Adult-onset amenorrhea: A study of 262 patients

      This paper is only available as a PDF. To read, Please Download here.


      A series of 262 patients with amenorrhea of adult onset are reported. Hypothalamic suppression followed by inappropriate positive feedback, and then hyperprolactinemia and ovarian failure are the most frequently encountered etiologies. Other etiologies are diverse and numerically less frequent. Amenorrhea after use of oral contraceptives, or postpill amenorrhea, occurred in 77 (29%) of all patients. The average age of presentation, prior menstrual history, associated morbidity, and subsequent reproductive potential of each diagnostic group are reported. Adult-onset amenorrhea has a less significant impact on future wellbeing than was reported for a similar-sized group of patients whose amenorrhea developed as a result of pubertal aberrancy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Pettersson F
        • Fries H
        • Nillius SJ
        Epidemiology of secondary amenorrhea.
        Am J Obstet Gynecol. 1973; 117: 80
        • Reindollar RH
        • Byrd JR
        • McDonough PG
        Delayed sexual development: a study of 252 patients.
        Am J Obstet Gynecol. 1981; 140: 371
        • Black WB
        • Govon ADT
        Laparoscopy and gonadal biopsy for assessment of gonadal function in primary amenorrhea.
        Br Med J. 1972; 1: 672
        • Henyl M
        • Presl J
        • Horsky J
        Practical possibilities for classification of primary amenorrhea.
        Am J Obstet Gynecol. 1965; 98: 70
        • Tolis G
        • Ruggere D
        • Popkin DR
        • et al.
        Prolonged amenorrhea and oral contraceptives.
        Fertil Steril. 1979; 32: 265
        • Hull MGR
        • Knuth UA
        • Murray MAF
        • Jacobs HS
        The practical value of the progestogen challenge test, serum oestradiol estimation or clinical examination in assessment of the oestrogen state and response to clomiphene in amenorrhea.
        Br J Obstet Gynaecol. 1979; 86: 799
        • Soules MR
        • Jelousek FR
        • Wiebe RH
        • Tyrey L
        • Paulson DF
        • Hammond CB
        Amenorrhea: observations based on the analysis of luteinizing hormone-releasing hormone testing.
        Am J Obstet Gynecol. 1979; 135: 651
        • Kletzky OA
        • Davajan V
        • Nakamura RM
        • Thorneycroft IH
        • Mishell DR
        Clinical categorization of patients with secondary amenorrhea using progestrone-induced uterine bleeding and measurement of serum gonadotropin levels.
        Am J Obstet Gynecol. 1975; 121: 695
        • Scott JC
        • Mussey E
        Menstrual patterns in myxedema.
        Am J Obstet Gynecol. 1964; 90: 161
        • Fries H
        • Nillius SJ
        Dieting, anorexia nervosa and amenorrhea after oral contraceptive treatment.
        Acta Psychiatr Scand. 1973; 49: 669
        • Hancock KW
        • Scott JS
        • Panigrahi NM
        • Stitch SR
        Significance of low body weight in ovulatory dysfunction after stopping oral contraceptives.
        Br Med J. 1976; 2: 399
        • Wentz AC
        Body weight and amenorrhea.
        Obstet Gynecol. 1980; 56: 482
        • Sherman BM
        • Schlechte J
        • Halmi NS
        • et al.
        Pathogenesis of prolactin-secreting pituitary adenomas.
        Lancet. 1978; 2: 1019
        • Davajan V
        • Kletzky O
        • March CM
        • Roy S
        • Mishell Jr, DR
        The significance of galactorrhea in patients with normal menses, oligomenorrhea, and secondary amenorrhea.
        Am J Obstet Gynecol. 1978; 130: 894
        • Coulam CB
        • Annegers JR
        • Abboud CF
        • Laws Jr, ER
        • Kurland LT
        Pituitary adenoma and oral contraceptives: a case-control study.
        Fertil Steril. 1979; 31: 25
        • Maheuk R
        • Jenicek M
        • Cleroux R
        • et al.
        Oral contraceptives and prolactinomas: a case-control study.
        Am J Obstet Gynecol. 1982; 143: 134