Perimenopause, menopause, and primary ovarian insufficiency Quiz: Ace Your Exams
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A 49-year-old woman comes to the clinic for evaluation of irregular menstrual cycles for the past year. She reports intervals ranging from 4 weeks to 3 months, as well as frequent hot flashes, night sweats, and recent onset of difficulty sleeping. She notes vaginal dryness and occasional pain with vaginal intercourse. Her medical history includes hyperthyroidism from Graves disease, treated with radioactive iodine ablation 10 years ago. Her only medication is levothyroxine. Vitals are within normal limits. BMI is 25 kg/m2. Physical examination reveals a well-appearing woman. Laboratory testing is shown below. Which of the following findings is most likely to be identified on physical examination?
| Estradiol | <30 pg/mL |
| Follicle-stimulating hormone (FSH) | 65 mU/mL (60 U/L) |
| Luteinizing hormone | 50 mU/mL (60 U/L) |
| Testosterone, free | 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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