Reproduction: perimenopausal FSH rise: 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: perimenopausal FSH rise

Sample item

A 47-year-old woman has regular but shortening cycles. Her FSH is raised while LH and oestradiol are still normal. Which change is chiefly responsible for the early FSH rise?

ARise in prolactin suppressing dopamineBFailure of oestradiol positive feedback at the pituitaryCFalling inhibin B from the dwindling pool of folliclesDFall in progesterone from a persistent corpus luteum

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

The answer and the reasoning

C. Falling inhibin B from the dwindling pool of follicles

As the follicle pool declines in the late reproductive years, granulosa cells secrete less inhibin B, so FSH is no longer restrained and rises first. Oestradiol may remain near normal for some time, and LH rises later when oestradiol finally falls.

Option by option

A. Rise in prolactin suppressing dopamine
Raised prolactin would reduce gonadotrophins rather than raise FSH.
B. Failure of oestradiol positive feedback at the pituitary
The patient still has normal oestradiol, and an LH rise would be expected if positive feedback failed.
C. Falling inhibin B from the dwindling pool of follicles (correct)
Correct. Reduced inhibin B releases FSH early, while oestradiol is still adequate.
D. Fall in progesterone from a persistent corpus luteum
A persistent corpus luteum would raise progesterone and suppress FSH.

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, Falling inhibin B from the dwindling pool of follicles. As the follicle pool declines in the late reproductive years, granulosa cells secrete less inhibin B, so FSH is no longer restrained and rises first.

Why is "Rise in prolactin suppressing dopamine" not the answer?

Raised prolactin would reduce gonadotrophins rather than raise FSH.

Why is "Failure of oestradiol positive feedback at the pituitary" not the answer?

The patient still has normal oestradiol, and an LH rise would be expected if positive feedback failed.

Why is "Fall in progesterone from a persistent corpus luteum" not the answer?

A persistent corpus luteum would raise progesterone and suppress FSH.

What concept does this question test?

It tests Reproduction: perimenopausal FSH rise in Physiology. Oestradiol may remain near normal for some time, and LH rises later when oestradiol finally falls.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: perimenopausal FSH rise?

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.