Perimenopausal TransitionDownloads

A middle-aged female presents with increasing visual loss, breast enlargement, and irregular menses. What is the most appropriate investigation to diagnose the underlying condition?

A 46-year-old woman presents for her annual examination. Her main complaint is frequent sweating episodes with a sensation of intense heat starting at her upper chest and spreading up to her head. These have been intermittent for the past 6 to 9 months but are gradually worsening. She has three to four flushing/sweating episodes during the day and two to three at night. She occasionally feels her heart race for about a second, but when she checks her pulse it is normal. She reports feeling more tired and has difficulty with sleep due to sweating. She denies major life stressors. She also denies weight loss, weight gain, or change in bowel habit. Her last menstrual cycle was 3 months ago. Physical examination is normal. Which treatment is most appropriate in alleviating this woman's symptoms?