II. Causes: Pelvic Factors (Structural etiology)

  1. Infection
    1. Pelvic Inflammatory Disease
    2. Sexually Transmitted Disease
    3. Septic Abortion
    4. Endometritis
    5. Pelvic Tuberculosis
  2. Surgical History
    1. Pelvic adhesions
    2. Dilatation and Curettage
    3. Ruptured Appendicitis
    4. Endometriosis
    5. Adnexal surgery
    6. Leiomyoma (Uterine Fibroids)
  3. Contraception and Pregnancy History
    1. Prior Intrauterine Device use
    2. DES Exposure in-utero
    3. Ectopic Pregnancy
    4. Habitual abortion
  4. Menstrual Cycle abnormalities
    1. Secondary Dysmenorrhea
    2. Cyclic abdominal or Pelvic Pain

III. Causes: Ovulatory Factors (Hormonal etiology: 40%)

  1. Menstrual history
    1. Secondary Amenorrhea
    2. Ovulatory Dysfunction or Anovulation
    3. Abnormal Uterine Bleeding
    4. Luteal Phase defect
    5. Premenstrual molimina (Premenstrual tension)
    6. Premature Ovarian Failure
  2. Endocrine conditions
    1. Hyperprolactinemia
    2. Thyroid disease
    3. Adrenal Disease
    4. Polycystic Ovary Syndrome

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