This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Reproductive physiology and hormones in females, Subject name: Gynaecology & Obstetrics
Anovulatory cycles are characterized by which of the following? 
Select and explain. 
A. Elevated levels of plasma progesterone, B. Dysmenorrhea, C. A shoened luteal phase, D. Lack of a normal LH and FSH surge
D: Lack of a normal LH and FSH surge
Answer: D: Lack of a normal LH and FSH surge 
Explanation: The luteal phase of the menstrual cycle follows ovulation and is characterized by an increase in progesterone secretion by the corpus luteum. With anovulatory cycles, the corpus luteum does not form and progesterone levels remain low. Fuhermore, with anovulatory cycles, the characteristic surge of LH and FSH at midcycle is absent and menses are usually painless. Irregular estrogen breakthrough bleeding that occurs with anovulatory cycles is the consequence of persistent ovarian estradiol secretion and an absence of luteal-phase progesterone secretion.