Summary
Differentials
Common
- Eating disorders or female athlete triad
- Emotional or physical stress
- Postcontraception with depot medroxyprogesterone
- Hyperprolactinemia
- Polycystic ovary syndrome (PCOS)
- Idiopathic premature ovarian failure
- Postchemoradiation ovarian failure
- Chromosomal abnormality (Fragile X carrier, Turner syndrome mosaic)
- Nonclassic congenital adrenal hyperplasia
- Hypothyroidism
Uncommon
- Malnutrition or chronic disease state
- Empty sella syndrome
- Sheehan syndrome (postpartum pituitary necrosis)
- Postencephalitis
- Androgen-producing ovarian tumor
- Autoimmune premature ovarian failure
- Androgen-producing adrenal tumor
- Cushing syndrome
- Asherman syndrome
- Drug-induced
Contributors
Authors
Meir Jonathon Solnik, MD

Associate Professor of Obstetrics and Gynaecology
University of Toronto Faculty of Medicine
Head of Gynaecology and Minimally Invasive Surgery
Sinai Health System
Site Chief of Gynaecology
Women’s College Hospital
Toronto
Canada
Disclosures
MJS is a consultant for Pfizer, Abbvie, and Integra Life Sciences. He has previously been a consultant for Medtronic. He is an advisor for Felix Health.
Peer reviewers
Joseph S. Sanfilippo, MD, MBA
Professor
Department of Obstetrics, Gynecology, and Reproductive Sciences
Vice Chairman
Reproductive Sciences
Director
Division of Reproductive Endocrinology and Infertility
University of Pittsburgh
Pittsburgh
PA
Disclosures
JSS declares that he has no competing interests.
References
Key articles
Practice Committee of the American Society for Reproductive Medicine. Current evaluation of amenorrhea: a committee opinion. Fertil Steril. 2024 Jul;122(1):52-61.Full text Abstract
Goodman LR, Warren MP. The female athlete and menstrual function. Curr Opin Obstet Gynecol. 2005 Oct;17(5):466-70. Abstract
Wellons MF, Weeber KM, Rebar RW. Amenorrhea. In: Falcone T, Hurd WW, eds. Clinical reproductive medicine and surgery: a practical guide. 3rd ed. Heidelberg: Springer International Publishing; 2017:109-22.
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Patient information
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