Amenorrhea risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
The most common risk factor in the development of primary amenorrhea | The most common risk factor in the development of primary amenorrhea include [[chromosomal disorder|chromosomal disorders]] 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== | ==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]]. | *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:<ref name="pmid19007635">{{cite journal |vauthors= |title=Current evaluation of amenorrhea |journal=Fertil. Steril. |volume=90 |issue=5 Suppl |pages=S219–25 |year=2008 |pmid=19007635 |doi=10.1016/j.fertnstert.2008.08.038 |url=}}</ref><ref name="pmid18574222">{{cite journal |vauthors=Golden NH, Carlson JL |title=The pathophysiology of amenorrhea in the adolescent |journal=Ann. N. Y. Acad. Sci. |volume=1135 |issue= |pages=163–78 |year=2008 |pmid=18574222 |doi=10.1196/annals.1429.014 |url=}}</ref> | *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:<ref name="pmid19007635">{{cite journal |vauthors= |title=Current evaluation of amenorrhea |journal=Fertil. Steril. |volume=90 |issue=5 Suppl |pages=S219–25 |year=2008 |pmid=19007635 |doi=10.1016/j.fertnstert.2008.08.038 |url=}}</ref><ref name="pmid18574222">{{cite journal |vauthors=Golden NH, Carlson JL |title=The pathophysiology of amenorrhea in the adolescent |journal=Ann. N. Y. Acad. Sci. |volume=1135 |issue= |pages=163–78 |year=2008 |pmid=18574222 |doi=10.1196/annals.1429.014 |url=}}</ref> | ||
=== Hypothalamic risk factors === | ===Hypothalamic risk factors=== | ||
* [[Kallmann syndrome]] | |||
* Chronic disorders | *[[Kallmann syndrome]] | ||
** [[Crohn disease]] | *Chronic disorders | ||
** [[Cystic fibrosis]] | **[[Crohn disease]] | ||
**[[Cystic fibrosis]] | |||
**[[Sickle cell disease]] | **[[Sickle cell disease]] | ||
**[[Thalassemia major]] | **[[Thalassemia major]] | ||
* Congenital [[gonadotropin-releasing hormone]] deficiency | *Congenital [[gonadotropin-releasing hormone]] deficiency | ||
* [[Irradiation]] to the [[hypothalamus]] | *[[Irradiation]] to the [[hypothalamus]] | ||
* Infiltrative disorders of the [[hypothalamus]] | *Infiltrative disorders of the [[hypothalamus]] | ||
** [[Langerhans cell granulomatosis]] | **[[Langerhans cell granulomatosis]] | ||
** [[Lymphoma]] | **[[Lymphoma]] | ||
**[[Sarcoidosis]] | **[[Sarcoidosis]] | ||
**[[TB|Tuberculosis (TB)]] | **[[TB|Tuberculosis (TB)]] | ||
* [[Tumors]] of the [[hypothalamus]] | *[[Tumors]] of the [[hypothalamus]] | ||
* [[Tumors]] of the [[brain]] | *[[Tumors]] of the [[brain]] | ||
** [[Meningioma]] | **[[Meningioma]] | ||
** [[Craniopharyngioma]] | **[[Craniopharyngioma]] | ||
**[[Gliomas]] | **[[Gliomas]] | ||
*[[Traumatic brain injury]] | *[[Traumatic brain injury]] | ||
=== Pituitary risk factors === | ===Pituitary risk factors=== | ||
*[[Hyperprolactinemia]] | *[[Hyperprolactinemia]] | ||
*[[Pituitary microadenoma]] | *[[Pituitary microadenoma]] | ||
*[[Cushing syndrome]] | *[[Cushing syndrome]] | ||
* [[GnRH]] receptor [[gene]] mutations | *[[GnRH]] receptor [[gene]] mutations | ||
* Infiltrative disorders of the [[pituitary]] | *Infiltrative disorders of the [[pituitary]] | ||
** [[Hemochromatosis]] | **[[Hemochromatosis]] | ||
** [[Langerhans cell granulomatosis]] | **[[Langerhans cell granulomatosis]] | ||
**[[Sarcoidosis]] | **[[Sarcoidosis]] | ||
**[[TB]] | **[[TB]] | ||
* Isolated [[gonadotropin]] deficiency | *Isolated [[gonadotropin]] deficiency | ||
* [[Sheehan's syndrome|Postpartum pituitary necrosis (Sheehan syndrome)]] | *[[Sheehan's syndrome|Postpartum pituitary necrosis (Sheehan syndrome)]] | ||
* [[Traumatic brain injury]] | *[[Traumatic brain injury]] | ||
* [[Aneurysms]] of the [[pituitary]] | *[[Aneurysms]] of the [[pituitary]] | ||
===Gonadal risk factors=== | |||
*[[Turner syndrome]] | |||
* [[Turner syndrome]] | |||
*[[Androgen insensitivity syndrome]] ([[testicular feminization]]) | *[[Androgen insensitivity syndrome]] ([[testicular feminization]]) | ||
| Line 60: | Line 64: | ||
