Snapshot A 52-year-old female presents with a feeling of heat beginning in the face, neck, and chest followed by profuse sweating in the upper body that lasts five minutes.These episodes are happening repetitively throughout the day and disturb her sleep at night. Her last menstrual period was over six months ago. Introduction Permanent cessation of menstruation secondary to login to view 2 more bullets Premature menopause is defined by menopause before age 40 Post-menopausal women lose the protective effects of estrogen with increased risk for login to view 2 more bullets Epidemiology Mean age in the US is 51 Early menopause is associated with cigarette smoking Presentation Symptoms login to view 9 more bullets Evaluation This is a clinical diagnosis Elevated serum FSH (> 30 mIU/mL) login to view 1 more bullet Androstenedione levels do not change Estrogen levels will be low login to view 1 more bullet DEXA scan (at 65 years or older) login to view 3 more bullets Differential Premature ovarian failure Rule out other conditions that can cause amenorrhea login to view 1 more bullet Treatment Estrogen hormone replacement therapy (HRT) login to view 28 more bullets Alternative drugs for vasomotor symptoms login to view 4 more bullets Complications Oosteoporosis Coronary artery disease