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Q. |
A 44-year-old woman has a lumpectomy and radiation therapy for stage II breast cancer. She receives 6 months of chemotherapy. Her periods cease while she is receiving chemotherapy, and she remains amenorrheic. Her tumor was found to be rich in estrogen receptor, and she is taking tamoxifen. Her hair is growing back and her energy is returning, but she is having severe hot flushes that keep her awake at night. She is so tired during the day that she is unable to perform her job in a satisfactory manner. She also relates that she and her husband have been unable to have satisfying sexual relations because intercourse is painful for her. What would be the most appropriate treatment for this patient? |
A. | A selective serotonin reuptake inhibitor and use of nonhormonal vaginal lubricating preparations |
B. | Reassurance that these normal physiologic responses to menopause will resolve in time |
C. | Estrogen replacement therapy with a progesterone supplement |
D. | Work-up for endometrial cancer because she is taking tamoxifen |
Answer» A. A selective serotonin reuptake inhibitor and use of nonhormonal vaginal lubricating preparations |
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