A 48-year-old female presents to the office complaining of bothersome hot flashes and difficulty sleeping. Her past medical history is significant for an estrogen receptor-positive breast cancer treated surgically 6 months ago. She is currently on tamoxifen for endocrine therapy. Her last menstrual period was 4 months ago, and over the past 4 months, she has experienced moderate hot flashes and trouble sleeping due to night sweats. In addition, she has difficulty concentrating at work due to sudden and frequent hot flashes, which has impaired her work performance. She notes that her symptoms have not been relieved with lifestyle changes and nonprescription approaches.