A lady with secondary amenorrhea is negative for progesterone challenge test but positive for combined estrogen and progesterone challenge test. What is the probable cause:-: (A) Ovarian failure, (B) PCOD, (C) Asherman syndrome, (D) Pregnancy
Answer is A. PCOS has plenty estrogens but no progesterones, hence Progesterone therapy will elicit a withdrawal bleeding Asherman Syndrome is Endometrial Fibrosis, hence no estrogen or progesterone will show any effect In Pregnancy , if Estrogen and progesterones are given, it will not cause a withdrawal since the patient herself is making adequate amount of those hormones. Only ovarian failure or an Hypothalamic failure will be positive for combined estrogen and progesterone challenge test.