Question

A 27 year old woman who had delivered a female child 9 months back, came to the gynaecologist with complaints of absent periods since child birth. She has been using contraceptive methods as a family control measure. She was advised to get her serum beta hCG levels tested, which came out as 4.9 mIU/ml. Her prolactin level was 88ng/ml, and TSH was 3.8. What could be the reason for amenorrhea in this case?

• A. Normal pregnancy
• B. Lactational amenorrhea
• C. Hypothyroidism
• D. Prolactinoma

Answer 1

The Correct Option is B

The given scenario involves a 27-year-old woman with amenorrhea since childbirth, using contraceptives, with a serum beta hCG level of 4.9 mIU/ml, a prolactin level of 88 ng/ml, and a TSH level of 3.8. Let's analyze these findings to determine the cause of amenorrhea:

• Serum beta hCG level: The level of 4.9 mIU/ml is indicative of a non-pregnant state, as levels below 5 mIU/ml are typically considered negative for pregnancy.
• Prolactin level: Elevated prolactin levels (88 ng/ml) are documented, which can be associated with lactational amenorrhea, a physiological process that occurs during breastfeeding and results in the suppression of ovulation and menstruation.
• TSH level: A TSH level of 3.8 is within normal limits (typically 0.4-4.0 mIU/L), ruling out significant hypothyroidism as a primary cause.

The physiological condition explained above is lactational amenorrhea, which naturally occurs during breastfeeding due to increased prolactin levels inhibiting reproductive hormones. Therefore, based on the clinical findings and hormonal profile, the most likely cause of amenorrhea in this woman is lactational amenorrhea.