Chapter 162 Amenorrhea: Secondary
INTRODUCTION
Description: Secondary amenorrhea is the absence of normal menstruation in a patient with previously established cycles.
ETIOLOGY AND PATHOGENESIS
Causes: Most common—pregnancy. Other causes—end organ: Asherman’s syndrome, outflow obstruction; ovarian: menopause, resistant ovary [Savage’s] syndrome, toxin exposure, surgery, autoimmune disease; central, behavioral, and others: anorexia, obesity, athletics (overtraining), drugs/medications, nutritional deprivation, psychogenic (stress); medical: adenoma, craniopharyngioma, Sheehan’s syndrome, tuberculosis, sarcoid, empty sella syndrome; virilizing syndromes: polycystic ovary syndrome, adrenal hyperplasia, virilizing tumors.
