Susan is a 39-year-old (G2P2) married white female with menstrual cycle changes. She tells you, “My bleeding varies in how heavy or light it is—sometimes I am 5 to 7 days late and only have light spotting”. She reports that she has become much more irritable and moody prior to the onset of her menses, and is experiencing hot flashes and night sweats that wake her up two to three times a night. She is fatigued and finds herself dozing off throughout her work day. Her boss has commented on fatigue and has suggested she see her health care provider.

Questions

1. What is the background or “big picture” of the problem or issue?”
2. On an average, what is the length of a normal menstrual cycle?
3. A deficit in which hormone can lead to heavy menstrual bleeding and hot flashes?
4. What laboratory abnormalities would you anticipate, given her menopausal symptoms?

Please validate your opinions and ideas with a minimum of two scholarly references and cite all sources using in-text citations.  Include a corresponding reference list.  Adhere to APA 7th edition guidelines for all work.

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