A 53-year-old female with symptoms including insomnia and fatigue should have which hormone evaluated to assess for menopause?

The evaluation of FSH, or follicle-stimulating hormone, is critical when assessing a woman for menopause, especially in the context of symptoms such as insomnia and fatigue. During the perimenopausal and menopausal stages, the ovaries produce lower levels of estrogen, which leads to an increase in the production of FSH from the pituitary gland as a compensatory mechanism.

Measuring FSH levels can provide insight into the functioning of the ovaries and help confirm whether a woman is in menopause. Elevated levels of FSH are typically associated with decreased ovarian function, which is a hallmark of menopause. Therefore, evaluating FSH is a straightforward and effective way to assess menopausal status in women presenting with related symptoms.

Other hormones like prolactin, testosterone, and dehydroepiandrosterone (DHEA) may be evaluated in different clinical contexts but are not the primary tests for assessing menopause. Prolactin is more associated with lactation and certain disorders, testosterone may provide information about androgen levels but is not definitive for menopause, and DHEA levels do not specifically indicate menopausal status. Hence, FSH is the most appropriate hormone to evaluate in this scenario.