Development of secondary sexual characters in a case of idiopathic hypogonadotropic hypogonadism

Neelima Singh, Agnes Mathew, Ramesh Chand Chauhan, Parvathavarthini .


We report a rare case of idiopathic hypogonadotropic hypogonadism in a 15 year old adolescent girl, who presented in gynecology outpatient clinic with complaint of primary amenorrhea and poor development of secondary sexual characters. Her clinical examination revealed small, underdeveloped breasts (Tanner stage II), absent axillary hair and sparse pubic hair (Tanner stage II). Ultrasound pelvis showed uterus of 4.76 x 2.29 x 1.25 centimeter, small and hypoplastic with very thin endometrial lining, bilateral ovaries were small with 1-2 small follicles. Magnetic Resonance Imaging (MRI) of the hypothalamic-pituitary unit showed no abnormality. Further workup was done to detect other causes of hypogonadism, which was normal, hence we concluded the patient to have idiopathic hypogonadotropic hypogonadism. 


Primary amenorrhea, Idiopathic hypogonadotrophic hypogonadism

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Thomas Lathrop Stedman. Gonadal hormones. In: Thomas Lathrop Stedman, eds. Stedman’s Medical Dictionary. 27th ed. Philadelphia: Lippincott Williams & Wilkins; 2000: 56.

Pettersson F, Fries H, Nillius SJ. Epidemiology of secondary amenorrhea. I. Incidence and prevalence rates. Am J Obstet Gynecol. 1973;117-6.

Bachmann G, Kemmann E. Prevalence of oligomenorrhea and amenorrhea in a college population. Am J Obstet Gynecol. 1982;144:98-102.

Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV et al. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the pediatric research in office settings network. Pediatr. 1997;99:505-12.

Brioude F, Bouligand J, Trabado S et al. Non-syndromic congenital hypogonadotropic hypogonadism: clinical presentation and genotype-phenotype relationships. Eur J Endocrinol. 2010;162:835-51.

Seminara SB, Hayes FJ, Crowley WF Jr. Gonadotropin-releasing hormone deficiency in the human (idiopathic hypogonadotropic hypogonadism and Kallmann’s syndrome): pathophysiological and genetic considerations. Endocr Rev. 1998;19:521-39.

Quinton R, Duke VM, Robertson A, et al. Idiopathic gonadotropin deficiency: genetic questions addressed through phenotypic characterization. Clin Endocrinol (Oxf). 2001;55:163-74.

Kumar A, Mittal S. Primary amenorrhoea: analysis of 48 cases. J Indian Med Assoc. 1998;96(4):119-20.