Secondary amenorrhea

no menses for 3 months if previously regular menses

no menses for 6 months if previously irregular mentstruation

  1. Eugonadotropic
  2. Pregnancy
  3. Anovulation - no copus luteum - no progesterone - no mense (PCOS, thyroid, drug, etc)
  4. Hypergonadotropic (low estrogen)
  5. Premature ovarian failure
  6. Infection - mumps
  7. Autoimmune (SLE, adrenal insufficiency, radiation, chemotherapy) Dx - 2 FSH levels
  8. Hypogonadotropic (HPA dysfunciton)
  9. HPA failure
  10. tumors
  11. Sheehen syndrome

The most common cause of secondary amenorrhea is pregnancy.  Medications that induce the cytochrome P450 system (eg, antiepileptics) can reduce oral contraceptive efficacy and result in unplanned pregnancy.

Management

Test