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Lois is a 47 year old woman who attends the surgery to discuss her menstrual cycle. Her periods have become less frequent approximately every 12 weeks. There is no history of intermenstrual or post coital bleeding. She is not prescribed any hormonal contraception as her partner has had a vasectomy. She has never smoked, her BMI is 24.5 and has no other medical problems. She is experiencing severe hot flushes, irritability and her sleep patterns are affected. She is also finding sexual intercourse painful. After a lengthy discussion today and prior research at home, Lois chooses to start Hormone Replacement Therapy (HRT).

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