A 34-year old woman complains of fewer than nine menstrual periods in 1 year and no menstrual periods for 3 consecutive months. Which is the most appropriate diagnosis for this woman?

• A. Polycystic ovarian syndrome
• B. Hypoandrogenism
• C. Menstrual dysfunction
• D. Perimenopause

Answer: (C)

The situation described in the question highlights a woman experiencing amenorrhea (no menstrual periods for 3 consecutive months) and oligomenorrhea (fewer than nine menstrual periods in a year). This pattern of menstrual irregularity is indicative of menstrual dysfunction, which encompasses a range of abnormalities in the menstrual cycle, including variations in frequency, duration, and volume of bleeding.

Menstrual dysfunction can be attributed to various factors, including hormonal imbalances, stress, weight changes, and underlying medical conditions. In this case, the absence of menstrual periods for a specified duration and the overall low frequency of menstruation suggest that the woman is experiencing disruptions in her menstrual cycle that align with this diagnosis.

In contrast, other conditions listed, such as polycystic ovarian syndrome or hypoandrogenism, involve more specific symptoms and hormonal profiles, which are not clearly indicated in the woman's complaint. Perimenopause typically occurs in women aged 40 and above, leading to irregularities as a transitional phase, but at 34 years old, this is less likely the underlying issue. Therefore, menstrual dysfunction is the most appropriate diagnosis based on the provided symptoms.