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Women's Health

Empowering women through hormone therapy and sexual dysfunction treatment.

Perimenopause & Menopause:

The Basics

Menopause is defined as the end of menstrual periods (for 12 consecutive months). The time before periods actually halt is known as "perimenopause".

Menopause is often experienced between the ages of 40 and 58. It is distinguished by the loss of ovarian function, low estrogen and progesterone levels, and high FSH and LH levels (sex hormones). There is a period *before* menopause that causes physical changes known as "perimenopause" which lasts around 4-8 years.

Menopause can occur naturally with age or due to hysterectomy. Other factors that can influence timing of menopause include smoking and genetics.

Symptoms

Symptoms of perimenopause and menopause are different for everyone. Women may have some or all of the following symptoms.
✓ Hot flashes ✓ Brain fog ✓ Dry vagina/painful sex
✓ Trouble Sleeping ✓ Forgetfulness ✓ Fatigue
✓ Muscle/joint pain ✓ Less sexual desire ✓ Urinary issues
✓ Irregular periods ✓ Mood changes ✓ Weight gain

FAQs

Am I a candidate?

If you are perimenopausal (last period less than one year ago) you may be! There are many factors that influence the decision making process, including contraindications to treatment and risks.

What are the contraindications?

History of breast, endometrial or ovarian cancer. History of blood clot or stroke. Smoking. Liver disease. Your provider will discuss these with you.

What type of treatments are available?

Depending on if you are in perimenopause or menopause, your provider will discuss all the options with you. Treatment is also dependent on if you have a uterus or not. Treatments can include estrogen, testosterone and progesterone therapy. These are available in injectable, oral, implantable and topical forms.

What are the side effects of treatment?

Side effects are dependent on the treatment type. Side effects can include vaginal spotting, breast tenderness, bloating, nausea, and headaches.

Are there nonhormonal medications?

Yes! Some options can include antidepressants for hot flashes, DHEA supplementation for painful intercourse, gabapentin or clonidine for hot flashes/sleep disturbance, and PT-141 peptide for low libido.


What about over the counter treatments?

Unfortunately there is no evidence that shows that black cohosh, botanical products, Omega-3, or lifestyle changes alleviate hot flashes.

Pellets: Are They Right for Me?

Easy & Long-Lasting

Bioidentical pellets contain plant-derived hormones that closely match the natural hormones our bodies make. They release a stable, consistent dose of hormones over the course of 3-6 months. They typically consist of testosterone or a combination of testosterone and estrogen.


Benefits can be seen as quickly as a few days after the procedure! They are a great option for women who prefer to avoid injections. 

What to expect...

The pellets, which are the size of a grain of rice, will be implanted under your skin (usually in the buttocks) after a local numbing medication is administered. The small incision will be covered with a dressing. You might be sore for a few days after the procedure.


Your provider will discuss after-care with you. You'll need to have labs drawn a few times a year to monitor your hormone levels.

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