Pathogenesis (development of disease)
In oligomenorrhea, the interval between bleeding is greater than 31 days, that is, bleeding occurs too infrequently.Follicle maturation disorder (egg maturation disorder) is present, which is usually accompanied by corpus luteum insufficiency (corpus luteum weakness) or, if necessary, leads to anovulation (failure to ovulate).
Etiology (causes)
Biographic causes
- Genetic burden from parents, grandparents.
- Genetic diseases
- Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.
- Genetic diseases
- Hormonal factors
- Puberty
- Laction phase (breastfeeding phase)
- Premenopause (before menopause; is rarely called its own phase; it can begin around the age of 35).
- Catastrophic situations
Behavioral causes
- Consumption of stimulants
- Alcohol
- Drug use
- Amphetamines (indirect sympathomimetic).
- Heroin
- LSD (lysergic acid diethylamide/lysergide)
- Physical activity
- Competitive sports
- Psycho-social situation
- Psychosocial stress
- Overweight (BMI ≥ 25; obesity).
Disease-related causes
- Diseases of endocrine organs
- Adrenal gland
- Cushing’s syndrome – group of disorders leading to hypercortisolism – oversupply of cortisol.
- Hyperandrogenemia (increase in male sex hormones in the blood).
- Ovary
- Onset of premature menopause/early menopause).
- Pancreas (diabetes mellitus)
- Thyroid (e.g., hypothyroidism/ hypothyroidism or latent (subclinical) hypothyroidism).
- Adrenal gland
- Genital causes (uterine and/or vaginal malformations or defects):
- Asherman syndrome – loss of the endometrium (uterine lining) due to severe inflammation or trauma.
- Genital tuberculosis
- Hypothalamic-pituitary disorders
- Functional gonadotropin deficiency (see below extragenital causes).
- Inflammation in the hypothalamic region; hypothalamic tumors.
- Hypopituitarism (hypofunction of the pituitary gland): eg.
- Sheehan syndrome (acquired anterior pituitary insufficiency (insufficient hormone production by the anterior lobe of the pituitary gland (pituitary gland)).
- Pituitary tumors (tumors of the pituitary gland).
- Hyperprolactinemia (elevation of prolactin levels in the blood) – which usually leads to disruption of follicle maturation (egg maturation), resulting in corpus luteum insufficiency (luteal weakness), anovulation (failure to ovulate), and oligomenorrhea (up to amenorrhea); see also under “Hyperprolactinemia due to medications”
- Ovarian disorders
- Corpus luteum persistence – non-regression of the corpus luteum and thus continued production of progesterone.
- Polycystic ovary syndrome (PCO syndrome) – symptom complex characterized by hormonal dysfunction of the ovaries. [50% of all women with oligomenorrhea.]
- Ovarian hyperandrogenemia(ovary-related (overproduction of male hormones).
- Premenopause
- Extragenital causes
- Stress
- Mental stress
- Competitive sports
- Diseases
- Obesity(Overweight)
- Consuming diseases
- Underweight – for example, because of eating disorders – anorexia nervosa (anorexia), bulimia nervosa (binge eating disorder).
Operations
- After forced curettage (traumatic amenorrhea) – Asherman syndrome due to destruction of the basalis of the endometrium (endometrium).
Medication
- Appetite suppressants – such as fenfluramine.
- Hormonal contraceptives (contraception using preparations containing estrogen and/or progestin); post-pill amenorrhea – absence of menstruation after stopping the use of contraceptives (contraceptives)
- See also under “Hyperprolactinemia due to medications.”
- Zust.n. Chemotherapy
Other causes
- Gravidity (pregnancy)
- Lactation period (breastfeeding phase)
- Zust. n. radiotherapy (radiotherapy, radiatio).
