Last reviewed: 25 Aug 2021
Last updated: 06 Jul 2018

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

Meir Jonathon Solnik, MD
Meir Jonathon Solnik

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.

Acknowledgements

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

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.

Mary Ann Lumsden, BSc Hons, MBBS, MRCOG, MD, FRCOG

Head of Section

Reproductive and Maternal Medicine

University of Glasgow Royal Infirmary

Glasgow

Scotland

Disclosures

MAL declares that she has no competing interests.

Robert Shaw, MD

Professor and Chair

Department of Neurology

Wake Forest University School of Medicine

Winston-Salem

NC

Disclosures

RS declares that he has no competing interests.

  • Evaluation of primary amenorrhea images

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