Summary
Differentials
Common
- Primary hypothalamic amenorrhea
- Emotional/physical stress, eating disorder or female athlete triad
- Constitutional delay
- Malnutrition or chronic disease state
- Kallman syndrome (hypogonadotropic hypogonadism)
- Hyperprolactinemia
- Polycystic ovary syndrome (PCOS)
- 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
- Gonadotropin-releasing hormone (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
Associate Professor of Obstetrics and Gynecology
Temerty Faculty of Medicine
University of Toronto
Head of Gynecology and Minimally Invasive Surgery
Mount Sinai Hospital & Women’s College Hospital
Toronto
Canada
Disclosures
MJS is a consultant for Medtronic, Olympus, Hologic, and Abbvie; and has stock in Field Trip Health Ltd and Felix Health, Canada.
Acknowledgements
Dr Meir Jonathon Solnik would like to gratefully acknowledge Dr Jessica Papillon-Smith, a previous contributor to this topic.
Disclosures
JP-S declared that she had 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.
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