagnosis of menopause and amenorrhea is currently based on the assay of circulating follicle stimulating hormone, luteinising hormone, and estradiol. The diagnostic performance of the three hormone assays, both as single and combined tests, was evaluated considering as reference data the results from 300 subjects for either condition, and assuming menopause-amenorrhea prevalence ratios corresponding to 1 and 10. In the calculation an "allocation" scheme was adopted, and the uncertainty associated with the diagnostic performance parameters was accounted for. The results obtained clearly demonstrate that the addition of a test for luteinising hormone or estradiol (or both) to the testing for follicle stimulating hormone is not justified in terms of improvement of the diagnostic information.