[Answered]: You have a 54 year old patient who had her last…

You have a 54 year old patient who had her last menstrual period 3 years ago, until 4 months ago when she started having some light spotting every few weeks 9 me is having hot flashes several times nightly that interfere with sleep and would lase to consider starting estrogen to help with hot flawhes. She has no obler meflal problems. You tell her: Lets discuss the risks and benefits of menopausal hormone therapy together We cannot conslider hormone therapy until we evaluate your recent spotting We will need to get you a mammogram and do a breast exam before we start hormone therapy Hormone therapy is contraindicated for treatment of hot flashes based on results of the Women’s Health initiative (WHil) study