Patient presents with complaints consistent with hot flashes, also known as vasomotor symptoms.  She describes a sudden sensation of warmth in the face, neck, and chest, often accompanied by flushing and perspiration.  The patient reports the episodes are brief, lasting a few seconds to several minutes, and their frequency varies from several times a day to a few times a week.  Severity of hot flashes is reported as moderate, occasionally interfering with sleep and daily activities.  She denies palpitations, dizziness, or shortness of breath during these episodes.  Medical history includes menopause onset at age 52, which aligns with the current age of 54.  No other significant medical history, including cardiovascular disease, thyroid disorders, or cancer, was reported.  Current medications include a daily multivitamin.  Family history is positive for menopause-related symptoms.  Physical examination revealed normal vital signs and no clinically significant findings.  Assessment:  Hot flashes secondary to menopause (ICD-10 N95.1). Plan:  Discussed lifestyle modifications such as maintaining a cool environment, avoiding triggers like caffeine and spicy foods, and practicing stress reduction techniques.  Patient education provided on hormone replacement therapy (HRT) and non-hormonal treatment options including selective serotonin reuptake inhibitors (SSRIs) and gabapentin.  Shared decision-making regarding treatment options will be addressed at follow-up appointment scheduled in four weeks. Differential diagnoses considered included anxiety, hyperthyroidism, and medication side effects, but were ruled out based on clinical presentation and history.