Amenorrhea risk factors
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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
The most common risk factor in the development of primary amenorrhea is chromosomal disorder and the most common risk factor in the development of secondary amenorrhea is breastfeeding. Common risk factors in the development of amenorrhea include risk factors related to hypothalamus, pituitary, ovaries, and also functional amenorrhea. Most common hypothalamic risk factors are Kallmann syndrome and chronic disorders. Most common pituitary risk factors are hyperprolactinemia and pituitary microadenoma.
Risk Factors
- The most common risk factor in the development of primary amenorrhea is chromosomal disorder and the most common risk factor in the development of secondary amenorrhea is breastfeeding.
- Common risk factors in the development of amenorrhea include risk factors related to hypothalamus, pituitary, ovaries, and also functional amenorrhea. The risk factors in the development of amenorrhea, in an order from most common to least common, are as following:
Hypothalamic risk factors
- Kallmann syndrome
- Chronic disorders
- Congenital gonadotropin-releasing hormone deficiency
- Irradiation to the hypothalamus
- Infiltrative disorders of the hypothalamus
- Tumors of the hypothalamus
- Tumors of the brain
- Traumatic brain injury
Pituitary risk factors
- Isolated gonadotropin deficiency
- Postpartum pituitary necrosis (Sheehan syndrome)
- Traumatic brain injury
- Aneurysms of the pituitary
Gonadal risk factors
- Androgen insensitivity syndrome (testicular feminization)
- Autoimmune disorders
- Autoimmune oophoritis (in myasthenia gravis, thyroiditis, or vitiligo)
- Chemotherapy (e.g., high-dose alkylating drugs)
- Congenital adrenal virilism
- Gestational trophoblastic disease
- Drug-induced virilization
- Androgens
- Antidepressants
- Danazol
- High-dose progestins
- Prader-Willi syndrome
- Fragile X syndrome
- Idiopathic accelerated ovarian follicular atresia
Anatomical defects risk factors
- Family history of anatomical defects
- Radiation within pregnancy
- Dilation and curettage (D & C)
- Prior complicated Cesarean section
- Severe pelvic inflammatory disease (PID)-induced adhesion
- Uterus scarring
Functional amenorrhea risk factors
Miscellaneous
High risk sports in female athletes
- Cross country
- Ballet
- Track and Field
- Swimming
- Cycling
- Rowing
- Diving
- Figure skating
- Gymnastics
- All other intense and strenuous sports