What is NOT a cause of amenorrhea related to the HPO axis?

The selected answer highlights a cause of amenorrhea that is not directly related to the hypothalamic-pituitary-ovarian (HPO) axis dysfunction. Uncontrolled diabetes mellitus is primarily a systemic condition impacting metabolism and blood glucose regulation. While it can have downstream effects on menstrual cycles due to its influence on metabolism and associated complications like hyperandrogenism and obesity, it does not inherently disrupt the hormonal interactions between the hypothalamus, pituitary gland, and ovaries that usually define amenorrhea due to HPO axis dysfunction.

In contrast, conditions like polycystic ovary syndrome (PCOS), hypothyroidism, and hypogonadism directly affect the HPO axis. PCOS involves an imbalance of reproductive hormones affecting ovarian function, leading to irregular menstruation. Hypothyroidism can result in elevated levels of thyroid-stimulating hormone (TSH), which can interfere with the normal regulation of the menstrual cycle, thereby causing amenorrhea. Hypogonadism, which involves underdeveloped or dysfunctional gonads, adversely affects the production of sex hormones critical for normal menstrual function and can lead to the absence of menstruation.

Thus, while uncontrolled diabetes can influence menstrual cycles through a variety of indirect mechanisms, it does