A 19-year-old athlete (marathon runner) presents with secondary amenorrhea for 8 months, stress fractures, and eating behaviour suggesting caloric restriction. FSH and LH are low, estradiol is low, BMD is reduced. This triad is best described as:

• A Primary ovarian insufficiency
• B Hyperprolactinaemia-induced amenorrhea
• C Hypothalamic amenorrhea (functional HPA suppression) as part of the Female Athlete Triad ✓
• D Anorexia nervosa with secondary hypogonadotropic hypogonadism — different from Female Athlete Triad

Explanation

The Female Athlete Triad (IOC consensus 2014 revised to Relative Energy Deficiency in Sport — RED-S) comprises: (1) low energy availability (with or without disordered eating), (2) menstrual dysfunction (amenorrhea), and (3) low bone mineral density. Low LH/FSH and estradiol confirm functional hypothalamic amenorrhea from energy deficit suppressing GnRH pulsatility. This differs from primary ovarian insufficiency (FSH high, LH high) and hyperprolactinaemia. Treatment centres on increasing caloric intake and modifying training load.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.