Reproduction: menopausal hormones: practice question

A Physiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Physiology · Reproduction: menopausal hormones

Sample item

A 52-year-old woman has not menstruated for 14 months and has hot flushes. Which hormone profile is expected?

ALow FSH, high LH and normal oestradiolBHigh FSH, high LH and high oestradiolCHigh FSH and LH (FSH more), low oestradiol and low inhibin BDLow FSH, low LH and low oestradiol

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. High FSH and LH (FSH more), low oestradiol and low inhibin B

At menopause the ovarian follicles are exhausted, so oestradiol and inhibin B fall. Loss of negative feedback raises both gonadotrophins, and FSH rises earliest and highest because inhibin selectively restrains it. The main remaining oestrogen is oestrone from peripheral aromatisation of androstenedione in fat.

Option by option

A. Low FSH, high LH and normal oestradiol
A low FSH with high LH does not occur after menopause, where FSH dominates.
B. High FSH, high LH and high oestradiol
High oestradiol with high gonadotrophins does not fit, since oestradiol would suppress them.
C. High FSH and LH (FSH more), low oestradiol and low inhibin B (correct)
Loss of ovarian oestradiol and inhibin removes feedback and raises gonadotrophins, especially FSH.
D. Low FSH, low LH and low oestradiol
Low gonadotrophins with low oestradiol would indicate hypothalamic or pituitary failure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is C, High FSH and LH (FSH more), low oestradiol and low inhibin B. At menopause the ovarian follicles are exhausted, so oestradiol and inhibin B fall.

Why is "Low FSH, high LH and normal oestradiol" not the answer?

A low FSH with high LH does not occur after menopause, where FSH dominates.

Why is "High FSH, high LH and high oestradiol" not the answer?

High oestradiol with high gonadotrophins does not fit, since oestradiol would suppress them.

Why is "Low FSH, low LH and low oestradiol" not the answer?

Low gonadotrophins with low oestradiol would indicate hypothalamic or pituitary failure.

What concept does this question test?

It tests Reproduction: menopausal hormones in Physiology. Loss of negative feedback raises both gonadotrophins, and FSH rises earliest and highest because inhibin selectively restrains it. The main remaining oestrogen is oestrone from peripheral aromatisation of androstenedione in fat.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Reproduction: menopausal hormones?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.