What are the causes of amenorrhoea?

The causes of amenorrhoea can be classified as follows:

Uterine causes

  • Asherman's syndrome - this condition results from damage to the lining of the uterus (the endometrium).
  • Pregnancy
  • Congenital abnormality - Mullerian agenesis, Testicular Feminisation Syndrome, Imperforate Hymen.

Ovarian causes

  • Polycystic ovarian syndrome
  • Premature ovarian failure - this results in an early menopause
  • Menopause
  • Gonadal dysgenesis - results in the abnormal development of the ovary
  • Resistant ovarian syndrome - in this condition the ovary is resistant to circulating hormones

Pituitary causes

  • Hyperprolactinaemia - for more details click here
  • Pituitary adenoma - for more details click here
  • Craniopharygioma
  • Pituitary Necrosis
  • Sheehan's syndrome - during pregnancy, the blood flow through the pituitary gland increases. This syndrome results from the vasoconstriction after a post-partum haemorrhage. This decrease in blood flow to the pituitary results in infarction and either acute or chronic symptoms of hypopituitarism.
  • Pituitary apoplexy - this is a dramatic condition in which a pre-existing adenoma undergoes infarction usually involving some haemorrhage. The patient may present with a sudden collapse and will later show either single or multiple hormone deficiencies.

Hypothalamic causes

  • Anorexia
  • Starvation
  • Stress
  • Excess Exercise
  • Kallmann's syndrome - a rare congenital condition of hypogonadotrophic hypogonadism.

Other Endocrine causes

  • Hypothyroidism
  • Hyperthyroidism
  • Cushing's syndrome
  • Androgen secreting tumour