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?
More from AMC
See allA 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…
A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…
A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…
A 26-year-old backpacker is snorkelling off Port Douglas in far north Queensland in December when she feels a mild sting on her forearm, leaving only faint redn…
A 34-year-old man in suburban Sydney felt a sharp pinprick on the back of his hand while moving pot plants stacked against the house. Over the next two hours he…