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Anatomical

Authoring team

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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