• Explain how missing information from the patient history might change the diagnoses for the patients in the posting selected.

• Based on your personal and/or professional experiences, expand on your postings by providing additional insights or contrasting perspectives.

Week Five: Case Study #3
A 48-year-old Caucasian female is in the clinic concerned about prolonged menstrual bleeding for three weeks now. Her prior menstrual periods have been irregular for the past eight months, lasting no more than three days each. There have been one to two months when she had no menstrual cycles at all. She reports occasional hot flushes and mood swings.

Primary Diagnosis: Perimenopause
I feel the patient is most likely experiencing perimenopause due to the symptoms she has been having. Perimenopause refers to the years leading up to menopause in which the amount of estrogen produced by the ovaries start to fluctuate (The American College of Obstetricians and Gynecologists [ACOG], 2018). Perimenopause often begins in a women’s 30s and 40s (ACOG, 2018). This transition phase can last anywhere from four to eight years and often starts with changes to a women’s menstrual cycle and ends one year after her final menstrual period (The North American Menopause Society [NAMS], n.d.). Women going through perimenopause often complain of irregular periods or skipping their menstrual periods (ACOG, 2018). The periods that perimenopausal women do have are often described as being longer or shorter in duration and lighter or heavier than usual (ACOG, 2018). Other common symptoms of perimenopause include hot flashes, night sweats, vaginal dryness, insomnia or sleep disturbances, irritability, mood swings, and short-term memory problems and difficulty concentrating (Harvard Health Publishing, 2009).