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40. A 13-year-old girl is brought for a well-child examination. Menses have occurred every other month since menarche 10 months ago. Her last menstrual period was 1 week ago. She is not sexually active. Sexual development is Tanner stage 3. Examination shows no abnormalities. Which of the following is the most appropriate next step in management?

A
) Discussion of pregnancy prevention

B
) Measurement of serum luteinizing and follicle-stimulating hormone levels

C
) Urine β-hCG test

D
) Pelvic examination

E
) Estrogen therapy

F
) Diagnostic laparoscopy

Estrogen therapy

E

y Estrogen therapy ?..........y not A

Menses have occured every other month ( inconsistent menses) , probably due to anovulatory cycles. Estrogen therapy.

LMP is only last week , 13 year old, not involved in sexual activity yet . More important than discussion of pregnancy prevention is to regularise her menstrual cycles first.

its normal not to have regular menses in first months so ,i think A is correct.

A for sure

PS. It's normal to have irreg menses first year, even she is not sex active today but hey... she can be active tomorow.

i go for A too.irreg periods due to immaturity of HPO axis is common in 1st yr n no trt is needed for tht

n @ age 13, can estrogen make ne effect on growth pattern ? ? ?