Answer to Question 1
ANS: D
In menopause, FSH rises first and then LH rises, both greater than 100 mU/mL. A fall in estradiol is the last hormonal change that occurs with the decline of ovarian function. An estradiol level of less than 30 pg/mL indicates loss of ovarian function.
Answer to Question 2
ANS: A
Dysmenorrhea is the most common gynecological complaint, particularly in the adolescent and young adult population. Primary dysmenorrhea is due to a rise in prostaglandins that occurs at the onset of menses, and it has been found that prostaglandins are higher in women with dysmenorrhea. Recently, increased leukotriene levels have been found to contribute to dysmenorrhea. Other psychosocial variables may contribute, such as response to pain, anxiety, stress, and attitudes about menstruation. Secondary dysmenorrhea is most often caused by endometriosis. Other causes include chronic PID, adhesions, IUDs, cervical stenosis, and uterine fibroids.