Perimenopause & Menopause
Why This Phase Deserves More Than "Just Deal With It"
Many women spend years being told their symptoms are stress, aging, or anxiety — particularly in perimenopause, when hormonal testing can appear normal. Meanwhile, the changes happening during this time can significantly affect sleep, mood, cognition, bone density, cardiovascular health, and quality of life.
You deserve to understand what is happening in your body, and to have access to treatments that actually work.
Common perimenopause and menopause symptoms include:
Hot flashes and night sweats
Sleep disruption
Brain fog and difficulty concentrating
Mood changes, anxiety, or irritability
Irregular periods or cycle changes
Vaginal dryness and changes in libido
Joint pain and fatigue
Heart palpitations
Similar Symptoms, Different Hormonal States
Perimenopause and menopause are often spoken about interchangeably — but they are two distinct hormonal states, and understanding the difference matters when it comes to getting the right support.
Perimenopause is the transition leading up to menopause. It is characterized by hormonal fluctuation — estrogen levels rising and falling unpredictably, cycles becoming irregular, and symptoms that can feel inconsistent and hard to pin down. This phase can begin years, sometimes a decade, before a woman's last period, and it is frequently dismissed or misdiagnosed because hormonal testing during this time doesn't always capture the full picture.
Menopause is defined as the complete cessation of menstrual cycles for 12 consecutive months. At this point, the body has settled into a sustained state of low estrogen and progesterone — the hormonal fluctuations of perimenopause have resolved, but the impact of low hormones on the body can cause a range of symptoms.
While there is significant overlap in symptoms and many of the same tools are used across both stages, treatment approaches often differ between perimenopause and menopause. Individualized assessment is essential — what works well in one stage may not be appropriate or sufficient in the other.
My Approach to Perimenopause & Menopause
Symptom Management
There are many effective hormonal and non-hormonal strategies for managing the symptoms of perimenopause and menopause. I use evidence-based supplementation, nutritional medicine, and lifestyle strategies to address the full range of symptoms — whether as standalone approaches or alongside hormonal support.
Long-Term Health
The hormonal changes of perimenopause and menopause have implications that extend well beyond symptoms. Declining estrogen affects bone density, cardiovascular health, and cognitive function — and proactive screening and prevention are an important part of care at this stage of life. I work with my patients to ensure the right monitoring is in place and that every treatment decision takes long-term health into account.
Hormone Replacement Therapy (HRT)
The evidence on perimenopause and menopause care has evolved significantly in recent years, and HRT is now well-supported as a safe and effective treatment option for many women — when prescribed appropriately and at the right stage. I am licensed to prescribe bioidentical hormones and approach prescribing thoughtfully and carefully, always with your individual health history, stage of transition, and safety in mind.
It is important to understand that HRT is not appropriate for everyone, and the approach differs between perimenopause and menopause. Prescribing decisions are never one-size-fits-all — they are always based on a thorough assessment of your individual picture.
Treatment may include:
Comprehensive hormonal lab panels to understand your full picture and guide treatment
Bioidentical hormone therapy (HRT), where appropriate — individualized and monitored carefully for the right candidate at the right stage
Evidence-based supplementation for symptom management and long-term health support (bone, cardiovascular, cognitive)
Therapeutic nutrition and lifestyle strategies to support your health and ease the changes you’re experiencing
Sleep and stress support — practical, sustainable approaches
Whether you’re newly noticing changes in your cycle or well into menopause and still struggling, you don’t have to navigate this alone.