Author: Anonymous

JG is a 49-year-old female referred to your pharmacotherapy clinic for a consult related to symptoms of vaginal dryness, severe hot flashes, and night sweats.  JG reports her current symptoms have been a problem for 6-8 months and her primary care provider has prescribed topical estrogen without benefit.  Additionally, she has tried evening primrose and black cohosh and those have not worked.  Her most recent vaginal exam was normal, she has an intact uterus, and she has no history of thromboembolism. Her current medical problems include dry eyes, migraine without aura, and hypertension. Her current medications are hydrochlorothiazide 25mg daily, topiramate 100mg twice daily, sumatriptan 100mg at onset of migraine, may repeat one time in 24-hour period, and ibuprofen 400mg two or three times daily as needed.  All medications are prescribed by referring physician.  What product would you recommend as the best treatment for JG?

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