Amenorrhea epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The incidence of primary amenorrhea is approximately 3,000 per 100,000 individuals, mostly due to hypothalamic amenorrhea. The incidence of secondary amenorrhea is approximately 3,300 per 100,000 individuals in Sweden. The prevalence of amenorrhea is approximately 3,000 to 4,000 per 100,000 individuals worldwide. The prevalence of amenorrhea was estimated to be 13,400 cases per 100,000 female athletes. The case-fatality rate/mortality rate of amenorrhea is approximately below 1%, due to pituitary macroadenomas or generally brain lesions which cause amenorrhea. Primary amenorrhea is usually first diagnosed among adolescence, 16 years of age. There is no racial predilection to amenorrhea. Commonly, it seems that girls from developed countries experience the puberty and menarche earlier than developing countries, due to nutritional and socioeconomic situation. But, since the diagnosis age of primary amenorrhea is based on the society mean age of puberty onset and menarche, therefore there is not any difference between developing and developed countries in prevalence of amenorrhea.
Epidemiology and Demographics
Incidence
- The incidence of primary amenorrhea is approximately 3,000 per 100,000 individuals, mostly due to hypothalamic amenorrhea.[1]
- The incidence of secondary amenorrhea is approximately 3,300 per 100,000 individuals in Sweden.[2]
- In Oslo marathon games, the prevalence of amenorrhea was estimated to be 13,400 cases per 100,000 individuals.[3]
- The incidence of genital abnormality in patients with amenorrhea is about 15% (15,000 per each 100,000 individuals).[4]
- 10% of primary amenorrhea cases are caused by Mullerian agenesis, 10,000 per each 100,000 cases.[5]
- Androgen insensitivity syndrome is accounted for 5% of primary amenorrhea, 1 per each 60,000 of population.[6]
- Anatomic defects incidences are including imperforate hymen of 1 in 1,000 women and transverse vaginal septum of 1 in 80,000 individuals.[5]
- Among the women with fragile X syndrome, 16,000 cases per 100,000 individuals would experience amenorrhea.[7]
- The incidence of Mayer-Rokitansky-Küster-Hauser syndrome is approximately 1 per 5,000 individuals.[8]
- The incidence of Kallmann syndrome is approximately 1 per 40,000 girls.[9]
- The incidence of Turner syndrome is approximately 1 per 2,500 live female births.[10]
- The incidence of premature ovarian insufficiency is approximately 1 per 1,000 under 30 years, 1 per 250 around 35 years, and 1 per 100 at 40 years of age.[11]
Prevalence
- The prevalence of amenorrhea is approximately 3,000 to 4,000 per 100,000 individuals worldwide.[12]
- [13]
- In Oslo marathon games, the prevalence of amenorrhea was estimated to be 13,400 cases per 100,000 female athletes.[3]
- The prevalence of both primary and secondary amenorrhea is estimated to be 10-15 cases annually, in highly specialized referral centres.[4]
- [5]
- Premature ovarian failure prevalence among women is 1,000 to 5,000 per 100,000 individuals.[14]
- Prevalence of oligomenorrhea and amenorrhea among polycystic ovary syndrome patients are 76% and 24%, respectively.[15]
- The prevalence of weight related amenorrhea is approximately 1,000 to 5,000 per 100,000 individuals.[16]
- Hyperprolactinemia prevalence among patients with primary amenorrhea is about 1%.[17]
Case-fatality rate/Mortality rate
- The case-fatality rate/mortality rate of amenorrhea is approximately below 1%, due to pituitary macroadenomas or generally brain lesions which cause amenorrhea.
Age
- Patients of all age groups may develop secondary amenorrhea, before menopause.
- The incidence of premature ovarian insufficiency is approximately 1 per 1,000 under 30 years, 1 per 250 around 35 years, and 1 per 100 at 40 years of age.[11]
- Primary amenorrhea is usually first diagnosed among adolescence, 16 years of age.
Race
- There is no racial predilection to amenorrhea.
- Menarche usually occurs earlier in non-Hispanic black girls compared to girls of the White race.
- Whereas, menarche in Mexican American girls is slightly earlier than girls of the White race.[18]
Region
- The incidence of secondary amenorrhea is approximately 3,300 per 100,000 individuals in Sweden. 0.7% of studied population have amenorrhea secondary to oral contraceptives.[2]
- In Oslo marathon games, the prevalence of amenorrhea was estimated to be 13,400 cases per 100,000 individuals.[3]
Developed Countries vs. Developing Countries
- Commonly, it seems that girls from developed countries experience the puberty and menarche earlier than developing countries, due to nutritional and socioeconomic situation. But, since the diagnosis age of primary amenorrhea is based on the society mean age of puberty onset and menarche, therefore there is not any difference between developing and developed countries in prevalence of amenorrhea.[18]
References
- ↑ Rosenfield RL (1990). "Clinical review 6: Diagnosis and management of delayed puberty". J. Clin. Endocrinol. Metab. 70 (3): 559–62. doi:10.1210/jcem-70-3-559. PMID 2407749.
