Differential Diagnosis for Amenorrhea in a 22-year-old Female
Single Most Likely Diagnosis
- Polycystic Ovary Syndrome (PCOS): This is a common endocrine disorder in women of reproductive age, often presenting with oligomenorrhea or amenorrhea, and is associated with hormonal imbalance and ovulation problems.
Other Likely Diagnoses
- Stress or Weight-Related Amenorrhea: Significant psychological stress or changes in weight can disrupt the hypothalamic-pituitary-gonadal axis, leading to amenorrhea.
- Hypothyroidism: Thyroid hormone abnormalities can affect menstrual regularity, with hypothyroidism being a potential cause of amenorrhea.
- Hyperprolactinemia: Elevated prolactin levels can suppress gonadotropin-releasing hormone (GnRH) secretion, leading to amenorrhea.
Do Not Miss Diagnoses
- Pituitary Tumor: Although rare, a pituitary tumor (such as a prolactinoma) can cause amenorrhea by disrupting normal pituitary function.
- Premature Ovarian Failure (POF): Also known as premature ovarian insufficiency, this condition involves the loss of ovarian function before the age of 40, which can lead to amenorrhea.
- Asherman's Syndrome: This condition, characterized by the formation of adhesions in the uterus, can cause amenorrhea, often following uterine surgery or infection.
Rare Diagnoses
- Congenital Adrenal Hyperplasia: A group of inherited disorders that affect the adrenal glands, potentially leading to hormonal imbalances and amenorrhea.
- Androgen Insensitivity Syndrome: A rare genetic condition where an individual is genetically male but has a female or partially female appearance, which can present with primary amenorrhea.
- Gonadal Dysgenesis: A condition where the gonads (ovaries) do not develop properly, which can lead to amenorrhea and other developmental issues.