Q. A 46-year-old woman comes to her gynecologist for irregular menses and hot flashes for the past 8 months. She has persistent 10 to 12 days differences in her consecutive menstrual cycles with irregular flow. She has been diagnosed with hypothyroidism at the age of 30 years and she is on regular thyroxine replacement. Her temperature is 37°C (98.6°F), pulse is 90/min, respirations are 13/min, and blood pressure is 120/80 mm Hg. Physical examination shows a narrow, short, and in-distensible vagina with vulvovaginal dryness. The rest of the examination is normal. Laboratory investigations are shown below. What is the most likely diagnosis for this patient based on her clinical features?