Korean J Obstet Gynecol.  2010 Jul;53(7):579-593. 10.5468/kjog.2010.53.7.579.

Diagnostic approach of amenorrhea

• Rhee JH

• KMID: 2273938
• DOI: http://doi.org/10.5468/kjog.2010.53.7.579

Abstract

A complete interaction in the hypothalamic-pituitary-ovary-uterus (H-P-O-U) axis must take place in order for normal menstruation occurs. If any of the components in the H-P-O-U axis are nonfunctional, amenorrhea could occur. The prevalence of amenorrhea not due to pregnancy or lactation is approximately 3% to 4% in reproductive women. Because there are many causes of amenorrhea, the clinicians should be concerned with array of potential diseases and disorders involving unfamiliar organ systems, some carrying morbid and even lethal consequences for the patients. To explore the causes of amenorrhea, thorough evaluation of H-P-O-U axis and endocrinologic profiles are needed. The etiologic diagnosis is almost always possible with proceeding step by step approaches.

Keyword

Amenorrhea; Hypothalamic-pituitary-ovary-uterus axis; Causes of amenorrhea; Diagnosis

MeSH Terms

Amenorrhea
Axis, Cervical Vertebra
Female
Humans
Hypogonadism
Lactation
Lifting
Menstruation
Mitochondrial Diseases
Ophthalmoplegia
Pregnancy
Prevalence
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia

Figure

• 

  Fig. 1 Diagnostic approach in patient with amenorrhea. M-R-K-H: Mayer-Rokitansky-Küster-Hauser syndrome, AIS: androgen insensitivity syndrome, LH: luteinizing hormone, FSH: follicle stimulating hormone, TSH: thyroid stimulating hormone, DHEA-S: dehydroepiandrosterone sulfate, POF: premature ovarian failure, PCOS: polycystic ovary syndrome.

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