**[[Autoimmune]] [[oophoritis]] (in [[myasthenia gravis]], [[thyroiditis]], or [[vitiligo]]) | **[[Autoimmune]] [[oophoritis]] (in [[myasthenia gravis]], [[thyroiditis]], or [[vitiligo]]) | ||
* [[Chemotherapy]] (e.g., high-dose [[Alkylating agent|alkylating drugs]]) | *[[Chemotherapy]] (e.g., high-dose [[Alkylating agent|alkylating drugs]]) | ||
* Congenital [[adrenal]] [[virilism]] | *Congenital [[adrenal]] [[virilism]] | ||
* [[Gestational trophoblastic disease]] | *[[Gestational trophoblastic disease]] | ||
* Drug-induced [[virilization]] | *Drug-induced [[virilization]] | ||
** [[Androgens]] | **[[Androgens]] | ||
** [[Antidepressants]] | **[[Antidepressants]] | ||
**[[Danazol]] | **[[Danazol]] | ||
**High-dose [[progestins]] | **High-dose [[progestins]] | ||
| Line 73: | Line 77: | ||
*Idiopathic accelerated [[ovarian]] [[follicular atresia]] | *Idiopathic accelerated [[ovarian]] [[follicular atresia]] | ||
* [[Gonadal dysgenesis]] | *[[Gonadal dysgenesis]] | ||
* [[Irradiation]] to the [[pelvis]] | *[[Irradiation]] to the [[pelvis]] | ||
* [[True hermaphroditism]] | *[[True hermaphroditism]] | ||
*Tumors producing [[androgens]] ([[ovarian]] or [[adrenal]]) | *[[Tumors]] producing [[androgens]] ([[ovarian]] or [[adrenal]]) | ||
*[[Viral infections]] ([[mumps]]) | *[[Viral infections]] ([[mumps]]) | ||
=== Anatomical defects risk factors === | ===Anatomical defects risk factors=== | ||
* Family history of anatomical defects | |||
* [[Radiation]] within [[pregnancy]] | *Family history of anatomical defects | ||
* [[Dilation and curettage (patient information)|Dilation and curettage]] (D & C) | *[[Radiation]] within [[pregnancy]] | ||
* Prior complicated [[Cesarean section]] | *[[Dilation and curettage (patient information)|Dilation and curettage]] (D & C) | ||
* Severe [[Pelvic inflammatory disease|pelvic inflammatory disease (PID)]]-induced [[adhesion]] | *Prior complicated [[Cesarean section]] | ||
* [[Uterus]] [[scarring]] | *Severe [[Pelvic inflammatory disease|pelvic inflammatory disease (PID)]]-induced [[adhesion]] | ||
*[[Uterus]] [[scarring]] | |||
===Functional amenorrhea risk factors=== | |||
*[[Stress]] | |||
*[[Exercise|Excessive exercise]] | |||
*[[Dieting]] | |||
*[[Obesity]] | |||
*[[Cachexia]] | |||
*[[Eating disorders]] | |||
* [[ | **[[Anorexia nervosa]] | ||
* | **[[Bulimia]] | ||
* [[ | |||
* | |||
* [[ | |||
* [[ | *[[Malnutrition]] | ||
===Miscellaneous=== | |||
*[[Hyperthyroidism]] | *[[Hyperthyroidism]] | ||
*[[Hypothyroidism]] | *[[Hypothyroidism]] | ||
* [[HIV infection]] | *[[HIV infection]] | ||
* [[Drug abuse]] | *[[Drug abuse]] | ||
*[[Alcohol]] | *[[Alcohol]] | ||
| Line 114: | Line 121: | ||
*[[Opioids]] | *[[Opioids]] | ||
* [[Immunodeficiency]] | *[[Immunodeficiency]] | ||
* [[Metabolic disorders]] | *[[Metabolic disorders]] | ||
** [[Addison disease]] | **[[Addison disease]] | ||
** [[Diabetes mellitus]] | **[[Diabetes mellitus]] | ||
**[[Galactosemia]] | **[[Galactosemia]] | ||
| Line 128: | Line 135: | ||
**[[Psychoactive drugs]] | **[[Psychoactive drugs]] | ||
==== High risk sports in female athletes ==== | ====High risk sports in female athletes==== | ||
* Cross country | |||
* Ballet | *Cross country | ||
* Track and Field | *Ballet | ||
* [[Swimming]] | *Track and Field | ||
* [[Cycling]] | *[[Swimming]] | ||
* [[Rowing exercise|Rowing]] | *[[Cycling]] | ||
* Diving | *[[Rowing exercise|Rowing]] | ||
* Figure skating | *Diving | ||
* Gymnastics | *Figure skating | ||
* All other intense and strenuous sports | *Gymnastics | ||
*All other intense and strenuous sports | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Gynecology]] | |||
[[Category:Obstetrics]] | |||
Latest revision as of 15:45, 21 May 2021
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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 include chromosomal disorders 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:[1][2]
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
References
- ↑ "Current evaluation of amenorrhea". Fertil. Steril. 90 (5 Suppl): S219–25. 2008. doi:10.1016/j.fertnstert.2008.08.038. PMID 19007635.
- ↑ Golden NH, Carlson JL (2008). "The pathophysiology of amenorrhea in the adolescent". Ann. N. Y. Acad. Sci. 1135: 163–78. doi:10.1196/annals.1429.014. PMID 18574222.