A 51-year-old woman presents with eight months of frequent hot flushes and drenching night sweats that wake her four to five times each night and are affecting her concentration at work. She had a hysterectomy with conservation of both ovaries at age 45 for fibroids. She has no personal or family history of breast cancer or venous thromboembolism, and her blood pressure and breast examination are normal. She asks for the most effective treatment available. Which one of the following is the most appropriate therapy?
Menopause, urogynaecology and prolapse practice
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