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HOT FLASHES AND NIGHT SWEATS
Hot flashes and night sweats are among the most disruptive symptoms of menopause, affecting sleep, confidence, and quality of life. If hormone therapy isn’t an option, we use proven non-hormonal treatments that reduce frequency and intensity — including Veozah (fezolinetant), the first FDA-approved medication that targets the brain’s thermoregulation center to stop hot flashes at their source. Other options may include low-dose SSRIs/SNRIs (such as paroxetine or venlafaxine), or gabapentin (helpful for night sweats and sleep) when appropriate. We also incorporate science-backed lifestyle and mind-body approaches, including cognitive behavioral therapy (CBT) for hot flashes and sleep disruption, paced breathing, cooling strategies, and targeted supplements shown to help regulate temperature perception. Together, we build a customized plan to help you feel calmer, sleep better, and regain control of your day — and your nights.
VAGINAL DRYNESS AND URINARY
SYMPTOMS
Mood changes, anxiety, and disrupted sleep are common during menopause, especially when night sweats and racing thoughts make it hard to unwind. We use an integrative approach that combines relaxation techniques, sleep hygiene, stress-management tools, and targeted supplementation to calm the nervous system and support natural hormone rhythms. Gut health plays a powerful role here as well. Over 90% of serotonin is made in the gut. It helps regulates mood and is a precursor to melatonin which regulates sleep/wake cycles. When the microbiome is imbalanced, mood and sleep often suffer. By improving gut health, we can support more stable emotions, better sleep cycles, and improved resilience to stress. For women who are not candidates for estrogen therapy, micronized progesterone can be a helpful option. While it is a hormone, it is not estrogen, and is often safe for women who cannot take estrogen due to concerns like cardiovascular disease, or clotting risk. When taken orally, it is processed in the liver and converted into allopregnanolone, a neuroactive metabolite that works on GABA receptors in the brain — producing a calming effect and improving sleep quality naturally.
SLEEP AND MOOD
Genitourinary Syndrome of Menopause or GSM includes symptoms such as vaginal dryness, burning, discomfort with intimacy, recurrent UTIs, and urinary urgency or leakage. These symptoms occur because estrogen naturally declines in the tissues of the vagina and urinary tract, causing thinning and loss of elasticity. We start with non-hormonal options including vaginal moisturizers and lubricants to improve comfort, hydration, and elasticity of the tissues. Moisturizers are used regularly to restore moisture over time, while lubricants provide immediate relief during intimacy. Another option is vaginal DHEA (prasterone) — a non-estrogen hormone precursor placed vaginally where it gently converts into estrogen and testosterone inside the vaginal tissue only, improving dryness and sexual comfort without increasing systemic hormone levels. We also offer local vaginal estrogen therapy, which is technically hormonal, but the dose is extremely low and acts only in the vaginal tissues. Systemic absorption is minimal — so minimal that many oncologists allow even breast cancer survivors to use local vaginal estrogen to improve dryness, reduce infections, and restore comfort.
MENOPAUSE SYMPTOMS WE CAN HELP WITH
