Assignment task: Joyce Reynolds is a 52-year-old woman being seen for her annual physical. Over the past 8 months, Joyce has noticed that her menstrual periods are very infrequent and last only 2 to 3 days. She has also been experiencing hot flashes several times each day and is frequently awakened at night with night sweats. Her LMP was about 8-9 months ago after several months of erratic menstrual cycles. She complains of stress incontinence and has been treated for recurrent UTIs over the past 6 months. She complains of dyspareunia. She believes that these are symptoms related to menopause and she would like you to prescribe something to ease these symptoms.
Answer the following questions:
1. Based on the information provided above, can a diagnosis of menopause be definitively established?
2. Identify Joyce's clinical symptoms that are consistent with a diagnosis of menopause.
3. What could be the cause of Joyce's complaints of dyspareunia?
4. What are the goals of drug therapy for Joyce?
5. Identify a clinical indication for the justified use of hormone replacement therapy in this case.
6. What other information would you need to determine if Joyce has any medical conditions or diseases that would contraindicate the administration of hormonal therapy?
7. If you agree to begin HRT, what medication would you prescribe? Explain. What patient education would you include?