<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 22-year-old woman presents to the gynecologist for evaluation of amenorrhea and dyspareunia. The patient states that she recently got married and has been worried about getting pregnant. The patient states that she has never had a period and that sex has always been painful. On examination, the patient is Tanner stage 5 with no obvious developmental abnormalities. The vaginal exam is limited with no identified vaginal canal. What is the most likely cause of this patients symptoms?? A: Hyperprolactinemia, B: Exposure to DES in utero, C: Turner syndrome, D: PCOS, E: Mullerian agenesis,  <response>: This is a question about a 22-year-old woman with primary amenorrhea never had a period and dyspareunia painful intercourse. The key findings are that she has normal secondary sexual characteristics Tanner stage 5 and an absent vagina on exam. The most likely diagnosis given these findings is mullerian agenesis, which is a congenital abnormality where the mullerian ducts fail to develop, resulting in an absent uterus and vagina. Hyperprolactinemia, PCOS, and exposure to DES in utero can all cause secondary amenorrhea but would not explain the absent vagina. Turner syndrome could cause primary amenorrhea but is associated with lack of secondary sexual development.E: Mullerian agenesis 