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Hormonal replacement therapy with estrogen alone
55%
16/29
Hormonal replacement therapy with combined estrogen/progesterone
34%
10/29
Hormonal replacement therapy with progesterone alone
7%
2/29
Paroxetine
3%
1/29
Gabapentin
0%
0/29
Select Answer to see Preferred Response
This patient presents with symptoms strongly suggestive of menopause, including hot flashes and mood swings. For symptomatic relief, the first-line treatment is hormonal therapy with an estrogen-based regimen. Menopause has a median age of onset of 51 years, and classically presents with subacute symptoms that include systemic manifestations (hot flashes, malaise), psychiatric/behavioral manifestations (mood swings, insomnia, depression), and urogenital symptoms (vaginal dryness). For patients without a contraindication (such as prior VTE), first-line therapy includes an estrogen compound. If the patient still has a uterus, progesterone should be added to protect against dysplasia. Patients with refractory symptoms can be considered for SSRI, SNRI, or gabapentin as alternatives. Incorrect Answers: Answer 2: Combined estrogen/progesterone therapy would be indicated for a patient with an intact uterus Answer 3: There is no role for progesterone monotherapy in this clinical context Answer 4: SSRIs are an alternative, but is not first line therapy for menopausal symptoms. Answer 5: Gabapentin is an alternative, but not first-line therapy for menopausal symptoms
5.0
(7)
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