Case Presentation A 15-year-old adolescent girl, followed in pediatric allergology for asthma and rhinitis, was found to have primary amenorrhea during evaluation. Medical History Family history: mother attained menarche at 15 years No other relevant findings  Physical Examination Height at the 15th percentile, weight between 50th–85th percentiles (overweight) Tanner stage IV pubertal development Well-formed external genitalia, intact hymen Non-palpable thyroid gland Ferriman-Gallwey score: 6 (<8, not consistent with hyperandrogenism) Laboratory Findings Routine Hormonal Profile: FSH: 1.85 mUI/mL LH: 2.98 mUI/mL Estradiol: 82 pg/mL Progesterone: 1.40 ng/mL DHEA-S: 162 µg/dL TSH: 0.412 µUI/mL Free T4: 0.9 ng/dL Extended Hormonal Panel (Endocrinology follow-up): Androstenedione: normal 17-hydroxyprogesterone: normal Cortisol: normal ACTH: normal Imaging Pelvic Ultrasound: Slightly…