A Review of Amenorrhea in Women
Corresponding Author(s) : K.Praveena
vemugantipraveena@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 9 No. 2 (2021): 2021 Volume - 9 Issue - 2
Abstract
Amenorrhea is the absence or abnormal cessation of menstrual cycles in a woman of reproductive age. Prolonged cessation of menstrual cycles might result in complications such as infertility, psycho social developmental delays, Osteoporosis, fractures etc. Better understanding of physiology of menstruation is essential to understand the various causes of primary and secondary amenorrhea. Any disruption or functional abnormality in the hypothalamic-pituitary-ovarian axis can result in abnormal menstruation or amenorrhea. Therefore it is crucial to identify this menstrual distress in women at early age to minimize the risks of reproductive dysfunction in premenstrual and post menstrual conditions.
Keywords
LH-(Luteinizing hormone)
FSH(Follicle stimulating hormone)
GnRH(Gonadotropin releasing hormone)
PolyCystic Ovarian Syndrome (PCOS)
AN(Anovulation)
Thyrotropin releasing hormone(TRH)
Müllerian agenesis also known as Mayer–Rokitansky–Küster–Hauser syndrome (MRKH)
1.
Dr.A.Jyothy, Dr.M.Sujatha, Deepika, K.Praveena. A Review of Amenorrhea in Women. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2021 Apr. 19 [cited 2026 Apr. 27];9(2):163-70. Available from: https://ijamscr.com/ijamscr/article/view/991
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References
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1. Practice Committee of American Society for Reproductive Medicine. Current evaluation of amenorrhea.FertilSteril. Speroff L, Fritz MA. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins
2. Euling SY, Herman-Giddens ME, Lee PA, et al. Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics.
3. Reindollar RH, Novak M, Tho SP, McDonough PG. Adult-onset amenorrhea: a study of 262 patients. Am J Obstet Gynecol.
4. Reindollar RH, Byrd JR, McDonough PG. Delayed sexual development: a study of 252 patients. Am J Obstet Gynecol.
5. Nelson LM. Clinical practice. Primary ovarian insufficiency. N Engl J Med.
6. Gordon CM. Clinical practice. Functional hypothalamic amenorrhea. N Engl J Med.
7. Pickett CA. Diagnosis and management of pituitary tumors: recent advances. Prim
8. Welt CK. Primary ovarian insufficiency: a more accurate term for premature ovarian failure. Clin Endocrinol (Oxf).
9. Zieman M, Hatcher RA, Cwiak C, Darney PD, Creinin MD, Stosur HR. A Pocket Guide to Managing Contraception. New York, NY: Ardent Media; 2010.
10. Master-Hunter T, Heiman DL. Amenorrhea: evaluation and treatment. Am Fam Physician. 2006;73(8):1374–1382.
11. Diaz A, Laufer MR, Breech LL; American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics.
12. Rebar RW, Connolly HV. Clinical features of young women with hypergonadotropic amenorrhea. FertilSteril.
13. d'Alva CB, Abiven-Lepage G, Viallon V, et al. Sex steroids in androgen-secreting adrenocortical tumors: clinical and hormonal features in comparison with nontumoral causes of androgen excess. Eur J Endocrinol.
14. Sybert VP, McCauley E. Turner's syndrome. N Engl J Med.
15. Rarick LD, Shangold MM, Ahmed SW. Cervical mucus and serum estradiol as predictors of response to progestin challenge. FertilSteril. 1990;54(2):353–355.
16. Nakamura S, Douchi T, Oki T, Ijuin H, Yamamoto S, Nagata Y. Relationship between sonographic endometrial thickness and progestin-induced withdrawal bleeding. Obstet Gynecol. 1996;87(5 pt 1):722–725.
17. Folch M, Pigem I, Konje JC. Müllerian agenesis: etiology, diagnosis, and management. ObstetGynecolSurv. 2000;55(10):644–649.
18. Maimoun L, Philibert P, Bouchard P, et al. Primary amenorrhea in four adolescents revealed 5?-reductase deficiency confirmed by molecular analysis. FertilSteril. 2011;95(2):804.e1–e5.
19. Capito C, Leclair MD, Arnaud A, et al. 46,XY pure gonadal dysgenesis: clinical presentations and management of the tumor risk. J Pediatr Urol. 2011;7(1):72–75.
20. Yu D, Wong YM, Cheong Y, Xia E, Li TC. Asherman syndrome—one century later. FertilSteril. 2008;89(4):759–779.
21. van Noord PA, Dubas JS, Dorland M, Boersma H, te Velde E. Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. FertilSteril. 1997;68(1):95–102.
22. Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986;67(4):604–606.
23. van Kasteren YM, Schoemaker J. Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy. Hum Reprod Update. 1999;5(5):483–492.
24. Trenor CC III, Chung RJ, Michelson AD, et al. Hormonal contraception and thrombotic risk: a multidisciplinary approach. Pediatrics. 2011;127(2):347–357.
25. Alper MM, Jolly EE, Garner PR. Pregnancies after premature ovarian failure. Obstet Gynecol. 1986;67(3 suppl):59S–62S.
26. Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17(1):25–54.
27. Caronia LM, Martin C, Welt CK, et al. A genetic basis for functional hypothalamic amenorrhea. N Engl J Med. 2011;364(3):215–225.
28. Bachelot A, Rouxel A, Massin N, et al.; POF-GIS Study Group. Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Eur J Endocrinol. 2009;161(1):179–187.
29. Wittenberger MD, Hagerman RJ, Sherman SL, et al. The FMR1 premutation and reproduction. FertilSteril. 2007;87(3):456–465.
References
1. Practice Committee of American Society for Reproductive Medicine. Current evaluation of amenorrhea.FertilSteril. Speroff L, Fritz MA. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins
2. Euling SY, Herman-Giddens ME, Lee PA, et al. Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics.
3. Reindollar RH, Novak M, Tho SP, McDonough PG. Adult-onset amenorrhea: a study of 262 patients. Am J Obstet Gynecol.
4. Reindollar RH, Byrd JR, McDonough PG. Delayed sexual development: a study of 252 patients. Am J Obstet Gynecol.
5. Nelson LM. Clinical practice. Primary ovarian insufficiency. N Engl J Med.
6. Gordon CM. Clinical practice. Functional hypothalamic amenorrhea. N Engl J Med.
7. Pickett CA. Diagnosis and management of pituitary tumors: recent advances. Prim
8. Welt CK. Primary ovarian insufficiency: a more accurate term for premature ovarian failure. Clin Endocrinol (Oxf).
9. Zieman M, Hatcher RA, Cwiak C, Darney PD, Creinin MD, Stosur HR. A Pocket Guide to Managing Contraception. New York, NY: Ardent Media; 2010.
10. Master-Hunter T, Heiman DL. Amenorrhea: evaluation and treatment. Am Fam Physician. 2006;73(8):1374–1382.
11. Diaz A, Laufer MR, Breech LL; American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics.
12. Rebar RW, Connolly HV. Clinical features of young women with hypergonadotropic amenorrhea. FertilSteril.
13. d'Alva CB, Abiven-Lepage G, Viallon V, et al. Sex steroids in androgen-secreting adrenocortical tumors: clinical and hormonal features in comparison with nontumoral causes of androgen excess. Eur J Endocrinol.
14. Sybert VP, McCauley E. Turner's syndrome. N Engl J Med.
15. Rarick LD, Shangold MM, Ahmed SW. Cervical mucus and serum estradiol as predictors of response to progestin challenge. FertilSteril. 1990;54(2):353–355.
16. Nakamura S, Douchi T, Oki T, Ijuin H, Yamamoto S, Nagata Y. Relationship between sonographic endometrial thickness and progestin-induced withdrawal bleeding. Obstet Gynecol. 1996;87(5 pt 1):722–725.
17. Folch M, Pigem I, Konje JC. Müllerian agenesis: etiology, diagnosis, and management. ObstetGynecolSurv. 2000;55(10):644–649.
18. Maimoun L, Philibert P, Bouchard P, et al. Primary amenorrhea in four adolescents revealed 5?-reductase deficiency confirmed by molecular analysis. FertilSteril. 2011;95(2):804.e1–e5.
19. Capito C, Leclair MD, Arnaud A, et al. 46,XY pure gonadal dysgenesis: clinical presentations and management of the tumor risk. J Pediatr Urol. 2011;7(1):72–75.
20. Yu D, Wong YM, Cheong Y, Xia E, Li TC. Asherman syndrome—one century later. FertilSteril. 2008;89(4):759–779.
21. van Noord PA, Dubas JS, Dorland M, Boersma H, te Velde E. Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. FertilSteril. 1997;68(1):95–102.
22. Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986;67(4):604–606.
23. van Kasteren YM, Schoemaker J. Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy. Hum Reprod Update. 1999;5(5):483–492.
24. Trenor CC III, Chung RJ, Michelson AD, et al. Hormonal contraception and thrombotic risk: a multidisciplinary approach. Pediatrics. 2011;127(2):347–357.
25. Alper MM, Jolly EE, Garner PR. Pregnancies after premature ovarian failure. Obstet Gynecol. 1986;67(3 suppl):59S–62S.
26. Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17(1):25–54.
27. Caronia LM, Martin C, Welt CK, et al. A genetic basis for functional hypothalamic amenorrhea. N Engl J Med. 2011;364(3):215–225.
28. Bachelot A, Rouxel A, Massin N, et al.; POF-GIS Study Group. Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Eur J Endocrinol. 2009;161(1):179–187.
29. Wittenberger MD, Hagerman RJ, Sherman SL, et al. The FMR1 premutation and reproduction. FertilSteril. 2007;87(3):456–465.
2. Euling SY, Herman-Giddens ME, Lee PA, et al. Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics.
3. Reindollar RH, Novak M, Tho SP, McDonough PG. Adult-onset amenorrhea: a study of 262 patients. Am J Obstet Gynecol.
4. Reindollar RH, Byrd JR, McDonough PG. Delayed sexual development: a study of 252 patients. Am J Obstet Gynecol.
5. Nelson LM. Clinical practice. Primary ovarian insufficiency. N Engl J Med.
6. Gordon CM. Clinical practice. Functional hypothalamic amenorrhea. N Engl J Med.
7. Pickett CA. Diagnosis and management of pituitary tumors: recent advances. Prim
8. Welt CK. Primary ovarian insufficiency: a more accurate term for premature ovarian failure. Clin Endocrinol (Oxf).
9. Zieman M, Hatcher RA, Cwiak C, Darney PD, Creinin MD, Stosur HR. A Pocket Guide to Managing Contraception. New York, NY: Ardent Media; 2010.
10. Master-Hunter T, Heiman DL. Amenorrhea: evaluation and treatment. Am Fam Physician. 2006;73(8):1374–1382.
11. Diaz A, Laufer MR, Breech LL; American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics.
12. Rebar RW, Connolly HV. Clinical features of young women with hypergonadotropic amenorrhea. FertilSteril.
13. d'Alva CB, Abiven-Lepage G, Viallon V, et al. Sex steroids in androgen-secreting adrenocortical tumors: clinical and hormonal features in comparison with nontumoral causes of androgen excess. Eur J Endocrinol.
14. Sybert VP, McCauley E. Turner's syndrome. N Engl J Med.
15. Rarick LD, Shangold MM, Ahmed SW. Cervical mucus and serum estradiol as predictors of response to progestin challenge. FertilSteril. 1990;54(2):353–355.
16. Nakamura S, Douchi T, Oki T, Ijuin H, Yamamoto S, Nagata Y. Relationship between sonographic endometrial thickness and progestin-induced withdrawal bleeding. Obstet Gynecol. 1996;87(5 pt 1):722–725.
17. Folch M, Pigem I, Konje JC. Müllerian agenesis: etiology, diagnosis, and management. ObstetGynecolSurv. 2000;55(10):644–649.
18. Maimoun L, Philibert P, Bouchard P, et al. Primary amenorrhea in four adolescents revealed 5?-reductase deficiency confirmed by molecular analysis. FertilSteril. 2011;95(2):804.e1–e5.
19. Capito C, Leclair MD, Arnaud A, et al. 46,XY pure gonadal dysgenesis: clinical presentations and management of the tumor risk. J Pediatr Urol. 2011;7(1):72–75.
20. Yu D, Wong YM, Cheong Y, Xia E, Li TC. Asherman syndrome—one century later. FertilSteril. 2008;89(4):759–779.
21. van Noord PA, Dubas JS, Dorland M, Boersma H, te Velde E. Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. FertilSteril. 1997;68(1):95–102.
22. Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986;67(4):604–606.
23. van Kasteren YM, Schoemaker J. Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy. Hum Reprod Update. 1999;5(5):483–492.
24. Trenor CC III, Chung RJ, Michelson AD, et al. Hormonal contraception and thrombotic risk: a multidisciplinary approach. Pediatrics. 2011;127(2):347–357.
25. Alper MM, Jolly EE, Garner PR. Pregnancies after premature ovarian failure. Obstet Gynecol. 1986;67(3 suppl):59S–62S.
26. Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17(1):25–54.
27. Caronia LM, Martin C, Welt CK, et al. A genetic basis for functional hypothalamic amenorrhea. N Engl J Med. 2011;364(3):215–225.
28. Bachelot A, Rouxel A, Massin N, et al.; POF-GIS Study Group. Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Eur J Endocrinol. 2009;161(1):179–187.
29. Wittenberger MD, Hagerman RJ, Sherman SL, et al. The FMR1 premutation and reproduction. FertilSteril. 2007;87(3):456–465.