Differential Diagnosis of Amenorrhea
| Primary Amenorrhea | Secondary Amenorrhea | |
| Central (hypothalamus/pituitary; hypogonadotropic hypogonadism with low FSH) | Constitutional delayaChronic illnessaFunctional hypothalamic amenorrheaaKallmann syndromeLaurence-Moon-Biedl andPrader-Willi syndromesTumors (craniopharyngioma and prolactinoma)Infiltration (hemochromatosis)InfarctionIatrogenic (radiation, surgery)Congenital hypopituitarism | Functional hypothalamica amenorrheaChronic illnessTumors (prolactinoma) |
| Ovarian (hypergonadotropic hypogonadism with high FSH) | Turner syndromeaGonadal dysgenesisPrimary ovarian insufficiencyOophoritisGalactosemiaTumorRadiation, chemotherapy | Primary ovarian insufficiencyOophoritisRadiation, chemotherapy |
| Genital outflow tract | Imperforate hymenaMRKHaTransverse vaginal septumVaginal agenesisAndrogen insensitivityIntersex disorders | Uterine synechiae (Asherman syndrome) |
| Other | PregnancyPCOS (uncommon)Thyroid diseaseCushing syndromeAddison disease | PregnancyaPCOSaContraceptive useHyperprolactinemia due to medication or illicit drug useThyroid diseaseLate-onset congenital adrenal hyperplasiaCushing syndromeAddison disease |
↵a Most common diagnosis in each category; the other diagnoses are not listed in order of prevalence.