Amenorrhea causes: Difference between revisions

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Revision as of 19:37, 29 June 2015

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

Overview

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

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's 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, gnrh deficiency, hyperprolactinaemia, hyperthyroidism, hypogonadism, hypogonadotropic hypogonadism, hypopituitarism, hypothyroidism, incomplete androgen insensitivity, Kallmann syndrome, Laron syndrome , masculinization disorders,Mayer-Rokitansky syndrome, medroxyprogesterone acetate,menopause, mullerian aplasia., mullerian dysgenesis, 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 ovary syndrome,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	Climate change
Gastroenterologic	Anorexia nervosa,autoimmune hepatitis , Bearn-Kunkel syndrome, celiac disease ,cystic fibrosis,eating disorders,haemosiderosis, hepatocellular carcinoma, inflammatory bowel disease, liver cirrhosis,malabsorption syndrome, rapid weight loss, weight gain,
Genetic	18p minus syndrome, agenesis of lower vagina, androgen insensitivity syndrome, C21-hydroxylase deficiency, celiac disease,chromosome 15q duplication syndrome,Chromosome 17p, partial deletion , cortisone reductase deficiency,defect in sry gene, cystic fibrosis, Down's syndrome, Fgfr1 mutation, galactose-1-phosphate uridyltransferase deficiency, gonadal dysgenesis, Kal1 mutation, Kallmann syndrome, Laurence-Moon-Biedl syndrome, Mayer-Rokitansky syndrome, ovarian insufficiency,familial, Prader-Willi syndrome , prokr2 mutation, tetrasomy X, triple X syndrome, Turner syndrome,vanishing testes syndrome, Werner syndrome, Xy female
Hematologic	Anaemia, haemosiderosis, Hodgkin's disease,leukemia
Iatrogenic	No underlying causes
Infectious Disease	Mumps, tuberculosis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Brain tumor, craniopharyngioma, dystrophia adipose-genitalis, empty sella syndrome, frohlich's syndrome, glioma, hypothalamic tumor, meningioma, ovarioleukodystrophy, traumatic brain injury,
Nutritional/Metabolic	Dietetic deficiency,galactose-1-phosphate uridyltransferase deficiency,low weight,malabsorption syndrome, malnutrition, obesity, proprotein convertase 1/3 deficiency, rapid weight loss, underweight, vitamin A embryopathy, weight gain
Obstetric/Gynecologic	Anovulation, asherman syndrome, autoimmune hepatitis , autoimmune oophoritis, cervical closure, combined oral contraceptive pill,complications from d&c procedure, corpus luteum cyst , defect in sry gene, ectopic pregnancy, fsh receptor deficiency, germinoma, granulosa-cell tumor, hematocolpos, haematometra, hematosalpinx, hydatidiform mole, hypogonadism, hysterectomy, imperforate hymen, Mayer-Rokitansky syndrome, menopause, mullerian aplasia ., mullerian dysgenesis, ovarian cancer, ovarian failure, ovarian insufficiency due to fsh resistance , ovarian insufficiency, familial , ovarioleukodystrophy, ovary damage, perimenopause , polycystic ovary syndrome, pregnancy, premature ovarian failure, pseudoamenorrhea, pseudocyesis, reproductive disorders, Sheehan syndrome, Stein-Leventhal syndrome, tubal ligation syndrome , uterine aplasia, vaginal agenesis, vaginal closure, vaginal septum , virilizing ovarian tumor , Xy female,
Oncologic	Granulosa cell tumor, hepatocellular carcinoma, Hodgkin's disease, hypothalamic tumor,leukemia, meningioma, ovarian cancer, prolactinoma, virilizing ovarian tumor
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	Alcoholism, Anorexia nervosa, Anxiety, Bulimia, Depression, Eating disorders, Emotional turmoil, Excessive exercise, Female athlete syndrome, Grief, Insanity, Ovarioleukodystrophy, Primary affective disorder, Stress, female athlete syndrome, grief, insanity, ovarioleukodystrophy, primary affective disorder, stress
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

