Lois, a 32-year old unmarried female business executive
develops amenorrhea. She has not recently lost weight...
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Lois, a 32-year old unmarried female business executivedevelops amenorrhea. She has not recently lost weight but statesthat her job is very stressful. Laboratory evaluation reveals thefollowing results:
PARAMETER VALUE NORMAL RANGE
Serum estradiol 14pg/ml 23-145
LH 1.2mIU/ml 2-15
FSH 1.5mIU/ml 2-20
Prolactin 6.2ng/ml 2-25
TSH 1.2µU/ml 0.5-5.0
A serum pregnancy test is negative and an MRI scan of herpituitary gland is normal. What is the probable diagnosis? Explain.[6 marks]
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ANSWER The probable diagnosis is Functional hypothalamic amenorrhea FHA It is type of secondary amenorrhea and is classified as hypogonadotropic hypogonadism It is related to an aberration of the pulsatile release of gonadotropinreleasing hormone GnRH from the hypothalamus EXPLANATION Symptomatically patient is complaining of amenorrhea and gives history of stressful job History of weight is important key to understand causes
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