A46-year-old, 230lb woman with a family history of breast cancer. she is up to date on yearly mammograms. she has a history of htn. she complains of hot flushing, night sweats, and genitourinary symptoms. she had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. she has a history of ascus about 5 years ago on her pap, other than that, pap smears have been normal. home medications are norvasc 10mg qd and hctz 25mg qd. her bp today is 150/90. she has regular monthly menstrual cycles. her lmp was 1 month ago.