What is a potential cause of amenorrhea among individuals with exogenous androgen use?

Exogenous androgen use can lead to amenorrhea primarily due to ovarian dysfunction. The introduction of external androgens can disrupt the normal hormonal balance in the body, particularly affecting the hypothalamic-pituitary-ovarian (HPO) axis, which regulates the menstrual cycle. When androgens are administered externally, they can suppress the secretion of gonadotropins (LH and FSH) from the pituitary gland. This suppression leads to a reduction in ovarian stimulation, which in turn affects ovarian follicle development and can lead to anovulation.

Consequently, the lack of ovulation means that menstrual periods may cease, resulting in amenorrhea. Additionally, excessive androgen levels can lead to conditions such as polycystic ovary syndrome (PCOS) or even ovarian atrophy, further contributing to disrupted menstrual cycles.

In contrast, while pituitary dysfunction, hypothalamic dysfunction, and adrenal tumors can also lead to amenorrhea, they are not directly tied to the use of exogenous androgens in the same way. These conditions involve different physiological mechanisms and sources of hormonal imbalance that are not primarily induced by androgen intake.