A 27-year-old woman presents to her primary care physician because she has not menstruated for the past months. She achieved menarche at age 14, and her menses have historically been regular, with bleeding lasting 4 days every 29 days. She works as a software engineer and exercises moderately twice a week. She recently started a new relationship and uses condoms for birth control. She has not noticed any breast discharge, changes in voice, or abnormal hair growth. Her body mass index is . Her vital signs are normal. Physical examination shows normal thyroid size and no skin findings suggestive of hyperandrogenism. A urine pregnancy test performed at the clinic is negative. Which of the following is the most appropriate next step in the evaluation of this patient?
- AMagnetic resonance imaging of the brain
- BMeasurement of serum total testosterone and dehydroepiandrosterone sulfate levels
- Measurement of serum prolactin, thyroid-stimulating hormone, and follicle-stimulating hormone levelsCevap
- DOutpatient endometrial biopsy
- EMeasurement of serum estrogen and progesterone levels