Amenorrhea risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
Common risk factors in the development of [ | 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== | ==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 | |||
** [[Crohn disease]] | |||
* | ** [[Cystic fibrosis]] | ||
**[[Sickle cell disease]] | |||
**[[Thalassemia major]] | |||
* | |||
* | |||
* | |||
* [[ | |||
* Congenital [[gonadotropin-releasing hormone]] deficiency | |||
* [[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]] | |||
* 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}} | ||
Revision as of 14:48, 26 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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