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A 54-year-old G4P4 who has been menopausal for four years comes to you for a health maintenance examination. She is in good health, eats a balanced diet, exercises regularly, and has never had any menopausal symptoms and wants to know why. You explain to her that some untreated postmenopausal women will have circulating estrogen levels that are adequate to prevent them from experiencing the symptoms of menopause. What is the most likely source of these circulating estrogens?

A. Exogenous dietary intake
B. Limited adrenal estrogen secretion
C. Lingering ovarian estrogen
D. Aromatization of circulating androgens
E. Continued low-level ovarian production

User Sylence
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1 Answer

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Final answer:

The most likely source of circulating estrogens in a postmenopausal woman without menopausal symptoms is aromatization of circulating androgens. Other sources such as lingering ovarian activity, adrenal secretion, and exogenous dietary intake are either not significant or do not typically contribute to estrogen levels after menopause.

Step-by-step explanation:

The most likely source of circulating estrogens in a postmenopausal woman who does not exhibit menopausal symptoms is D. Aromatization of circulating androgens.

After menopause, the ovaries significantly reduce their production of estrogen. Nevertheless, estrogen can still be produced in smaller amounts through the process of aromatization, where androgens are converted into estrogen in adipose tissue and other organs. This can maintain enough estrogen to prevent symptoms in some women. Organisms no longer produce significant estrogen through lingering ovarian activity, or Continued low-level ovarian production, after menopause. The adrenal glands do produce a limited amount of estrogen, but this is minimal and often insufficient to prevent menopausal symptoms.

Exogenous dietary intake typically does not provide significant amounts of estrogens capable of altering a woman's hormone levels. It is important to understand these mechanisms, as the approach to hormone therapy (HT) and management of menopausal symptoms can be influenced by these contributing factors.

User Antonio Espinosa
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