Sarah, a 50-year-old G2P1011 woman, presents to the office with increasing hot flashes, night sweats, vaginal dryness, and insomnia over the past 4 months.
Sarah, a 50-year-old G2P1011 woman, presents to the office with increasing hot flashes, night sweats, vaginal dryness, and insomnia over the past 4 months. She indicates that she has made some dietary changes, specifically decreasing the intake of spicy foods and hot tea; however, they seem to have little effect on her symptoms. Her last menstrual period (LMP) was 14 months ago. She is also experiencing some constipation, dry skin, and thinning hair. Her mother experienced menopause at about age 51 years and seemed to “sail right through it.” Overall, Sarah’s general health has been good. Her BMI is 26 and vitals are within normal limits. She had a normal pelvic at her well-woman visit 10 months ago. Her uterus, ovaries, and cervix are intact. She exercises by walking for 30 minutes a day about 4 to 5 days a week. She takes a multivitamin every day.
- Discuss your three differential diagnoses for Sarah and include your reasoning for each. What is the most likely diagnosis?
- What further testing is recommended for Sarah and why?
- Discuss the medication you would prescribe for Sarah. Is there any further information you should obtain from Sarah before prescribing medication?
- Discuss your recommendations for a follow-up.
- What educational information is important to provide to Sarah?