What physical examination finding may suggest ovulatory dysfunction in a female patient?

Elevated BMI can be a significant physical examination finding that suggests ovulatory dysfunction in a female patient. Obesity can lead to hormonal imbalances, particularly involving estrogen and progesterone levels, which can negatively impact ovulation. This is often seen in conditions such as polycystic ovary syndrome (PCOS), where an elevated BMI is commonly associated with irregular or absent menstrual cycles due to anovulation.

In contrast, other options like small testes and varicocele are more pertinent to male reproductive health and are not applicable to assessing ovulatory dysfunction in females. Abdominal tenderness may indicate various conditions but is not a direct indicator of ovulatory issues. Therefore, recognizing an elevated BMI helps inform the clinician about the underlying endocrine and metabolic factors that may be contributing to a female patient's ovulatory dysfunction.