Question of the Week

For February 27, 2024

A 19-year-old woman reports irregular menses. She reached menarche at age 12 and has typically had a menstrual period every 60 to 70 days since then, with each one lasting approximately 5 days. It has now been 3 months since her last period. She is not sexually active and has had no galactorrhea. She feels well, exercises regularly, and does not report any recent changes in weight.

Her vital signs are normal, and her BMI is 21.5. Inflammatory acne is evident on her face and back, and a few terminal hairs are evident on the thighs and on the abdominal midline below the umbilicus. The thyroid gland is not enlarged. Abdominal and external genital examinations are normal.

The patient’s mother developed Hashimoto thyroiditis at a young age.

A urine pregnancy test is negative.

Which one of the following diagnoses is most likely in this case?

Physiologic anovulatory cycle
Hyperprolactinemia
Polycystic ovary syndrome
Functional hypothalamic amenorrhea
Primary ovarian insufficiency

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