Review Question - QID 210793

A 51-year-old woman presents to the primary care clinic complaining of trouble sleeping. She reports that she has episodes of “overheating” and “sweating” during the day and at night. The nightly episodes keep her from staying asleep. She also explains how embarrassing it is when she suddenly becomes hot and flushed during work meetings. The patient becomes visibly upset and states that she is worried about her marriage as well. She says she has been fighting with her husband about not going out because she is “too tired.” They have not been able to have sex for the past several months because “it hurts.” Her temperature is 98.6°F (37°C), blood pressure is 129/65 mmHg, pulse is 90/min, respirations are 12/min, and oxygen saturation is 98% on room air. Labs are drawn, as shown below:

Follicle-stimulating hormone (FSH): 62 mIU/mL
Estradiol: 34 pg/mL
Progesterone: 0.1 ng/mL
Luteinizing hormone (LH): 46 mIU/mL
Free testosterone: 2.1 ng/dL

Which of the following tissues is most responsible for estrogen production in this patient?