Question

Nulliparous 34y/o patient presents with *12 month history* of *amenorrhea* (for the last two years she has had irregular cycles in which she skipped menses) and she is experiencing *dyspareunia*. Normal stature, normal vitals and overall in good health. With normal TSH and prolactin levels. (-) UPT and normal PE. What is the most likely Dx?

Answer 1

The most likely diagnosis for the patient is polycystic ovary syndrome (PCOS), a disorder of the endocrine system characterized by hormonal imbalances. PCOS can cause irregular menstrual cycles, amenorrhea, and other symptoms such as weight gain, acne, and excess facial hair. It is important to diagnose and manage PCOS to address fertility concerns and reduce the risk of complications.

Step-by-step explanation:

The most likely diagnosis for the 34-year-old nulliparous patient presenting with a 12-month history of amenorrhea and dyspareunia is polycystic ovary syndrome (PCOS). PCOS is a disorder of the endocrine system that can cause irregular menstrual cycles, amenorrhea, and other symptoms such as weight gain, acne, and excess facial hair. It is characterized by hormonal imbalances, specifically high levels of androgens (male hormones) and insulin resistance. PCOS can be diagnosed based on a combination of symptoms, physical examination findings, and hormonal tests.

It's important to note that PCOS can have significant implications for fertility and long-term health. Women with PCOS may have difficulty getting pregnant due to irregular or absent ovulation. Additionally, PCOS is associated with an increased risk of complications such as type 2 diabetes, cardiovascular disease, and endometrial cancer.

Treatment for PCOS focuses on managing symptoms and reducing the risk of complications. This may include lifestyle modifications such as weight loss, medications to regulate menstrual cycles or improve insulin sensitivity, and fertility treatments if pregnancy is desired.