{"id":11039,"date":"2026-09-14T00:20:09","date_gmt":"2026-09-14T08:20:09","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=11039"},"modified":"2026-08-13T15:53:55","modified_gmt":"2026-08-13T23:53:55","slug":"usmle-step-1-question-of-the-day-amenorrhea","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day:\u00a0Amenorrhea"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea\/#Major_Takeaway\" >Major Takeaway&nbsp;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-amenorrhea\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em><strong>Today\u2019s USMLE\u00ae Step 1 question of the day features a 55-year-old patient seeking an evaluation for amenorrhea, as well as headaches, night sweats, and pain during intercourse. What\u2019s the underlying cause of her condition? Let\u2019s find out!<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A <strong>55-year-old woman<\/strong> presents for evaluation of <strong>amenorrhea that has been ongoing for the past 12 months<\/strong>. She has also experienced <strong>dyspareunia, recurrent headaches, and infrequent episodes of night sweats<\/strong>. The patient is subsequently diagnosed with menopause. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Which of the following laboratory findings is <em>most specific<\/em> to this patient\u2019s condition?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Increase in serum estrogen levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Decrease in serum LH levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Increase in serum FSH levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Decrease in GnRH levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Increase in testosterone levels<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Learn with Osmosis\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/iDxHtjjCMbU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Increase in serum FSH levels\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Correct:<\/strong> See Main Explanation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Increase in serum estrogen levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Menopause is associated with a decrease in serum estrogen production due to an age-related decline in ovarian follicular function.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Decrease in serum LH levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Serum LH increases during menopause due to loss of negative feedback.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Decrease in GnRH levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> GnRH secretion increases during menopause due to loss of negative feedback.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Increase in testosterone levels<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Testosterone levels decrease with menopause. However, estrogen levels drop by a greater amount in comparison, leading to an increased androgen-to-estrogen ratio.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Menopause<\/strong>&nbsp;is the permanent cessation of menstruation due to&nbsp;<strong>loss of ovarian follicular function<\/strong>. It is diagnosed retrospectively after 12 months of&nbsp;<strong>amenorrhea<\/strong>.&nbsp;Menopause typically occurs around age 50 and is preceded by several years of hormonal and physical changes known as&nbsp;<strong>perimenopause<\/strong>.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">During&nbsp;<strong>menopause<\/strong>,&nbsp;the age-linked decline in ovarian function leads to decreased levels of&nbsp;<strong>estrogen&nbsp;<\/strong>and&nbsp;<strong>inhibin&nbsp;<\/strong>production,&nbsp;resulting in loss of&nbsp;<strong>negative feedback<\/strong>&nbsp;on the hypothalamic-pituitary axis. This leads to increased secretion of both&nbsp;<strong>follicle-stimulating hormone (FSH)<\/strong>&nbsp;and&nbsp;<strong>luteinizing hormone (LH)<\/strong>. Elevated&nbsp;<strong>FSH&nbsp;<\/strong>is a characteristic laboratory&nbsp;finding&nbsp;in menopause.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Common&nbsp;symptoms&nbsp;of menopause include&nbsp;<strong>hot flashes<\/strong>,&nbsp;<strong>night sweats<\/strong>,&nbsp;<strong>mood changes<\/strong>,&nbsp;<strong>headaches<\/strong>, and&nbsp;<strong>atrophic vaginitis<\/strong>&nbsp;(vaginal dryness, itchiness, and&nbsp;dyspareunia). Menopause is also associated with increased risk of osteoporosis and coronary artery disease.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Elevated\u00a0<strong>FSH\u00a0<\/strong>is a characteristic laboratory finding in\u00a0<strong>menopause\u00a0<\/strong>and results from loss of\u00a0<strong>negative feedback<\/strong>\u00a0due to declining ovarian hormone production (<strong>estrogen<\/strong>,\u00a0<strong>inhibin<\/strong>).\u00a0<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Learn more about this condition: <\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Menopause\">Menopause<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Jameson, J.L., Fauci, A.S., Kasper, D.L., et al. (2018)\u00a0<strong>Harrison&#8217;s\u00a0principles of internal medicine<\/strong> (20th ed.). New York, NY: McGraw Hill. ISBN: 978-1259644030.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/01\/Blog_Display_Ads_GENERAL2_2023.png?w=700\" alt=\"\" class=\"wp-image-5098\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/01\/Blog_Display_Ads_GENERAL2_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/01\/Blog_Display_Ads_GENERAL2_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>Get your Osmosis from Elsevier <a href=\"http:\/\/osmosis.org\/plans\">free trial<\/a> today to discover why millions of clinicians and caregivers love learning by Osmosis<\/strong>!<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 55-year-old patient presents with 12 months of amenorrhea and other characteristic symptoms. Can you identify the laboratory finding most specific to her condition?<\/p>\n","protected":false},"author":208,"featured_media":11042,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,16,1366,1369,44],"tags":[3373,2967,489,3108,2801,1807,3376,84,1721,462,3377,3374,3375,664,242],"class_list":["post-11039","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-questions","category-step-1-questions","category-step-1","tag-amenorrhea","tag-board-exam-prep","tag-clinical-reasoning","tag-clinical-vignette","tag-endocrinology","tag-gynecology","tag-hormone-regulation","tag-medical-education","tag-menopause","tag-osmosis","tag-perimenopause","tag-reproductive-endocrinology","tag-reproductive-physiology","tag-usmle-step-1","tag-womens-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - 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