May 7th, 2021
A 28-year-old woman presents with amenorrhea for six months, along with intermittent hot flashes and night sweats. She first assumed that she was pregnant, but urine dipstick testing four months ago was negative. Her menarche was at 12 years of age. Her cycles were regular during her teenage years and early twenties, but became irregular afterwards. Her medical and surgical histories are unremarkable. Her mother attained menopause at the age of 36; this was not investigated. She has been married for two years now and is looking forward to starting a family.
Pregnancy dipstick testing is negative. A full blood count, fasting plasma glucose, and renal and liver profiles are normal. Endocrine assessment is significant for a serum FSH of 103 IU/mL (normal: 3.5-12.5), LH of 92 IU/mL (normal: 2.4-12.6), and estradiol (E2) of 12 pg/mL (normal: 12.5-166). T4, TSH, and prolactin levels are within normal limits.