Perimenopause, menopause, and primary ovarian insufficiency Quiz: Ace Your Exams

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A 33-year-old woman comes to her physician’s office for evaluation of a 6-month history of amenorrhea with associated vaginal dryness and hot flashes. She has been attempting to conceive for the past year without success. Her past medical history is significant for Hashimoto thyroiditis for which she takes daily levothyroxine. Vitals are within normal limits. BMI is 24 kg/m2. Hair growth and pattern are normal, and breast development is normal. Pelvic examination is normal and there is no evidence of bleeding, masses, or cervical motion tenderness. Laboratory studies are shown below. Which of the following is the most likely diagnosis?  

Estradiol
<5 pg/mL  
Follicle-stimulating hormone (FSH)  
65 mU/mL (60 U/L)  
Luteinizing hormone  
60 mU/mL (60 U/L)  
Total testosterone  
25 ng/dL  
Thyroid-stimulating hormone (TSH)  
2.3 μU/mL (2.3 mU/L)  
Prolactin
18 ng/mL (18 µg/L)  
Human chorionic gonadotropin  
Negative

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