A cause of secondary amenorrhea

A cause of secondary amenorrhea

Secondary amenorrhea refers to the absence of menstrual periods in a woman who has previously had regular menstrual cycles. There are several potential causes of secondary amenorrhea, including hormonal imbalances, structural abnormalities, and lifestyle factors. One common cause of secondary amenorrhea is polycystic ovary syndrome (PCOS).

Polycystic Ovary Syndrome (PCOS)

Description: PCOS is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels.

Mechanism: In PCOS, the ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs, leading to ovulatory dysfunction and secondary amenorrhea.

Symptoms and Diagnostic Criteria for PCOS

  1. Menstrual Irregularities: Infrequent, irregular, or prolonged menstrual cycles are a hallmark of PCOS.
  2. Hyperandrogenism: Elevated levels of male hormones can cause physical signs such as excess facial and body hair (hirsutism), severe acne, and male-pattern baldness.
  3. Polycystic Ovaries: Enlarged ovaries containing numerous small cysts can be seen on ultrasound.

Other Causes of Secondary Amenorrhea

While PCOS is a common cause, secondary amenorrhea can result from various other conditions:

  1. Hypothalamic Amenorrhea:
  • Stress and Weight Changes: Significant weight loss, eating disorders, excessive exercise, or severe emotional stress can disrupt the hypothalamus, leading to amenorrhea.
  1. Hyperprolactinemia:
  • Elevated Prolactin Levels: Prolactin-secreting pituitary tumors or other conditions that increase prolactin levels can inhibit ovulation and menstruation.
  1. Thyroid Disorders:
  • Hypothyroidism or Hyperthyroidism: Thyroid hormone imbalances can affect menstrual cycles.
  1. Premature Ovarian Insufficiency (POI):
  • Early Menopause: Loss of normal ovarian function before the age of 40 can cause secondary amenorrhea.
  1. Asherman’s Syndrome:
  • Intrauterine Adhesions: Scar tissue in the uterus, often due to surgical procedures like dilation and curettage (D&C), can lead to amenorrhea.
  1. Medications:
  • Certain Drugs: Antipsychotics, antidepressants, chemotherapy agents, and some contraceptives can cause secondary amenorrhea.


PCOS is a common cause of secondary amenorrhea, but there are many other potential causes that need to be considered based on the patient’s history, symptoms, and clinical findings. A thorough evaluation by a healthcare provider is essential to diagnose the underlying cause and determine appropriate treatment.