What is a common cause of primary amenorrhea?

What is a common cause of primary amenorrhea?

• A. Congenital abnormalities of the reproductive system.
• B. Endometriosis.
• C. Weight loss.
• D. Pregnancy.

Answer: (A)

A clear pattern for primary amenorrhea is that the body’s outflow pathway or its reproductive structures fail to develop or are obstructed, so menstrual blood cannot be produced or expelled. When congenital abnormalities of the reproductive system are present, especially where the uterus or upper vagina are missing (as in Müllerian agenesis) or where there is an outflow obstruction (like an imperforate hymen or a transverse vaginal septum), menses never occur despite normal early puberty. This explains why primary amenorrhea is often due to structural issues detected from birth or early adolescence. Endometriosis, by contrast, usually causes painful periods or infertility after menarche and is not a typical cause of primary amenorrhea. Weight loss can interfere with puberty by suppressing the hormonal axis, but it’s a less common cause of primary amenorrhea compared with congenital tract abnormalities. Pregnancy would result in no menses during pregnancy, but it is not a cause of primary amenorrhea in someone who has not yet had menarche.

A clear pattern for primary amenorrhea is that the body’s outflow pathway or its reproductive structures fail to develop or are obstructed, so menstrual blood cannot be produced or expelled. When congenital abnormalities of the reproductive system are present, especially where the uterus or upper vagina are missing (as in Müllerian agenesis) or where there is an outflow obstruction (like an imperforate hymen or a transverse vaginal septum), menses never occur despite normal early puberty. This explains why primary amenorrhea is often due to structural issues detected from birth or early adolescence.

Endometriosis, by contrast, usually causes painful periods or infertility after menarche and is not a typical cause of primary amenorrhea. Weight loss can interfere with puberty by suppressing the hormonal axis, but it’s a less common cause of primary amenorrhea compared with congenital tract abnormalities. Pregnancy would result in no menses during pregnancy, but it is not a cause of primary amenorrhea in someone who has not yet had menarche.