CAUSES OF PRIMARY

AMENORRHOEA
CAUSES
1. HYPOGONADOTROPHIC HYPOGONADISM
2. HYPERGONADOTROPHIC HYPOGONADISM
3. ABNORMAL CHROMOSOMAL PATTERN
4. DEVELOPMENTAL DEFECT OF GENITAL TRACT
5. DYSFUNCTION OF THYROID AND ADRENAL CORTEX
6. METABOLIC DISORDERS
7. SYSTEMIC ILLNESS
8. UNRESPONSIVE ENDOMETRIUM
HYPOGONADOTROPHIC
HYPOGONADISM
1. DELAYED PUBERTY: DELAY IN GnRH
REACTIVATION
2. HYPOTHALAMIC & PITUITARY
DYSFUNCTION: GONADOTROPHIN
DEFICIENCY DUE TO STRESS, CHRONIC
DISEASE
3. KALLMANNS SYNDROME: IT IS A SYNDROME
WHERE THERE IS A DELAY OR ABSENT IN
THE PUBERTY DUE TO INADEQUATE GnRH
HYPERGONADOTROPHIC HYPOGONADISM

1. PRIMARY OVARIAN FAILURE/PREMATURE

OVARIAN INSUFFICIENCY OR FAILURE: loss of
function of ovaries
2. RESISTANT OVARIAN SYNDROME/ SAVAGE
SYNDROME: FUNCTIONAL DISTURBANCE OF
GOADOTROPHIN RECEPTORS IN THE OVARIAN
FOLLLICLES.
3. ENZYME DEFICIENCY: 17 alpha hydroxylase
deficiency this synthesis cortisol and sex
steroids
4. Others: gonadotrophin receptors mutations
leads to decrease in FSH & LH levels
ABNORMAL CHROMOSOMAL PATTERN

1. Turners syndrome : missing x chromosome in sex

chromosome of female
2. Various mosaic state: presence of different
genotype in one individual
3. Pure gonadal dysgenesis: congenital
developmental disorder o the reproductive system
– loss of germ cells on the gonads- streak gonads-
non functional
4. Androgen insensitivity syndrome: partial or
complete inability of cells to respond to
androgens
DEVELOPMENTAL DEFECT OF GENITAL TRACT

1.Imperforated hymen : congenital disorder where

hymen without an opening completely obstructs the
vagina
2. Transverse vaginal septum
3. Atresia of upper third of vagina and cervix
4. Complete absence of vagina
5. Absence of uterus
DYSFUNCTION OF THYROID AND ADRENAL
CORTEX

1. Adrenogenital syndrome/ congenital

adrenal hyperplasia: it involves excessive or
deficient production of sex steroids
2. Cretinism: is a condition of severely
stunted physical and mental growth due to
untreated congenital deficiency of thyroid
hormone.
METABOLIC DISORDERS

 Juvenile diabetes
 Genital tuberculosis
SYSTEMIC ILLNESS

1. Malnutrition
2. Anaemia
3. Weight loss
UNRESPONSIVE ENDOMETRIUM
1. Uterine synechiae / shermans syndrome: is a
condition characterized by adhesions and fibrosis of
the endometrium.