What symptoms suggest primary ovarian failure in a woman under 40?

Primary ovarian failure, also known as primary ovarian insufficiency, occurs when a woman's ovaries stop functioning normally before the age of 40. This condition often leads to a decrease in estrogen production, which is vital for various bodily functions.

Hot flashes and vaginal dryness are significant symptoms of estrogen deficiency, which can arise from primary ovarian failure. Hot flashes are characterized by sudden feelings of warmth, often accompanied by sweating and flushing, while vaginal dryness can lead to discomfort during sexual activity and urinary problems. The presence of these symptoms in a younger woman can be indicative of a decrease in ovarian function.

Other symptoms of primary ovarian failure may also include menstrual irregularities, such as missed periods, but the combination of hot flashes and vaginal dryness is particularly telling as it points directly to the hormonal changes associated with this condition. This makes option D the correct choice, as it captures the hallmark manifestations of premature menopause caused by primary ovarian insufficiency.