Amenorrhea
Amenorrhea: Excerpt from A Pocket Manual of Differential Diagnosis
Hypothalamic and Pituitary Causes
Androgen excess
Chorionic gonadotropin-secreting tumors
Chronic debilitating diseases (e.g., liver disease, uremia, regional ileitis)
Congenital hypothalamic hypogonadism
Idiopathic
With anosmia or hyposmia (Kallman's syndrome)
Cushing's syndrome
Defects in gonadotropin synthesis
Estrogen-secreting ovarian or adrenal tumors
Gonadotropin-secreting pituitary tumors
Hypopituitarism
Hypothalamic-pituitary dysfunction due to extrinsic factors
Anovulation
Hypothyroidism
Obesity
Perimenopause
Hyperprolactinemia
Lactation
Nutritional
Acute weight loss
Malnutrition (including anorexia nervosa)
Underweight
Post-pill amenorrhea
Pregnancy
Pseudocyesis
Strenuous exercise
Stress
Thyrotoxicosis
Idiopathic delayed puberty
Secretion of biologically inactive gonadotropin
Ovarian Causes
Acquired (premature ovarian failure)
Autoimmune
Chemotherapy
Idiopathic (premature menopause)
Myotonic dystrophy
Postinfection
Mumps oophoritis
Severe pelvic inflammatory disease
Radiation
Surgical castration
Trauma
Congenital
Congenital thymic aplasia
Galactosemia
Gonadal agenesis
Gonadal dysgenesis (including Turner's syndrome)
Ovarian enzymatic deficiency
17
α-Hydroxylase deficiency
17,20-Lyase deficiency
Resistant ovary syndrome (Savage syndrome)
Sex chromosome mosaicism
Trisomy X
True hermaphroditism
XY gonadal dysgenesis
Menopause
Uterine and Outflow Tract Abnormalities
Female pseudohermaphroditism
Congenital adrenal hyperplasia
Exposure to maternal androgens
in utero
Hysterectomy
Male pseudohermaphroditism
5
α-Reductase deficiency
Complete and incomplete androgen insensitivity
Enzymatic defects in testosterone biosynthesis
Müllerian agenesis
Müllerian anomalies
Absence or anomalies of vagina, cervix, endometrium, or endometrial cavity
Imperforate hymen
Labial agglutination or fusion
Trauma (including surgical)
Cervical stenosis
Sclerosis of the uterine cavity (Asherman's syndrome)
Abortion
After uterine surgery (caesarian section, metroplasty, myomectomy)
Repeated or overzealous uterine curettage
Severe, generalized pelvic infections
Tuberculous endometritis
Uterine schistosomiasis
Vaginal stenosis
References
1. Speroff L, Glass RH, Kase NG: Amenorrhea. pp. 418–445. See Bibliography, 8.
2. McIver B, Romanski SA, Nippoldt TB: Evaluation and Management of Amenorrhea.
Mayo Clin Proc 72:1161–1169, 1997.
Book Source Details
- Book Title: A Pocket Manual of Differential Diagnosis
- Author(s): Stephen N. Adler, Dianne B. Gasbarra
- Year of Publication: 1999
- Copyright Details: A Pocket Manual of Differential Diagnosis, Copyright © 1999 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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