Study and clinical evaluation of 25 cases of primary amenorrhea


  • Jaydeep J. Bhatu Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India
  • Govind B. Bhadaraka Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India



Cryptomennorhea, Mayer-Rokitansky-Küster-Hauser syndrome, Mullerian duct, Primary amenorrhea, Turner syndrome


Background: Primary amenorrhea is absence of menstruation and secondary sexual characters by age of 14 years primary amenorrhea is < 1%. Development of female genital organs takes place from mullerian DUCT (paramesonephric duct). The objective of this study was to note the various causes, complete clinical picture and the management in 25 such cases of primary amenorrhea.

Methods: This is a prospective study done in 25 cases. They were investigated, managed and patients were called up for follow up for their response to treatment.

Results: Out of 25 cases studied, maximum cases presented at 14-16 years of age, with chief complaint of primary amenorrhea, out of which 8% were married, 44% cases were of MRKH syndrome which was the most common cause of primary amenorrhea.

Conclusions: Amenorrhea has got multi factorial etiology. For patients with amenorrhea physical examination should focus on pubertal development and possible genital out flow obstruction.


Rock JA, Jones HW. TeLinde’ s Operative Gynaecology. 10th ed. New Delhi: Lipincott Williams and Wilkins; 2009:550-590.

Troiano RN. Magnetic resonance imaging of mullerian duct anomalies of the uterus. Topics Magn Reson Imag. 2003;14(4):269-79.

Griffin JE, Edwards C, Madden JD, Harrod MJ, Wilson JD. Congenital absence of the vagina: the Mayer-Rokitansky-Kuster-Hauser syndrome. Ann Int Med. 1976;85(2):224-36.

Folch M, Pigem I, Konje JC. Müllerian agenesis: etiology, diagnosis, and management. Obstet Gynecol Surv. 2000;55(10):644-9.

Varner RE, Younger JB, Blackwell RE. Müllerian dysgenesis. The J Reprod Med. 1985;30(6):443-50.

Strubbe EH. Mayer-Rokitansky-Kuster-Hauser syndrome: distinction between two forms based on excretory urographic, sonographic, and laparoscopic findings. Am J Roentgenol. 1993;160:331-4.

Golden NH, Carlson JL. The pathophysiology of amenorrhea in the adolescent. Ann New York Academy Sci. 2008;1135(1):163-78.

Speroff L, Fritz MA, editors. Clinical gynecologic endocrinology and infertility. Lippincott Williams and Wilkins; 2005.






Original Research Articles