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	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
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	No underlying causes

Causes in Alphabetical Order

• Liver cirrhosis

• Acromegaly

• Cystic fibrosis

• 18p minus syndrome

• 5-alpha-reductase deficiency

• Achard-Thiers syndrome

• Addison's disease

• Adrenal cortex tumours

• Adrenal gland disorders

• Adrenocortical hyperplasia

• Agenesis of lower vagina

• Ahumada-del castillo syndrome

• Alcoholism

• Anaemia

• Androgen insensitivity syndrome

• Anorexia nervosa

• Anovulation

• Anterior pituitary failure

• Antidepressants

• Antipsychotic agents

• Antipsychotics

• Anxiety

• Arrhenoblastoma

• Asherman syndrome

• Autoimmune adrenalitis

• Autoimmune hepatitis

• Autoimmune oophoritis

• Bearn-Kunkel syndrome

• Blepharophimosis syndrome

• Brain tumor

• Breastfeeding

• Bulimia

• C21-hydroxylase deficiency

• Celiac disease

• Cervical closure

• Chemotherapy

• Chiari-frommel syndrome

• Chromosome 15q duplication syndrome .

• Chromosome 17p, partial deletion

• Chronic alcohol poisoning

• Chronic illness

• Chronic lead poisoning

• Chronic mercury poisoning

• Chronic morphine poisoning

• Chronic renal failure

• Climate change

• Combined oral contraceptive pill

• Complications from d&c procedure

• Congenital adrenal hyperplasia

• Conn syndrome

• Constitutional delay of puberty

• Corpus luteum cyst

• Cortisone reductase deficiency

• Cranial irradiation

• Craniopharyngioma

• Cretinism

• Cushing disease

• Cushing syndrome

• Cyclophosphamide

• Defect in sry gene

• Denys-drash syndrome

• Depression

• Diabetes mellitus

• Dietetic deficiency

• Down's syndrome

• Dystrophia adipose-genitalis

• Eating disorders

• Ectopic pregnancy

• Emotional turmoil

• Empty sella syndrome

• Epirubicin

• Ethanol

• Excessive exercise

• Exogenous androgen use

• Female athlete syndrome

• Fgfr1 mutation

• Fluoxymesterone

• Forbes-albright syndrome

• Frasier syndrome

• Fröhlich's syndrome

• Fsh receptor deficiency

• Galactorrhea

• Galactorrhoea-hyperprolactinaemia

• Galactose-1-phosphate uridyltransferase deficiency

• Germinoma

• Glioma

• Gnrh deficiency

• Gonadal dysgenesis

• Granulosa-cell tumor

• Grief

• Haematocolpos

• Haematometra

• Haematosalpinx

• Haemosiderosis

• Heart disease

• Hepatocellular carcinoma

• Hodgkin's disease

• Hydatidiform mole

• Hyperprolactinaemia

• Hyperthyroidism

• Hypogonadism

• Hypogonadotropic hypogonadism

• Hypokalaemic distal renal tubular acidosis

• Hypopituitarism

• Hypothalamic tumor

• Hypothyroidism

• Hysterectomy

• Imperforate hymen

• Incomplete androgen insensitivity

• Inflammatory bowel disease

• Insanity

• Isolated defect

• Kal1 mutation

• Kallmann syndrome

• Laron syndrome

• Laurence-moon-biedl syndrome

• Leukamia

• Low weight

• Malabsorption syndrome

• Malnutrition

• Masculinization disorders

• Mayer-rokitansky syndrome

• Medroxyprogesterone acetate

• Meninigioma

• Menopause

• Metoclopramide

• Mullerian aplasia .

• Mullerian dysgenesis

• Multiple endocrine neoplasia type 1

• Mumps

• Myxoedema

• Nandrolone

• Nephritis

• Obesity

• Oral contraceptives

• Ovarian cancer

• Ovarian failure

• Ovarian insufficiency due to fsh resistance

• Ovarian insufficiency, familial

• Ovarioleukodystrophy

• Ovary damage

• Panhypopituitarism

• Perimenopause

• Pituitary apoplexy

• Pituitary dwarfism

• Pituitary infarct

• Pituitary tumour

• Polycystic ovary syndrome

• Prader-willi syndrome

• Pregnancy

• Premature ovarian failure

• Primary affective disorder

• Prokr2 mutation

• Prolactinoma

• Proprotein convertase 1/3 deficiency

• Pseudoamenorrhea

• Pseudocyesis

• Pseudohermaphroditism, female

• Radiotherapy

• Rapid weight loss

• Reproductive disorders

• Sheehan syndrome

• Simmond's disease

• Spironolactone

• Stanozolol

• Stein-leventhal syndrome

• Stress

• Systemic lupus erythematosus

• Testicular feminization syndrome

• Testosterone

• Tetrasomy x

• Thyrotoxicosis

• Traumatic brain injury

• Triple x syndrome

• Tubal ligation syndrome

• Tuberculosis

• Turner syndrome

• Underweight

• Uterine aplasia

• Vaginal agenesis

• Vaginal closure

• Vaginal septum

• Vanishing testes syndrome

• Virilizing ovarian tumor

• Vitamin a embryopathy

• Weight gain

• Werner syndrome

• Xy female

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

References