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Within the first year of private practice, I was faced with an interesting set of cases. A mother and daughter presented on the same day with the same complaint: no menstrual cycle for several months with hot flashes and night sweats. They had been cycling together since the onset of the daughter's puberty, about 1 year earlier. The same symptoms but significantly different ages suggested the probability of different etiologies, different evaluations, and ultimately different treatment approaches. This scenario illustrates the complexity of evaluating amenorrhea.
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