Amenorrhea classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Amenorrhea may be classified according to etiology into three subtypes, including primary amenorrhea, secondary amenorrhea, and functional amenorrhea. Primary amenorrhea is basically referred to a young girl that has not experienced menarche, at all, classified as hypergonadotropic hypogonadism, hypogonadotropic hypogonadism, and functional amenorrhea. Secondary amenorrhea reflects a woman that has ordinary menstruation cycles, experiencing at least 3 months of menstruation cycle absence, classified as polycystic ovary syndrome, hypothalamic-pituitary dysfunction, hypothalamic-pituitary failure, and ovarian failure. Functional amenorrhea is a subtype of the amenorrhea caused by exaggerated different lifestyles, classified as stress, weight loss, and exercise related groups.

Classification

• Amenorrhea may be classified according to etiology into three subtypes:
  • Primary amenorrhea
  • Secondary amenorrhea
  • Functional amenorrhea
• The main classification of amenorrhea is based on the etiology, including primary amenorrhea, secondary amenorrhea, and functional amenorrhea. Primary amenorrhea is basically referred to a young girl that has not experienced menarche, at all. Secondary amenorrhea reflects a woman that has ordinary menstruation cycles, experiencing at least 3 months of menstruation cycle absence. Functional amenorrhea is a subtype of the amenorrhea caused by exaggerated different lifestyles.
• Each of the subtypes of amenorrhea has their own classification, as following:

Amenorrhea classification

Life style etiology

Lack of menarche

Lack of mensturation more than 3 months

Functional amenorrhea

Primary amenorrhea

Secondary amenorrhea

Stress related

Weight loss related

Exercise related

Hypergonadotropic hypogonadism

Hypogonadotropic hypogonadism

Eugonadotropic

Polycystic ovary syndrome

Hypothalamic-pituitary dysfunction

Hypothalamic-pituitary failure

Ovarian failure

Amenorrhea is broadly classified as primary and secondary.

• Primary amenorrhea there is absence of menarche by the age of 16. Menstruation cycles never begin. There will be a delay of menses one year beyond the family history of first menses.

• Secondary amenorrhea is defined as absence of menses in a woman who had previously menstruated for at least 3 cycles or 6 months. Secondary amenorrhea is more common than primary amenorrhea.

The other type of classification based on the levels of gonadotropic hormones includes:

• Hypogonadotropic amenorrhoea refers to conditions where there are very low levels of serum FSH and LH.

• Hypergonadotropic amenorrhoea refers to conditions with high levels of FSH (and LH).

• Normogonadotropic amenorrhoea - FSH levels are in the normal range.