As you enter your patient’s room, she begins to complain loudly about how warm it is, despite the room being somewhat chilly. She tells you that she is always tired, has frequent headaches, and has...

As you enter your patient’s room, she begins to complain loudly about how warm it is, despite the room being somewhat chilly. She tells you that she is always tired, has frequent headaches, and has been especially down for the last six months (starting shortly after her 50th birthday). A  menstrual history reveals irregular menses for the last year. What is causing her symptoms and what treatments are available?