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Symptoms and Signs – Differential Diagnosis of Amenorrhoea
Non-pathological: pregnancy, lactation, menopause, drugs (e.g. Depo-Provera)
Hypothalamus: starvation, anorexia, excessive exercise, weight loss, GnRH
deficiency (isolated or part of Kallmann's syndrome)
Pituitary: hypopituitarism, hyperprolactinaemia
Ovaries: PCOS, premature ovarian failure, damage to ovaries (infection e.g.
mumps, autoimmune, surgery, radiotherapy), ovarian dysgensis (e.g. Turner's
syndrome)
Uterus/vagina: absent uterus, imperforate hymen, transverse vaginal septum
Asherman's syndrome: scarring of endometrial lining 2° to infection and
instrumentation, e.g. D&C
Thyroid: hypo/hyperthyroidism
Adrenals: adrenal tumours, Cushing's syndrome
Note: The causes in italics present only with primary amenorrhoea.
Non-pathological: pregnancy, lactation, menopause, drugs (e.g. Depo-Provera)
Hypothalamus: starvation, anorexia, excessive exercise, weight loss, GnRH
deficiency (isolated or part of Kallmann's syndrome)
Pituitary: hypopituitarism, hyperprolactinaemia
Ovaries: PCOS, premature ovarian failure, damage to ovaries (infection e.g.
mumps, autoimmune, surgery, radiotherapy), ovarian dysgensis (e.g. Turner's
syndrome)
Uterus/vagina: absent uterus, imperforate hymen, transverse vaginal septum
Asherman's syndrome: scarring of endometrial lining 2° to infection and
instrumentation, e.g. D&C
Thyroid: hypo/hyperthyroidism
Adrenals: adrenal tumours, Cushing's syndrome
Note: The causes in italics present only with primary amenorrhoea.
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