Amenorrhea causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

Primary Amenorrhea

• 17 beta-hydroxysteroid dehydrogenase deficiency
• Agonadism
• After trauma
• Anorexia Nervosa
• Anovulation
• Complete androgen insenstivity syndrome
• Constitutional bradygenesis
• Constitutional delay of puberty
• Diabetes Mellitus
• Early infantile brain damage
• Gonadal dysgenesis
• Homozygous adrenogenital syndrome
• Hymenal atresia
• Hyperandrogenism
• Hypothalamic and pituitary tumors

  • Hyperprolactinemia / Prolactin-secreting tumors
  • Dysgerminoma
  • Craniopharyngioma

• Idiopathic gonadotropin deficiency
• Kallmann's Syndrome
• Mayer-Rokitansky-Hauser Syndrome
• Mullerian dysgenesis
• Outflow tract disorders
• Pituitary insufficiency

  • Pituitary schistosomiasis
  • Pituitary tuberculosis
  • Empty Sella Syndrome

• Polycystic Ovary Syndrome
• Post-hormonal contraceptive Amenorrhea
• Severe systemic diseases
• Swyer's Syndrome
• Testicular feminization
• Turner's Syndrome
• Uterine atresia
• Uterine hypoplasia
• Vaginal atresia / gynatresia

Secondary Amenorrhea

• 5-alpha-reductase deficiency
• Addiction
• Addison's Disease
• Adrenocortical insuffiency
• After curettage
• After hysterectomy
• After radiation (can be reversed)
• Adrenal tumors
• Anovulation
• Asherman's Syndrome
• Autoimmune diseases
• Body building (and use of androgens)
• Castration (radiation or surgical)
• Central nervous system tumor (CNS)
• Cervical stenosis
• Change of environment
• Complete and incomplete androgen insensitivity
• Congenital adrenal hyperplasia
• Craniocerebral trauma
• Cushing's Syndrome
• Depression
• Diabetes Mellitus
• Drug Side Effect- Ethynodiol diacetate and ethinyl estradiol Medroxyprogesterone, Norgestimate and Ethinyl estradiol, Norgestrel and Ethinyl estradiol, Sertraline, Methyltestosterone, Olanzapine, Pramipexole, Prochlorperazine
• Encephalitis
• Enzymatic defects in testosterone biosynthesis
• Exposure to maternal androgens in utero
• Extreme obesity
• During chemotherapy
• Functional hypothalalmic Amenorrhea due to:

  • Stress
  • Eating disorders
  • Excessive exercise
  • Weight loss

• Gonadotropin deficiency in tumors
• Hormone-active ovarian tumor
• Hermaphroditism
• Heterozygous adrenogenital syndrome
• Hyperprolactinemia
• Hyperthyroidism
• Hypothyroidism
• Hysterectomy
• Imprisonment
• Meningitis
• Mullerian anomalies
• Myotonic dystrophy
• Pituitary insufficiency
• Polycystic ovary syndrome
• Post-hormonal contraception
• Post-infection (mumps, severe pelvic inflammatory disease)
• Postoerative gonadotropin deficiency
• Pregnancy
• Premature menopause
• Prolactinoma
• Sheehan's Syndrome
• Stress
• Testicular feminization
• Transsexuality when taking androgens
• Turner's Syndrome
• Uterine cavity sclerosis

  • Uterine Schistosomiasis
  • Abortion
  • Severe generalized infections of the pelvis
  • Post uterine surgery
  • Overzealous or repeated uterine curettage
  • Tuberculosis endometritis

Differential Diagnosis Organized by Category of Causes

• Physiologic

  • Pregnancy
  • Lactation
  • Menopause

• Hypothalamic

  • Structural

    • Craniopharyngioma
    • Lymphoma
    • Sarcoidosis
    • Hemochromatosis

  • Functional

    • Anorexia/bulimia
    • Excessive exercise/weight loss
    • Stress

• Pituitary

  • Secretory tumors

    • Prolactinoma
    • Cushing’s disease
    • Acromegaly

  • Destructive lesions

    • Non-functional tumors
    • Sheehan's syndrome
    • Hemochromatosis

• Ovarian

  • Premature ovarian failure
  • Hyperandrogenic disorders

    • Polycystic ovary syndrome (PCOS)
    • Nonclassical congenital adrenal hyperplasia (NCCAH)
    • Adrenal/ovarian androgen-secreting tumors

• Anatomic

  • Destruction of uterine cavity

    • Asherman’s syndrome
    • Tuberculosis (TB)

• Other

  • Hyperthyroidism/hypothyroidism
  • Cushing’s syndrome

References

[[Category:Signs and symptoms]