Summary
Differentials
Common
- Primary hypothalamic amenorrhea
- Emotional/physical stress or female athlete triad
- Constitutional delay
- Malnutrition or chronic disease state
- Kallman syndrome (hypogonadotropic hypogonadism)
- Hyperprolactinemia
- Polycystic ovary syndrome
- Non-classic congenital adrenal hyperplasia
- Turner syndrome or mixed gonadal dysgenesis
- Mayer-Rokitansky-Kuster-Hauser syndrome (Mullerian agenesis)
- Outflow tract obstruction, including imperforate hymen or transverse vaginal septum
Uncommon
- Craniopharyngioma
- GnRH receptor deficiency
- Post-encephalitis
- Androgen-producing ovarian tumor
- Androgen-producing adrenal tumor
- Bilateral agenesis testes (Swyer syndrome)
- 5-alpha-reductase deficiency
- 17-alpha-hydroxylase (CYP17) deficiency
- Androgen insensitivity syndrome
Contributors
Authors

Associate Professor
Director
Division of Urogynecology
Director
Center for Minimally Invasive Gynecologic Surgery
Cedars-Sinai Medical Center
Los Angeles
CA
Disclosures
MJS is a consultant for Medtronic, serves on the advisory boards of Abbvie and Allergan, and has been a moderator for Bayer.
MJS would like to gratefully acknowledge Jessica Papillon-Smith, a previous contributor to this topic. JP-S declares that she has no competing interests.
Peer reviewers
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.
Head of Section
Reproductive and Maternal Medicine
University of Glasgow Royal Infirmary
Glasgow
Scotland
Disclosures
MAL declares that she has no competing interests.
Professor and Chair
Department of Neurology
Wake Forest University School of Medicine
Winston-Salem
NC
Disclosures
RS declares that he has no competing interests.
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