Etiology of Primary Amenorrhoea: A study of 50 cases

Abstract

Background: Amenorrhoea is one of the commonest reasons for referral of female patients to a gynaecology clinic. 
It is subdivided into primary and secondary. The etiology of primary amenorrhoea is complex.  
Objective: The aim of this study was to determine the etiological factors of primary amenorrhoea and to find out the 
mean age at first presentation. 
Design of Study: Descriptive Study. 
Place and Duration of Study: This Study was conducted in the department of Obstetrics and Gynaecology 
Foundation University Medical College Fauji Foundation Hospital Rawalpindi, from 1st January 2005 to 31st 
December 2007. 
Materials and Methods: 50 girls who reported to gynae outpatient department with the complaint of primary 
amenorrhoea were included in the study after informed consent. Detailed history, clinical examination and 
investigations (transabdominal ultrasonography, hormonal profile including serum FSH, LH & prolactin, 
karyotyping) were recorded in proformas for analysis. 
Results: A total of 50 girls reported to gynae OPD with complaints of primary amenorrhoea over a period of 24 
months with the mean age of 18.5 years at initial presentation. Almost half of the girls (48%) with normal secondary 
sexual characteristics had anatomical defects, Rokitansky’s syndrome being the commonest, while those with absent 
secondary sexual characteristics had constitutional delay as the commonest cause. 
Conclusion: Mean age at first presentation is late. Anatomical causes are the commonest. Turner’s syndrome is 
relatively uncommon in our patients.