Amenorrhoea — DRCOG MCQ

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HardGynaecologyAmenorrhoeaDRCOG

A 41-year-old has six months of amenorrhoea, galactorrhoea and a negative pregnancy test. Which initial blood tests are most informative?

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Correct answer: A — Prolactin and thyroid-stimulating hormone

The best answer is “Prolactin and thyroid-stimulating hormone”. Galactorrhoea suggests hyperprolactinaemia, while thyroid dysfunction can cause both menstrual disturbance and altered prolactin. Prolactin and thyroid testing are therefore appropriate after pregnancy has been excluded; medication review and symptom-guided pituitary assessment follow abnormal results. Persistently raised prolactin should be repeated under suitable conditions and reviewed for medicines, renal disease and pituitary symptoms before imaging is selected.

Reference: NICE CG156: Fertility problems assessment and treatment: https://www.nice.org.uk/guidance/cg156/chapter/recommendations