A 36-year-old woman presents to the GP with secondary amenorrhoea for 4 months. A pregnancy test is negative. She has recently lost 8 kg through dieti...

Question

A 36-year-old woman presents to the GP with secondary amenorrhoea for 4 months. A pregnancy test is negative. She has recently lost 8 kg through dieting and increased exercise. Her BMI is now 18.5 kg/m². Blood results show: FSH 3 IU/L (low), LH 1.5 IU/L (low), oestradiol low, prolactin normal, and TFTs normal. What is the single most important management recommendation?

Accepted Answer

Address the underlying cause - advise weight restoration and reduced exercise intensity to restore the hypothalamic-pituitary-ovarian axis

Answer

Prescribe the combined oral contraceptive pill to regulate her cycles

Answer

Prescribe gonadotrophin injections to induce ovulation

Answer

Refer for MRI pituitary

Answer

Prescribe clomifene citrate

uk-drcog MCQ (SBA): Weight-Loss-Related Amenorrhoea - Energy Restoration