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A 64 year old woman comes to see you in GP as she has noticed some PV bleeding in the last few weeks despite having gone through the menopause 5 years ago. She has had problems with atrophic vaginitis in the past and thinks this is just an exacerbation so wants you to give her some more cream to give her some relief. Her examination is normal other than a BMI of 32 and she has normal observations. Her PMH includes HTN, T2DM and rheumatoid arthritis. What is the most appropriate management for this patient?