Menopause treatment that treats you, not a lab value.

What menopause can actually feel like

Twelve months without a period marks menopause, but the experience is bigger than hot flashes. Common — and treatable — symptoms include:

• Vasomotor symptoms — hot flashes and night sweats, from occasional to hourly
• Sleep disruption — trouble falling asleep, 3 a.m. waking, unrefreshing nights
• Mood and cognition — irritability, low mood, anxiety, word-finding trouble, brain fog
• Genitourinary symptoms — vaginal dryness, painful sex, urinary urgency and recurring UTIs (see vaginal estrogen)
• Musculoskeletal symptoms — new joint pain, stiffness, frozen shoulder, tendon problems (see joint pain & hormones)
• Metabolic changes — central weight gain and shifting cholesterol (see midlife weight care)

Treatment options — the honest menu

Systemic hormone therapy is the most effective treatment for hot flashes and night sweats and also treats many of the sleep, mood, and genitourinary symptoms that travel with them. We use FDA-approved estradiol (patch, gel, or tablet) with micronized progesterone when you have a uterus — details on our HRT page, including what the FDA's 2025 boxed-warning removal changed.

Non-hormonal prescriptions matter too — for women who can't take hormones, prefer not to, or need something targeted. Depending on your picture these can include medications for hot flashes (such as certain low-dose antidepressants, gabapentin, or fezolinetant, a newer non-hormonal drug approved by the FDA in 2023 for hot flashes), sleep, or mood.

Local (vaginal) estrogen treats genitourinary symptoms with minimal absorption into the rest of the body, and can be used alone or alongside systemic therapy.

Not everything needs a prescription. Strength training, sleep timing, alcohol reduction, and bone-health basics carry real weight in a midlife plan, and we'll say so when they're the right first move. Medication is prescribed only when clinically appropriate after evaluation by a licensed clinician.

What to expect from care here

A full-length consultation first: symptoms, history, risk factors, preferences. Targeted labs where they change decisions. Then a written plan — what we're treating, with what, what to expect in the first three months, and when we'll check in. Dose adjustments are the norm, not a sign something went wrong; follow-up is built into how we price care.