How It Is Given
Getting Started
Most Common
Menopause symptoms
Most women arrive with several at once and have been told each one separately is nothing to worry about. Together they usually have a single cause, and several of them respond well to treatment. Treated routinely at our Los Angeles clinic.
Why they arrive together
The reason a Los Angeles patient can report aching joints, hot flashes and vaginal dryness at one appointment is anatomical rather than coincidental. Estrogen receptors are not confined to the reproductive system. They sit in the part of the brain that regulates body temperature, in the tissue of the vagina and urethra, in bone, in joints and in skin.
When estrogen falls and fluctuates, all of those systems are affected at once. That is why a woman rarely presents with one symptom, and why treating them as six unrelated problems usually fails.
It also explains why a single treatment can shift several symptoms together, and why the ones driven by tissue change rather than fluctuation behave differently. More on that in hair and skin changes, brain fog and memory and sleep problems for the rest of it. It also means a Los Angeles patient should list every symptom at the first visit, because the ones she considers unrelated may share the same cause.
What we do
Which symptoms, how severe, how long, and what your cycle has been doing. Written down, the pattern is usually obvious.
Thyroid, ferritin and a full blood count where the picture is unclear. Several conditions mimic this transition closely enough to matter.
Night sweats often turn out to be the cause of the fatigue, the low mood and the poor concentration. Fix the sweats and three symptoms move.
We score the symptoms that bothered you most at the start so the three-month review compares like with like instead of relying on memory.
Most common
Four of the ten: what causes each one, what helps, and how quickly to expect a change.
The most treatable symptom of the lot, and the one that disrupts sleep most.
Learn moreOften night sweats in disguise, sometimes a separate problem that needs its own answer.
Learn moreMeasurable, common, and for most women temporary. Why it happens and what helps.
Learn morePerimenopause is a window of raised vulnerability to low mood, not a character flaw.
Learn moreStiff mornings and aching hands that arrive with everything else.
Learn moreFatigue is usually downstream of broken sleep rather than separate.
Learn moreRarely one cause, so one fix rarely works.
Learn moreThe one menopause symptom that worsens without treatment.
Learn moreWhat changes at midlife, what hormone therapy does and does not do about it, and which measures have evidence.
Learn moreCommon questions
Answered the way a clinician would answer them, not the way a brochure would.
Patient reviews
I had been waking three or four times a night for two years and had been told it was just stress. The consultation actually went through my cycle history. Six weeks on a patch and I am sleeping through.
What I wanted was someone who would talk about the risks honestly rather than sell me something. They walked through the clot data and why a patch suited me better than tablets.
The brain fog was the part nobody warned me about. Having a clinician tell me it was a recognized symptom and not early dementia was worth the appointment on its own.
It took two dose changes before things settled, which they had told me upfront might happen. The three-month review was booked before I left the first appointment.
From the blog
Next step
Bring a list, even a rough one. Which symptoms, how long, and how much they interfere. Half an hour of history usually tells us more than a hormone panel will.
Consultations are by appointment. Prescriptions are issued only where clinically appropriate.