Update in hyper- and hypogonadotropic amenorrhea.

Abstract

Amenorrhea is a relatively common condition that is present in up to 5% of adult women at any time. The clinical significance of a lack of regular menstrual cycles extends beyond reproductive concerns. Episodes of amenorrhea as short as 90 d may have implications for bone and cardiovascular health. Prolonged amenorrhea, depending upon its underlying cause, can be a harbinger of substantial cardiovascular risk. This is an update of recent medical literature on this topic. The past few years have been marked by a greater appreciation of the early presentation of common ovulatory disorders, such as polycystic ovary syndrome, and less common disorders, such as premature ovarian insufficiency/failure. The long-term implications of functional hypothalamic amenorrhea and its genetic origins have also been further elucidated. Finally, health consequences of these and other menstrual disorders are increasingly well defined, with firmer clinical endpoints rather than merely risk factor assessments.