<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 53-year-old woman comes to the physician for evaluation of a 5-month history of painful sexual intercourse. She also reports vaginal dryness and occasional spotting. She has no pain with urination. She has hypertension, type 2 diabetes mellitus, and hypercholesterolemia. Her last menstrual period was 8 months ago. She is sexually active with her husband and has two children. Current medications include ramipril, metformin, atorvastatin, and aspirin. Her temperature is 37C 98.6F, pulse is 85min, and blood pressure is 14082 mm Hg. Pelvic examination shows decreasing labial fat pad, receding pubic hair, and clear vaginal discharge. Which of the following is the most appropriate pharmacotherapy?? A: Oral fluconazole, B: Topical nystatin, C: Topical estrogen cream, D: Oral metronidazole, E: Topical corticosteroidsn,  <response>: This is a question about the appropriate pharmacotherapy for a postmenopausal woman with symptoms of vaginal atrophy, including painful intercourse, vaginal dryness, and spotting. The history and physical exam findings are consistent with vaginal atrophy due to estrogen deficiency in a postmenopausal woman. The choices include antifungals, antibiotics, topical steroids, and topical estrogen. Vaginal atrophy is not caused by infection or inflammation, so antifungals, antibiotics, and steroids would not be appropriate. Topical vaginal estrogen is the most appropriate treatment for symptoms of vaginal atrophy in postmenopausal women.C: Topical estrogen cream 