Which condition best corresponds to primary hypergonadism?

• A. Ovarian tumors or PCOS
• B. Menopause or Turner syndrome
• C. Gonadotropin-secreting tumor
• D. Sheehan's syndrome

Answer: (A)

Primary hypergonadism means the gonads themselves are overactive and producing excess sex hormones, independent of pituitary stimulation. Ovarian tumors that secrete hormones and polycystic ovary syndrome both involve the gonads as the source of the excess hormones, so they fit this pattern. In menopause or Turner syndrome, the gonads fail to produce hormones, leading to low levels of estrogen and a rise in pituitary gonadotropins—this is primary hypogonadism, not hyper. A tumor that secretes gonadotropins (LH/FSH) drives the gonads via the pituitary, which is a secondary cause of hypergonadism rather than a primary gonadal overproduction. Sheehan's syndrome is pituitary failure, causing decreased gonadotropin release and low sex steroids. Thus the ovarian tumors or PCOS scenario best matches primary hypergonadism.