system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 15-year-old girl is brought to the physician by her parents because she has not had menstrual bleeding for the past 2 months. Menses had previously occurred at irregular 15–45 day intervals with moderate to heavy flow. Menarche was at the age of 14 years. Eight months ago, she was diagnosed with bipolar disorder and treatment with risperidone was begun. Her parents report that she is very conscious of her weight and appearance. She is 168 cm (5 ft 5 in) tall and weighs 76 kg (168 lb); BMI is 26.9 kg/m2. Pelvic examination shows a normal vagina and cervix. Serum hormone studies show:
Prolactin 14 ng/mL
Follicle-stimulating hormone 5 mIU/mL
Luteinizing hormone 5.2 mIU/mL
Progesterone 0.9 ng/mL (follicular N <3; luteal N >3–5)
Testosterone 2.7 nmol/L (N <3.5)
A urine pregnancy test is negative. Which of the following is the most likely cause of her symptoms?"
assistant
Anovulatory cycles