Anne says her wife is angry about

Anne says her wife is angry about the lack of sexual intercourse and she feels the stress in their marriage. She also is worrying about her oldest children leaving for college and about her mother’s ill health. She scores 20 on the Beck Depression Inventory, which indicates that she has mild to moderate depression. Her menstrual periods remain regular, but her cycle has shortened from 29 to 24 days. She reports that some hot flashes wake her at night and that she hasn’t had a good night’s sleep in months. Laboratory tests show follicle-stimulating hormone of 25 mIU/mL and inhibin B below 45 pg/mL. Her estradiol is 80 pg/mL—not yet in the menopausal range. Her thyroid-stimulating hormone is normal. Her shortened menstrual cycles suggest a diagnosis of perimenopause. Questions Last Name T-Z: What referrals would you make? SCIENCE HEALTH SCIENCE NURSING NURS 663

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