O Menopausal Symptoms

• Vasomotor symptoms (hot flashes, night sweats)

• Irregular menses

• Episodic amenorrhea

• Sleep disturbances

• Vaginal dryness

• Depression

Less Common Symptoms

• Irritability

• Arthralgia

• Myalgia Diagnosis

• Amenorrhea for 1 year

• Fivefold increase in LH

Patient Encounter, Part 2: Medical History, Physical Exam, and Diagnostic Tests

BW's work-up reveals the following additional information:

PMH: Osteoarthritis of the lower back for 5 years controlled on acetaminophen 500 mg two tablets by mouth 3 to 4 times daily; hypothyroidism since age 25, currently controlled

FH: Father: Alive with HTN and CHD (MI at age 60). Mother: Alive with hypothyroidism and GERD. Siblings: Two sisters alive and well

SH: Occupation: nurse; nonsmoker; drinks one to two glasses of red wine with dinner on the weekends; denies illicit drug use

Meds: Acetaminophen 500 mg two tablets by mouth 3 to 4 times daily; synthroid 0.075 mg by mouth once daily; multivitamin by mouth once daily

ROS: (+) hot flashes, night sweats, vaginal dryness and itching; (+) insomnia, myalgias, bowel changes, weight gain, constipation

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