How does primary amenorrhea occur?

Primary amenorrhea refers to the absence of menstruation in women aged 18 or above or whose secondary sexual characteristics have matured for more than 2 years. It is rare in clinical practice and is mostly caused by genetic reasons or congenital developmental defects. The causes of primary amenorrhea include:

Systemic diseases

Systemic wasting diseases can lead to primary amenorrhea, such as severe pulmonary tuberculosis, severe anemia, malnutrition, etc.; endocrine diseases, such as obesity, reproductive incompetence, malnutrition, and adrenal, thyroid, pancreatic and other functional disorders. Primary amenorrhea caused by systemic diseases can be cured and menstruation will come naturally.

Genital atresia

For example, if there is a congenital atresia in the cervix, vagina, hymen, labia, etc., or adhesion atresia caused by acquired damage, although menstruation occurs, the menstrual blood cannot flow out. This situation is called latent or pseudo-amenorrhea.

Incomplete development of reproductive organs

Some patients are born without ovaries, or their ovaries are dysplastic, or their ovaries are damaged, and they cannot produce estrogen and progesterone. Therefore, the endometrium cannot undergo cyclical changes, and there will be no endometrial shedding, and no menstruation. Some patients are born without uterus, or their endometrium is dysplastic, or their endometrium is damaged. Even if their ovaries are functioning well and the secretion of estrogen and progesterone is normal, they will not have menstruation.

Pituitary gland and hypothalamus malfunction

Abnormal pituitary and hypothalamus function can also cause amenorrhea. There are many reasons for hypothalamic dysfunction, such as mental stimulation, sadness, anxiety, fear, tension, fatigue, environmental changes, cold stimulation, etc. Amenorrhea caused by the hypothalamus is more common.