Chronic Disease, Physiologic, and Induced Causes
Patients with chronic disease may experience amenorrhea; however, these conditions are often recognized by individual signs and symptoms. Menopause should be considered in patients older than 40 years.[15,16,54] Pregnancy, lactation, hormonal contraceptives, and exogenous androgens (e.g., transgender care) may also cause amenorrhea.[2,3,6]
This article updates previous articles on this topic by Klein and Poth,3 and Master-Hunter and Heiman.55
Data Sources: A PubMed search was completed using the MeSH function with the key phrase amenorrhea and one of the following: diagnosis, evaluation, management, or treatment. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews published after August 1, 2011. Also searched were Essential Evidence Plus, and the Cochrane Database of Systematic Reviews. Search dates: April 18 to July 16, 2018, and January 20, 2019.
The contents of this article are solely the views of the authors and do not necessarily represent the official views of the Uniformed Services University of the Health Sciences, the U.S. Air Force, the U.S. Army, the U.S. Navy, the U.S. military at large, the U.S. Department of Defense, or the U.S. government.
Am Fam Physician. 2019;100(1):39-48. © 2019 American Academy of Family Physicians