Question
A 47-year-old woman comes to the physician because of fatigue, difficulty falling asleep, and night sweats for the past 6 months. Over the past year, her menstrual cycle has become irregular and her last menstrual period was 2 months ago. She quit smoking 2 years ago. Pelvic exam shows vulvovaginal atrophy. A pregnancy test is negative. Which of the following changes is most likely to occur in this patient’s condition?
| A. | Increased LH |
| B. |
Increased Estrogen |
| C. |
Increased Inhibin |
| D. |
Increased FSH |
|
Correct Answer » D Explanation |
 |
This 47-year-old patient presents with irregular menses, night sweats, insomnia, and vulvovaginal atrophy, which are all signs and symptoms of menopause.
Hormonal Changes in Menopause
-
Ovarian follicle depletion
-
Decreased estrogen
-
Decreased inhibin
Loss of negative feedback on the pituitary leads to:
-
Increased FSH
-
Increased LH
Most Significant Change
-
FSH increases more than LH.
-
Inhibin normally suppresses FSH.
-
Decreased inhibin causes marked rise in FSH.
-
FSH is the most sensitive marker of menopause.
Reason Why Other Options Are Incorrect
Increased LH
-
LH rises, but less than FSH.
Increased Estrogen
-
Estrogen decreases in menopause.
Increased Inhibin
-
Inhibin decreases due to follicular depletion.