3

Causes of Amenorrhea Based on Classification

Primary Amenorrhea^[1] ^[2]

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

References

↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

[1] Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016

[2] Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

[1]

[2]

@@ Line 61: / Line 61: @@
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"|[[De Grouchy Syndrome|18p minus syndrome]], [[Vaginal agenesis|Agenesis of lower vagina]], [[androgen insensitivity syndrome]], [[C21-hydroxylase deficiency]], [[celiac disease]],[[Chromosome 15q trisomy|chromosome 15q duplication syndrome]],[[Chromosome 17p, partial deletion ]], [[cortisone reductase deficiency]],[[Swyer's syndrome|defect in sry gene]], [[cystic fibrosis]], [[Down's syndrome]], [[Fibroblast growth factor receptor 1|Fgfr1 mutation]], [[galactose-1-phosphate uridyltransferase deficiency]], [[gonadal dysgenesis]], [[KAL1 gene|Kal1 mutation]], [[Kallmann syndrome]], [[Laurence-Moon-Biedl syndrome]], [[Mayer-Rokitansky-Hauser syndrome|Mayer-Rokitansky syndrome]], [[ovarian insufficiency,familial]], [[Prader-Willi syndrome ]], [[Prokineticin receptor 2|prokr2 mutation]], [[tetrasomy X]], [[triple X syndrome]], [[Turner syndrome]],[[vanishing testes syndrome]], [[Werner syndrome]], [[Swyer's syndrome|Xy female]]
+|bgcolor="Beige"|[[De Grouchy Syndrome|18p minus syndrome]], [[Vaginal agenesis|agenesis of lower vagina]], [[androgen insensitivity syndrome]], [[C21-hydroxylase deficiency]], [[celiac disease]],[[Chromosome 15q trisomy|chromosome 15q duplication syndrome]],[[Chromosome 17p, partial deletion ]], [[cortisone reductase deficiency]],[[Swyer's syndrome|defect in sry gene]], [[cystic fibrosis]], [[Down's syndrome]], [[Fibroblast growth factor receptor 1|Fgfr1 mutation]], [[galactose-1-phosphate uridyltransferase deficiency]], [[gonadal dysgenesis]], [[KAL1 gene|Kal1 mutation]], [[Kallmann syndrome]], [[Laurence-Moon-Biedl syndrome]], [[Mayer-Rokitansky-Hauser syndrome|Mayer-Rokitansky syndrome]], [[ovarian insufficiency,familial]], [[Prader-Willi syndrome ]], [[Prokineticin receptor 2|prokr2 mutation]], [[tetrasomy X]], [[triple X syndrome]], [[Turner syndrome]],[[vanishing testes syndrome]], [[Werner syndrome]], [[Swyer's syndrome|Xy female]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Hematologic'''
-|bgcolor="Beige"|[[Anaemia]], [[haemosiderosis]], [[hodgkin's disease]],[[leukemia]]
+|bgcolor="Beige"|[[Anaemia]], [[haemosiderosis]], [[Hodgkin's disease]],[[leukemia]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 106: / Line 106: @@
 |-bgcolor="LightSteelBlue"
 | '''Psychiatric'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"|[[Alcoholism]],
+[[Anorexia nervosa]],
+[[Anxiety]],
+[[Bulimia]],
+[[Depression]],
+[[Eating disorders]],
+[[Emotional turmoil]],
+[[Excessive exercise]],
+[[Female athlete syndrome]],
+[[Grief]],
+[[Insanity]],
+[[Ovarioleukodystrophy]],
+[[Primary affective disorder]],
+[[Stress]],
+[[Female athlete triad|female athlete syndrome]], [[grief]], [[insanity]], [[Leukoencephalopathy with vanishing white matter|ovarioleukodystrophy]], primary affective disorder, [[stress]]
 |-
 |-bgcolor="LightSteelBlue"