What is the background or “big picture” of the problem or issue?”

The background of the problem or issue that is occurring in this patient’s situation is that this patient is experiencing premature ovarian failure (Bai & Wang, 2022). This condition tends to affect women under the age of 40 where they experience amenorrhea, elevated levels of follicle-stimulating hormone, decreased levels of estrogen, and infertility (Ghahremani‐Nasab et al., 2019). This condition can occur from a patient’s genetics, enzymatic, autoimmune, oncologic, environmental, or unknown factors (Bai & Wang, 2022). The main histopathological forms of premature ovarian failure are follicular and afollicular (Ghahremani‐Nasab et al., 2019). Premature ovarian failure can also be known as early menopause which would explain the patient’s presented symptoms of experiencing amenorrhea, fatigue, mood changes, hot flashes, and night sweats. 


On an average, what is the length of a normal menstrual cycle?

The length of a normal menstrual cycle for each female may vary however the main process that occurs each month is the female’s body signaling the potential for pregnancy (Bai & Wang, 2022). A normal menstrual cycle occurs from 21 to 35 days and has four stages (Ghahremani‐Nasab et al., 2019). The four stages of menstrual cycle are menses, follicular, ovulation, and luteal. Hormonal stimulation from the ovary helps to stimulate simultaneous cyclical changes in the lining of the uterus in order to correspond with the menstrual cycle phases. 


A deficit in which hormone can lead to heavy menstrual bleeding and hot flashes?

If there is a deficit in the hormone estrogen, it can result in heavy menstrual bleeding and hot flashes (Bai & Wang, 2022). In relation to the patient’s scenario, premature ovarian failure is confirmed by looking into the hormone levels such as follicle-stimulating hormone, Estradiol, Anti-Müllerian hormone, inhibin B, and the ovarian reserve (Ghahremani‐Nasab et al., 2019). There are a few treatment options that can be utilized such as hormone replacement therapy, immunomodulation therapy, DHEA supplementation, stem cell transplantation, as well as melatonin. 


What laboratory abnormalities would you anticipate, given her menopausal symptoms?

Laboratory abnormalities that would be anticipated given the patient’s menopausal symptoms would begin with the patient’s estrogen levels being decreased while the follicle-stimulating hormone will be elevated which directly results in heavy menstrual bleeding and hot flashes (Ghahremani‐Nasab et al., 2019). Also, the patient needs to be made aware that premature ovarian failure can result in cardiovascular disease as well as osteoporosis therefore these conditions need to be monitored (Ghahremani‐Nasab et al., 2019). Also, it is important to educate the patient that with this condition they may experience symptoms such as the presented ones which were the hot flashes and the mood changes as well as some vaginal dryness that can occur. 

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