• Information
  1. Primary
  2. Secondary

A. Primary

1. Physiology
   1. Constitutional delay of puberty
   2. Pregnancy
2. Developmental Abnormalities 60%
   1. Gonadal Dysgenesis
   2. Genetic Muellerian Tract (genitourinary) Abnormalities
   3. Turner's Syndrome (46, XO)
   4. Others
3. Gonadotropin Deficiency
   1. Absent or delayed breast development
   2. GnRH Deficiency (isolated)
   3. Kallmann's Syndrome
   4. CNS Disorder: Hypothalamic or Pituitary Disease
4. Congenital adrenal hyperplasia
5. Testicular feminization

B. Secondary [1]

1. Weight Loss (Anorexia)
2. Endocrine
   1. Hypothyroidism
   2. Hyperprolactinemia
3. Androgen Excess
   1. Polycystic Ovary (Chronic Anovulatory) Syndrome
   2. Adrenal or ovarian steroid-producing tumor
   3. Ovarian hyperthecosis
4. Late-onset (nonclassic) congenital adrenal hyperplasia
5. Primary Ovarian Failure
6. Late onset Hypogonadism (hypogonadotropic) - pituiatry or hypothalamic disease
7. Ashermann's Syndrome (intrauterine adhesions)
8. Menopause
   1. Medications leading to hypogonadism (eg. GnRH analogs)
   2. Natural Menopause

References

1. McIver B, Romanski SA, Nippoldt TB. 1997. Mayo Clin Proc. 72(12):1161