Primary - no menstruation by age 16 with normal sexual devt
- Outflow abnormalities: androgen insensitivity, imperforate hymen, transverse vaginal septum
- Ovarian disorders: gonadal dysgenesis (e.g. Turner Syndrome, polycystic ovary syndrome
- Prolactinoma, Kallman's syndrome (congenital GnRH deficiency)
Secondary - no menstruation >= 3/12
Secondary amenorrhoea ddx
- Cerebral: starvation, anorexia nervosa, neoplasm, exercise++
- Pituitary: Ischaemia (low-flow states e.g. sepsis), prolactinoma, surgery
- Thyroid: Hypo/hyperthyroid
- Adrenal: Cushing's, androgen secreting tumour
- Ovary: Menopause, PCOS,
- Uterine: PREGNANCY....