Amenorrhea causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
Overview
Common causes of amenorrhea include breastfeeding, pregnancy, menopause, and stress. Causes of amenorrhea can be divided upon the classification of the disease, include primary amenorrhea (craniopharyngioma, idiopathic gonadotropin deficiency, Kallmann's Syndrome, Mayer-Rokitansky-Hauser Syndrome, Mullerian dysgenesis, and outflow tract disorders), secondaary amenorrhea (craniocerebral trauma, curettage, Cushing's Syndrome, depression, diabetes mellitus, and drug side effects), and functional amenorrhea (stress, rapid weight loss, and excessive exercise).
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of delayed puberty, however complications resulting from untreated delayed puberty are common.
Common Causes
- Breastfeeding
- Menopause
- Pregnancy
- Stress
- Turner syndrome
- Excessive exercise
- Dieting
- Obesity
- Hyperthyroidism
- Hypothyroidism
Less Common Causes
- Androgen insensitivity syndrome (testicular feminization)
- Autoimmune disorders
- Autoimmune oophoritis (in myasthenia gravis, thyroiditis, or vitiligo)
- Aneurysms of the pituitary
- Cachexia
- Chronic disorders
- Chemotherapy (eg, high-dose alkylating drugs)
- Congenital adrenal virilism
- Cushing syndrome
- Drug abuse
- Drug-induced virilization
- Androgens
- Antidepressants
- Danazol
- High-dose progestins
- Eating disorders
- Genetic disorder
- Congenital gonadotropin-releasing hormone deficiency
- GnRH receptor gene mutations
- Prader-Willi syndrome
- Congenital thymic aplasia
- Fragile X syndrome
- Idiopathic accelerated ovarian follicular atresia
- Gestational trophoblastic disease
- Gonadal dysgenesis
- HIV infection
- Hyperprolactinemia
- Idiopathic hypogonadotropic hypogonadism
- Infiltrative disorders of the pituitary
- Isolated gonadotropin deficiency
- Immunodeficiency
- Infiltrative disorders of the hypothalamus
- Irradiation to the pelvis
- Irradiation to the hypothalamus
Causes by Organ System
Causes in Alphabetical Order
Causes Based on Classification
Primary Amenorrhea[5][6]
- 17 beta-hydroxysteroid dehydrogenase deficiency
- Agonadism
- 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
- Trauma
- Turner's Syndrome
- Uterine atresia
- Uterine hypoplasia
- Vaginal atresia / gynatresia
Secondary Amenorrhea
- 5-alpha-reductase deficiency
- Addiction
- Addison's Disease
- Adrenocortical insuffiency
- Adrenal tumors
- Asherman's Syndrome
- Autoimmune diseases
- Body building (use of androgens)
- Castration (radiation or surgical)
- Central nervous system (CNS) tumor
- Cervical stenosis
- Change of environment
- Complete and incomplete androgen insensitivity
- Congenital adrenal hyperplasia
- Craniocerebral trauma
- Curettage
- 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, and Trifluoperazine)
- Encephalitis
- Enzymatic defects in testosterone biosynthesis
- Exposure to maternal androgens in utero
- Extreme obesity
- During chemotherapy
- 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 and severe pelvic inflammatory disease)
- Post-operative gonadotropin deficiency
- Pregnancy
- Premature menopause
- Prolactinoma
- Radiation
- Sheehan's Syndrome
- 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
Functional amenorrhea
- Stress
- Eating disorders
- Excessive exercise
- Weight loss
References
- ↑ Abed J, Judeh H, Abed E, Kim M, Arabelo H, Gurunathan R (2014). ""Fixing a heart": the game of electrolytes in anorexia nervosa". Nutr J. 13: 90. doi:10.1186/1475-2891-13-90. PMC 4168120. PMID 25192814.
- ↑ Andersen AE, Ryan GL (2009). "Eating disorders in the obstetric and gynecologic patient population". Obstet Gynecol. 114 (6): 1353–67. doi:10.1097/AOG.0b013e3181c070f9. PMID 19935043.
- ↑ Shaikh NB, Shaikh S, Shaikh F (2014). "A clinical study of ectopic pregnancy". J Ayub Med Coll Abbottabad. 26 (2): 178–81. PMID 25603672.
- ↑ Hobart JA, Smucker DR (2000). "The female athlete triad". Am Fam Physician. 61 (11): 3357–64, 3367. PMID 10865930.
- ↑ 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