The most common causes of amenorrhea

Hypothalamic amenorrhea is the most common type of amenorrhea. Hypothalamic dysfunction affects the pituitary gland, which in turn affects the ovaries, causing amenorrhea. Its etiology is complex and can be caused by organic lesions of the central nervous system, mental factors, systemic diseases, drugs, and other secretory disorders.

Mental and neurological factors: Psychological trauma, such as excessive tension, fear, anxiety, etc., can lead to dysfunction between the central nervous system and the hypothalamus, and through the hypothalamus-pituitary-ovarian axis, cause ovulation dysfunction, affect follicle maturation and cause amenorrhea.

Malnutrition: due to malnutrition or certain wasting diseases such as gastrointestinal disorders, severe tuberculosis, severe anemia, schistosomiasis, malaria, etc., systemic malnutrition affects the synthesis and secretion of gonadotropin-releasing hormone and growth hormone in the hypothalamus, thereby inhibiting gonadotropin and hypogonadism, leading to primary or secondary amenorrhea

Drug resistance syndrome: Some women develop secondary amenorrhea after long-acting contraceptive injections or oral contraceptives. This is common in women who have menstrual disorders or take contraceptives too early after miscarriage. The drugs inhibit the function of the hypothalamus and pituitary gland. However, it is often reversible and can be recovered naturally after stopping the drug for 3-6 months.

Amenorrhea and galactorrhea syndrome: In addition to amenorrhea, patients also have continuous lactation and internal genital atrophy. Decreased prolactin inhibitory factor or dopamine in the hypothalamus can lead to abnormal lactation, and insufficient secretion of gonadotropin-releasing hormone can lead to amenorrhea. There are many reasons for galactorrhea, such as oral contraceptives or long-term use of reserpine, chlorpromazine, meprobamate, etc., which can cause amenorrhea and galactorrhea syndrome.

Polycystic ovary syndrome: The main symptoms of patients are amenorrhea, infertility, hirsutism, obesity, bilateral ovarian enlargement, high luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio, increased secretion of androstenedione and testosterone by the ovaries, and a corresponding decrease in estrogen, resulting in anovulation and amenorrhea.

Other endocrine dysfunction: Dysfunction of the adrenal glands, thyroid gland, and pancreas can also cause amenorrhea. Common diseases include hyperthyroidism and hypothyroidism, adrenal cortex hyperfunction, adrenal cortex tumors, etc.