- ↑ 2.0 2.1 Pettersson F, Fries H, Nillius SJ (1973). "Epidemiology of secondary amenorrhea. I. Incidence and prevalence rates". Am. J. Obstet. Gynecol. 117 (1): 80–6. PMID 4722382.
- ↑ 3.0 3.1 3.2 Tomten SE (1996). "Prevalence of menstrual dysfunction in Norwegian long-distance runners participating in the Oslo Marathon games". Scand J Med Sci Sports. 6 (3): 164–71. PMID 8827845.
- ↑ 4.0 4.1 "Current evaluation of amenorrhea". Fertil. Steril. 90 (5 Suppl): S219–25. 2008. doi:10.1016/j.fertnstert.2008.08.038. PMID 19007635.
- ↑ 5.0 5.1 5.2 "Current evaluation of amenorrhea". Fertil. Steril. 86 (5 Suppl 1): S148–55. 2006. doi:10.1016/j.fertnstert.2006.08.013. PMID 17055812.
- ↑ Doody KM, Carr BR (1990). "Amenorrhea". Obstet. Gynecol. Clin. North Am. 17 (2): 361–87. PMID 2234749.
- ↑ Allingham-Hawkins DJ, Babul-Hirji R, Chitayat D, Holden JJ, Yang KT, Lee C, Hudson R, Gorwill H, Nolin SL, Glicksman A, Jenkins EC, Brown WT, Howard-Peebles PN, Becchi C, Cummings E, Fallon L, Seitz S, Black SH, Vianna-Morgante AM, Costa SS, Otto PA, Mingroni-Netto RC, Murray A, Webb J, Vieri F (1999). "Fragile X premutation is a significant risk factor for premature ovarian failure: the International Collaborative POF in Fragile X study--preliminary data". Am. J. Med. Genet. 83 (4): 322–5. PMC 3728646. PMID 10208170.
- ↑ Fedele L, Bianchi S, Tozzi L, Borruto F, Vignali M (1996). "A new laparoscopic procedure for creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome". Fertil. Steril. 66 (5): 854–7. PMID 8893702.
- ↑ Dodé C, Hardelin JP (2009). "Kallmann syndrome". Eur. J. Hum. Genet. 17 (2): 139–46. doi:10.1038/ejhg.2008.206. PMC 2986064. PMID 18985070.
- ↑ Nielsen J, Wohlert M (1991). "Chromosome abnormalities found among 34,910 newborn children: results from a 13-year incidence study in Arhus, Denmark". Hum. Genet. 87 (1): 81–3. PMID 2037286.
- ↑ 11.0 11.1 Timmreck LS, Reindollar RH (2003). "Contemporary issues in primary amenorrhea". Obstet. Gynecol. Clin. North Am. 30 (2): 287–302. PMID 12836721.
- ↑ Bachmann GA, Kemmann E (1982). "Prevalence of oligomenorrhea and amenorrhea in a college population". Am. J. Obstet. Gynecol. 144 (1): 98–102. PMID 7114117.
- ↑ Pettersson F, Fries H, Nillius SJ (1973). "Epidemiology of secondary amenorrhea. I. Incidence and prevalence rates". Am. J. Obstet. Gynecol. 117 (1): 80–6. PMID 4722382.
- ↑ Jones GS, De Moraes-Ruehsen M (1969). "A new syndrome of amenorrhae in association with hypergonadotropism and apparently normal ovarian follicular apparatus". Am. J. Obstet. Gynecol. 104 (4): 597–600. PMID 5786709.
- ↑ Bili H, Laven J, Imani B, Eijkemans MJ, Fauser BC (2001). "Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhoeic infertile women of reproductive years". Eur. J. Endocrinol. 145 (6): 749–55. PMID 11720900.
- ↑ Laughlin GA, Dominguez CE, Yen SS (1998). "Nutritional and endocrine-metabolic aberrations in women with functional hypothalamic amenorrhea". J. Clin. Endocrinol. Metab. 83 (1): 25–32. doi:10.1210/jcem.83.1.4502. PMID 9435412.
- ↑ Patel SS, Bamigboye V (2007). "Hyperprolactinaemia". J Obstet Gynaecol. 27 (5): 455–9. doi:10.1080/01443610701406125. PMID 17701788.
- ↑ 18.0 18.1 Chumlea WC, Schubert CM, Roche AF, Kulin HE, Lee PA, Himes JH, Sun SS (2003). "Age at menarche and racial comparisons in US girls". Pediatrics. 111 (1): 110–3. PMID 12509562.