Hot flushes — if ovarian failure is uncertain, exclude other causes such as: Endocrine causes, for example, hyperthyroidism and phaeochromocytoma, Tumours, for example, carcinoid tumour, pancreatic tumour, mastocytoma, and paraneoplastic syndrome, Excess alcohol consumption, Dumping syndrome, Panic disorders, Tuberculosis., Drugs, for example, nitrates, selective serotonin reuptake inhibitors (SSRIs), diltiazem, levodopa, gonadotrophin-releasing hormone agonists, and anti-oestrogens