Hypothalamic-pituitary causes (low-normal FSH)
- Idiopathic delayed puberty
- Pituitary tumor
- Hypothalamic amenorrhea, eg, stress, weight change, exercise
- Anorexia nervosa
- Hypothyroidism
- Cushing's syndrome
- GnRH or gonadotropin deficiency, eg, Kallmann syndrome
- Craniopharyngioma
Excess testosterone (low-normal FSH)
- Adrenal tumor or adrenal hyperplasia
- Polycystic ovary syndrome
- Ovarian tumor
- Androgenic steroids
Ovarian causes (high FSH)
- Gonadal dysgenesis, eg, Turner syndrome
- Autoimmune ovarian failure
- Rare ovarian enzyme deficiencies
Pseudohermaphroditism (high LH)
- Testosterone synthesis defect
- Complete androgen resistance (testicular feminization)
Anatomic defect (normal FSH)
- Vaginal agenesis, absent uterus, atrophic endometrium, imperforate hymen
Pregnancy (high hCG)