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Menopausal vasomotor symptoms — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareMenopausal vasomotor symptomsUSMLE Step 3

A 52-year-old woman has bothersome hot flashes and night sweats 8 months after her last menstrual period. She has an intact uterus, no breast cancer history, and low cardiovascular risk. Which of the following is the most appropriate next step in management?

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Correct answer: B — Offer combined estrogen-progestin therapy after shared decision-making

For symptomatic menopause with an intact uterus, systemic estrogen requires progestin to reduce endometrial hyperplasia risk.

Reference: North American Menopause Society hormone therapy guidance