Menopause and Perimenopause Treatment in Portland
Hot flashes, broken sleep, brain fog, mood swings, cycles gone unpredictable — perimenopause and menopause are real medicine, not something to white-knuckle through. Yet many women are told to just wait it out, or get a rushed visit that ends without a plan. This practice offers unhurried menopause care: a real conversation about your symptoms, an honest discussion of hormone therapy and its alternatives, and treatment tailored to your body and your history. Whether you're in the thick of perimenopause or years past your last period, if your symptoms are affecting your life, they're worth treating.
Overview
WHAT THIS COVERS
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Menopause and perimenopause care, including:
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Evaluation of symptoms at any stage — perimenopause through postmenopause
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Hormone therapy (estrogen and progesterone), prescribed and monitored with current evidence, not the fears of twenty years ago
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Non-hormonal treatment options when hormones aren't right for you or aren't what you want
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Testosterone for women, in select cases — considered once estrogen is optimized, when symptoms like low libido persist
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Genitourinary symptoms — vaginal dryness, discomfort, urinary changes — which are treatable and too often ignored
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Lab work when it's actually useful, and attention to what else deserves a look at this stage: thyroid, bone health, cardiovascular risk
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Ongoing follow-up to adjust treatment as your body changes
WHAT TO EXPECT
Care starts with a thorough first visit: your symptoms and how much they're disrupting your life, your medical and family history, and what you've already tried or been told. From there we talk through your options honestly — including a clear-eyed conversation about hormone therapy, its benefits, and its risks for you specifically. If you start treatment, follow-ups are spaced to dial things in, then drop to routine check-ins. Visits are available in person in Portland or by telehealth across Oregon and Washington.
COMMON QUESTIONS
Is hormone therapy safe?
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For most healthy women within about ten years of menopause, current evidence supports hormone therapy as safe and effective — the alarming headlines from the early 2000s came from a study that has since been substantially reinterpreted. That said, "safe for most" isn't "right for everyone," which is why the first visit includes a real conversation about your personal history and risk factors before anything is prescribed.
I think I'm in perimenopause but my periods haven't stopped. Is it too early to get help?
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No — perimenopause is often when symptoms are at their worst, and you don't have to wait for your final period to treat them. If your cycles are changing and symptoms are interfering with your life, that's reason enough for a visit.
Do I need hormone testing first?
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Usually not — menopause and perimenopause are diagnosed by your symptoms and cycle history, and hormone levels fluctuate too much in perimenopause to be a reliable gatekeeper. I order labs when they'll actually change the plan, not as a hurdle before treatment.
Do you prescribe testosterone for women?
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Sometimes, yes. Testosterone can help with persistent low libido in menopause, but it works best — and is only worth evaluating — once your estrogen is optimized first. Many symptoms attributed to low testosterone resolve with well-managed estrogen therapy alone. If they don't, testosterone is a reasonable next step, and it's one we can take together with proper monitoring.
Do you take insurance?
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This is a direct-pay practice, so visits are paid out of pocket at transparent flat rates — see the pricing page. Many patients use HSA or FSA funds, and I can provide a superbill you can submit to your insurance for possible out-of-network reimbursement. Prescriptions and labs can still be billed to your insurance as usual.
Do you see patients in Washington?
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Yes — I'm licensed in both Oregon and Washington and see Washington patients by telehealth. Prescriptions go to your local pharmacy, and lab work can be done near you.