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Menopausal symptoms — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareMenopausal symptomsUSMLE Step 3

A 53-year-old has severe hot flashes and night sweats 14 months after her last period. She has an intact uterus and no breast cancer, venous thromboembolism, or cardiovascular disease. What is the best option?

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Correct answer: B — Discuss systemic estrogen plus progestogen after individualized risk-benefit review

For a healthy symptomatic woman near menopause with an intact uterus, systemic estrogen plus endometrial protection is an effective option after individualized counseling. Estrogen alone risks endometrial hyperplasia.

Reference: ACOG: Hormone Therapy for Menopause: https://www.acog.org/womens-health/faqs/hormone-therapy-for-menopause