Which of the following is listed as a lifestyle factor contributing to anovulation?

• A. Hyperprolactinemia
• B. Adequate body weight
• C. Regular exercise
• D. Balanced nutrition

Answer: (A)

Elevated prolactin disrupts ovulation by quieting the hypothalamic GnRH pulse generator. Prolactin acts on the hypothalamus to reduce both the frequency and amplitude of GnRH pulses, so the pituitary releases less LH and FSH. Without enough LH and FSH, the ovarian follicles fail to mature and ovulation does not occur, leading to anovulation. Hyperprolactinemia can stem from a prolactin-secreting pituitary adenoma, certain medications that block dopamine (the natural inhibitory control on prolactin), hypothyroidism, or other conditions. In contrast, adequate body weight, regular exercise, and balanced nutrition do not directly cause anovulation; they generally support regular cycles, unless energy balance is severely disrupted or extreme exercise induces hypothalamic suppression, which operates through different pathways than prolactin.