Anatomical
Congenital causes include:
- intersex states - usually the effect of an underlying endocrine order such as congenital adrenal hyperplasia; for example, true hermaphroditism, and male or female pseudohermaphroditism
- malformation of the female genital tract - such as uterine agenesis, vaginal atresia, imperforate hymen. Müllerian agenesis is responsible for about 10% of primary amenorrhoea cases (1)
Acquired causes include:
- endometrial fibrosis - Asherman's syndrome, tuberculosis; both rare in the UK
- cervical stenosis - usually due to surgery, especially cautery or conization
Reference:
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