What does increased FSH/LH indicate in a patient with primary amenorrhea?

Increased levels of FSH (follicle-stimulating hormone) and LH (luteinizing hormone) in a patient with primary amenorrhea indicate ovarian failure. This hormonal increase occurs because the ovaries are not responding to the stimulating effects of these hormones, which leads to a feedback mechanism prompting the pituitary gland to release more FSH and LH. When the ovaries are not functioning properly due to failure (either due to genetic factors, environmental influences, or other underlying conditions), estrogen production diminishes, resulting in the absence of menstruation (amenorrhea).

In the context of primary amenorrhea, an elevated FSH/LH ratio suggests that the body is attempting to stimulate the ovaries to produce hormones, but the dysfunction lies within the ovaries themselves. The ovaries may not be releasing eggs or may be underdeveloped, leading to primary amenorrhea.

Understanding this hormonal balance is crucial in differentiating causes of amenorrhea and guiding further diagnostic and therapeutic approaches.