AMENORRHEA (Part Two)

Etiology

Amenorrhea is divided into 2 main forms:

1. Amenorrhea without accompanying signs of androgen excess
2. Amenorrhea accompanied by signs of increased androgen levels (hirsutism, virilization, obesity). It is most often encountered in Polycystic Ovary Syndrome.

Based on the time of onset, it is divided into:

1. Primary amenorrhea
2. Secondary amenorrhea

Causes of Amenorrhea:

1. Natural
   • Pregnancy
   • Menopause
2. Contraceptive
   • Oral contraceptives
   • Implants
   • IUD (Intrauterine Device)
3. Pharmaceutical
   • Medications
   • Antihypertensives
   • Antidepressants
   • Antipsychotics
   • Antiallergics
   • Chemotherapy
4. Lifestyle
   • Mental stress
   • Increased physical activity
   • Very low body weight (anorexia, bulimia)
5. Hormonal Disorders
   • Hypothalamic and pituitary tumors
   • Premature menopause (before the age of 40)
   • Polycystic Ovary Syndrome (PCOS)
   • Thyroid disorders (hypothyroidism and hyperthyroidism)
6. Organic Causes
   • Missing reproductive organs
   • Structural anomalies of the vagina (membranes or walls that obstruct blood flow)
   • Uterine scarring (Asherman's syndrome, cesarean section, surgical treatment of uterine fibroids)