Menopause Support

Menopause is a time to prioritize your health and wellbeing. While some women focus on lifestyle changes to manage symptoms and prevent disease, others may seek relief through hormone therapy or alternative treatments.

With the overwhelming information available, much of it misinformation, women benefit from personalized guidance from a​​​​​​​​​​​​​​​​ certified menopause specialist.

Services Offered: evidenced-based

  • Menopause education & personalized health screening

  • Diet/lifestyle counseling

  • FDA-approved bio-identical hormone & non-hormone therapies, including GLP1’s where appropriate

  • Management of related conditions:

    • Vaginal/urinary health (genitourinary syndrome) & libido

    • Breast and bone health

    • Metabolic health (thyroid, blood sugar, lipids)

    • Fertility and contraception

    • Weight and body composition

Note: Please maintain a primary care provider for acute care needs. Referrals available​​​​​​​​​​​​​ here

Menopause Frequently Asked Questions

Are my symptoms related to menopause?

Menopause is a gradual transition that can span many years. Key points:

  • Menopause officially occurs one year after your final menstrual period, typically between ages 50-52 (though possible between 40-60)

  • Symptoms can begin up to 10-15 years before final menses and may last several years after

  • Factors affecting transition include genetics, lifestyle habits, surgery, or medication

  • Symptoms can fluctuate daily and monthly due to erratic hormone production

**Important Note About Fertility:** Pregnancy is possible even with menopausal symptoms throughout your 40s. Contraception and fertility planning should be part of every woman's perimenopause assessment.

When to Seek Care: If you suspect perimenopausal symptoms, schedule a appointment; diagnosis typically comes from reviewing your medical/menstrual history and specific symptoms, not hormone testing.

Do I need hormones?

Not all women need menopausal hormone therapy (MHT). This decision should be individualized based on:

  • Your specific symptoms & their impact on quality of life

  • Personal medical history and risk factors

  • Other potential causes of symptoms (like thyroid issues)

  • Your preferences for treatment approaches

The key is finding the right balance between managing symptoms that affect your daily life and considering potential risks. This decision should be made through detailed discussion with your healthcare provider.

Why do I need to see a menopause specialist?

You might not —menopause is a natural life stage, not a disease. However, a certified menopause specialist can help:

  • * Individualized risk assessment

  • * Evidence-based treatment of menopause-related symptoms

  • * Management of associated conditions:

    • Osteoporosis

    • Anxiety and depression

    • Insomnia

    • Cardiovascular disease

    • Diabetes

    • Migraines

    • Sexual dysfunction

**Warning: Be cautious of practitioners promoting unregulated treatments like pellets, injections, or compounded hormones. These are not recommended by major professional societies.

Do you prescribe bio-identical hormones?

Yes, but understand the terminology:

  • "Bio-identical" means hormones chemically identical to those your body produces

  • FDA-approved bio-identical options are available in various doses/formulations

  • Custom-compounded hormones rarely necessary and:

    • Not covered by insurance

    • Less regulatory oversight

    • Typically more expensive

    • No evidence of being safer or more effective

Are there non-hormonal treatment options?

Yes, several evidence-based options exist:

  • Lifestyle modifications:

    • Diet changes

    • Regular activity

    • Stress management

    • Acupuncture

  • Targeted supplements (when appropriate):

    • Valerian for sleep

    • Calcium and vitamin D if dietary sources are insufficient

  • Non-hormonal meds meay address multiple symptoms

  • Most "menopause supplements" lack research support and can be expensive

Aren't hormones dangerous?

MHT offers benefits but requires careful consideration:

Benefits can include:

  • Reduced hot flashes and night sweats

  • Improved sleep and mood

  • Better cognitive function

  • Relief from urinary and vaginal symptoms

  • Improved bone density

  • Potential reduction in heart disease and diabetes risk if started early

Important Considerations:

  • No systemic MHT is completely risk-free for all

  • Vaginal estradiol can be used safely without progesterone

  • MHT may be appropriate for most:

    • Women in perimenopause

    • Those within 10 years of menopause

    • Healthy older women with persistent symptoms

  • Treatment can continue beyond age 65 if beneficial

  • Individualized decisions with professional guidance

What lab work or testing will I need?

Most women don't need extensive hormone testing because:

  • Hormone levels fluctuate during perimenopause

  • Single measurements can be misleading

  • Normal levels don't rule out perimenopause

  • Symptoms, not levels, guide treatment

Testing may be warranted for:

  • Sexual dysfunction evaluation

  • Fertility concerns

  • Early menopause

  • Rule out other conditions (thyroid, vitamin deficiencies)

  • Screening for associated health risks (lipids, glucose)

  • **Note: Salivary/urine hormone testing not recommended for evaluating/treating symptoms.

Still have questions? Contact me

A Picture is Worth a Thousand Words:

Aanswer to the question, “Why don’t you test estrogen & FSH in perimenopause?”

And here is the answer to “What is the difference between all the different types of hormone therapy?” Click to see larger

menopausal hormone therapy explained

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