A 25-year-old woman (gravida 1, para 1, living children 1) presented to her gynecologist with a complaint of reduced libido, amenorrhea, and fatigue. Approximately eight months ago, she delivered a 9-lb infant by cesarean section after a prolonged failed induction of labor. She had yet to regain her menses. Although her antenatal course was unremarkable, her delivery was complicated by a right-sided uterine artery laceration. It was repaired without difficulty, and she received a postoperative blood transfusion.
During the postpartum period, she did not desire any form of contraception and also failed to establish breastfeeding. She reported a loss of more weight following delivery than she expected; her weight is now 20 pounds less than her pre-pregnancy weight. She denies any fevers, rashes, or gastrointestinal symptoms, including any change in appetite. She also reported experiencing…
