Amenorrhea causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Kiran Singh, M.D. [2]

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

• Pregnancy
• Breastfeeding
• Menopause
• Turner syndrome

Causes by Organ System

Cardiovascular	Haemosiderosis, heart disease
Chemical/Poisoning	Alcoholism, chronic alcohol poisoning, chronic lead poisoning, chronic mercury poisoning, chronic morphine poisoning
Dental	No underlying causes
Dermatologic	Systemic lupus erythematosus,
Drug Side Effect	Antidepressants, antipsychotics, chemotherapy, combined oral contraceptive pill, cyclophosphamide, epirubicin, ethanol, fluoxymesterone, metoclopramide, nandrolone, spironolactone, stanozolol,
Ear Nose Throat	No underlying causes
Endocrine	Acromegaly, 5-alpha-reductase deficiency, Achard-Thiers syndrome, addison's disease, adrenal cortex tumours, adrenal gland disorders, adrenocortical hyperplasia, Ahumada-Del Castillo syndrome, androgen insensitivity syndrome, anorexia nervosa, anovulation, anterior pituitary failure, arrhenoblastoma, autoimmune adrenalitis, breastfeeding, C21-hydroxylase deficiency, Chiari-Frommel syndrome, congenital adrenal hyperplasia , conn syndrome, constitutional delay of puberty, corpus luteum cyst , cortisone reductase deficiency, cretinism, cushing disease, cushing syndrome, diabetes mellitus , dystrophia adipose-genitalis, eating disorders, empty sella syndrome, exogenous androgen use, Female athlete syndrome, Forbes-Albright syndrome, Frohlich's syndrome, fsh receptor deficiency, galactorrhea , galactorrhoea-hyperprolactinaemia, gnrhdeficiency, hyperprolactinaemia, hyperthyroidism, hypogonadism, hypogonadotropic hypogonadism, hypopituitarism, hypothyroidism, incomplete androgen insensitivity, Kallmann syndrome, Laron syndrome , masculinization disorders, Mayer-Rokitansky syndrome, medroxyprogesterone acetate,menopause, mullerianaplasia., mulleriandysgenesis, multiple endocrine neoplasia type 1 , myxoedema, obesity, ovarian failure, ovarian insufficiency due to fsh resistance , ovarian insufficiency, familial, panhypopituitarism , perimenopause , pituitary apoplexy, pituitary dwarfism, pituitary infarct, pituitary tumour, polycystic ovarysyndrome,premature ovarian failure, prolactinoma, pseudoamenorrhea, pseudocyesis, rapid weight loss, Sheehan syndrome, Simmond's disease, Stein-Leventhal syndrome, testicular feminization syndrome, testosterone, thyrotoxicosis, underweight, vanishing testes syndrome, weight gain, Xy female,
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	chronic illness

Causes in Alphabetical Order

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3

Causes of Amenorrhea Based on Classification

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- Chlorpromazine, Desogestrel and Ethinyl Estradiol, Docetaxel, Epirubicin hydrochloride, Ethynodiol diacetate and ethinyl estradiol, Fluoxymesterone, Histrelin, Iloperidone, Loxapine, Medroxyprogesterone, Norgestimate and Ethinyl estradiol, Norgestrel and Ethinyl estradiol, Sertraline, Methyltestosterone, Olanzapine, Pramipexole, Prochlorperazine, Tiagabine, Trifluoperazine
• 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