Version May 2024
| WHO class 1: Hypogonadotropic hypogonadal anovulation (hypothalamic amenorrhea) |
| These women have low or low-normal serum follicle-stimulating hormone (FSH) concentrations and low serum estradiol concentrations due to decreased hypothalamic secretion of gonadotropin-releasing hormone (GnRH) or pituitary unresponsiveness to GnRH. |
| WHO class 2: Normogonadotropic normoestrogenic anovulation |
| These women may secrete normal amounts of gonadotropins and estrogens. However, FSH secretion during the follicular phase of the cycle is subnormal. This group includes women with polycystic ovary syndrome (PCOS). Some ovulate occasionally, especially those with oligomenorrhea. |
| WHO class 3: Hypergonadotropic hypoestrogenic anovulation |
| The primary causes are premature ovarian failure (absence of ovarian follicles due to early menopause) and ovarian resistance (follicular form). |
| Hyperprolactinemic anovulation |
| These women are anovulatory because hyperprolactinemia inhibits gonadotropin and therefore estrogen secretion; they may have regular anovulatory cycles, but most have oligomenorrhea or amenorrhea. Their serum gonadotropin concentrations are usually normal. |
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