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{{Amenorrhea}}
{{Amenorrhea}}


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==Overview==
==Overview==
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==
Risk factors for [[amenorrhea]] include:
 
* Drugs - [[Progestogen only pill|contain only progestogen]] like the oral contraceptive Micronor, and especially higher-dose formulations like the injectable [[Depo Provera]] commonly induce amenorrhea.
*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]].
* High risk sports such as the following can lead to amenorrhea in female athletes:
*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>
** Cross country
 
** Ballet
===Hypothalamic risk factors===
** Track and Field
 
** Swimming
*[[Kallmann syndrome]]
** Cycling
*Chronic disorders
** Rowing
**[[Crohn disease]]
** Diving
**[[Cystic fibrosis]]
** Figure skating
**[[Sickle cell disease]]
** Gymnastics
**[[Thalassemia major]]
** All other intense and strenuous sports
 
* [[Dilation and curettage]] (D and C)
*Congenital [[gonadotropin-releasing hormone]] deficiency
* Being born with poorly formed genital or pelvic organs (missing uterus or vagina, vaginal septum, cervical stenosis, or imperforate hymen) can lead to primary amenorrhea.
 
*[[Irradiation]] to the [[hypothalamus]]
 
*Infiltrative disorders of the [[hypothalamus]]
**[[Langerhans cell granulomatosis]]
**[[Lymphoma]]
**[[Sarcoidosis]]
**[[TB|Tuberculosis (TB)]]
 
*[[Tumors]] of the [[hypothalamus]]
*[[Tumors]] of the [[brain]]
**[[Meningioma]]
**[[Craniopharyngioma]]
**[[Gliomas]]
*[[Traumatic brain injury]]
 
===Pituitary risk factors===
 
*[[Hyperprolactinemia]]
*[[Pituitary microadenoma]]
*[[Cushing syndrome]]
 
*[[GnRH]] receptor [[gene]] mutations
*Infiltrative disorders of the [[pituitary]]
**[[Hemochromatosis]]
**[[Langerhans cell granulomatosis]]
**[[Sarcoidosis]]
**[[TB]]
 
*Isolated [[gonadotropin]] deficiency
*[[Sheehan's syndrome|Postpartum pituitary necrosis (Sheehan syndrome)]]
*[[Traumatic brain injury]]
*[[Aneurysms]] of the [[pituitary]]
 
===Gonadal risk factors===
 
*[[Turner syndrome]]
 
*[[Androgen insensitivity syndrome]] ([[testicular feminization]])
*[[Autoimmune disorders]]
**[[Autoimmune]] [[oophoritis]] (in [[myasthenia gravis]], [[thyroiditis]], or [[vitiligo]])
 
*[[Chemotherapy]] (e.g., high-dose [[Alkylating agent|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]]
 
*[[Gonadal dysgenesis]]
*[[Irradiation]] to the [[pelvis]]
*[[True hermaphroditism]]
 
*[[Tumors]] producing [[androgens]] ([[ovarian]] or [[adrenal]])
 
*[[Viral infections]] ([[mumps]])
 
===Anatomical defects risk factors===
 
*Family history of anatomical defects
*[[Radiation]] within [[pregnancy]]
*[[Dilation and curettage (patient information)|Dilation and curettage]] (D & C)
*Prior complicated [[Cesarean section]]
*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]]
*[[Hypothyroidism]]
 
*[[HIV infection]]
*[[Drug abuse]]
 
*[[Alcohol]]
*[[Cocaine]]
*[[Marijuana]]
*[[Opioids]]
 
*[[Immunodeficiency]]
 
*[[Metabolic disorders]]
**[[Addison disease]]
**[[Diabetes mellitus]]
**[[Galactosemia]]
 
*[[Psychiatric disorders]]
**[[Stress]]
**[[Depression]]
**[[Obsessive-compulsive disorder]]
**[[Schizophrenia]]
**[[Psychoactive drugs]]
 
====High risk sports in female athletes====
 
*Cross country
*Ballet
*Track and Field
*[[Swimming]]
*[[Cycling]]
*[[Rowing exercise|Rowing]]
*Diving
*Figure skating
*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

Pituitary risk factors

Gonadal risk factors

Anatomical defects risk factors

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

  1. ↑ "Current evaluation of amenorrhea". Fertil. Steril. 90 (5 Suppl): S219–25. 2008. doi:10.1016/j.fertnstert.2008.08.038. PMID 19007635.
  2. ↑ 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.


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