Menopause Care
Specialized, individualized care for perimenopause, menopause symptoms, sexual and vaginal health, hormone and nonhormone treatment options, and the long-term health priorities that become increasingly important through midlife.
Perimenopause & Menopause
Perimenopause and menopause can affect sleep, temperature regulation, mood, bleeding patterns, sexual comfort, bladder and vaginal health, bone density, body composition, and cardiovascular risk. Dr. Allison Alexander brings dedicated menopause training and a whole-person approach to helping patients understand what is changing and choose treatment that fits their symptoms, health history, preferences, and long-term goals.
Perimenopause is the transition leading up to menopause and may begin years before the final menstrual period. Cycles can become shorter, longer, heavier, lighter, or less predictable. Menopause is reached after 12 consecutive months without a menstrual period when there is no other cause.
Vasomotor symptoms can range from occasional warmth to frequent episodes that disrupt sleep, work, and quality of life. Treatment can include hormone therapy for appropriate candidates as well as nonhormonal prescription and lifestyle approaches.
Sleep disruption, irritability, anxiety, mood changes, and difficulty concentrating are common concerns during the menopause transition. Evaluation considers hormonal changes as well as sleep disorders, thyroid disease, medications, life stress, and other contributors.
Declining estrogen can contribute to dryness, burning, discomfort with intercourse, urinary urgency, recurrent urinary symptoms, and other changes sometimes grouped as genitourinary syndrome of menopause. Effective local and systemic treatment options are available.
Menopausal hormone therapy can be highly effective for hot flashes and night sweats and may offer additional benefits for selected patients. The decision is individualized according to symptoms, age, time since menopause, uterine status, personal and family history, and medical risk factors.
Hormones are not the only option. Depending on the concern, care may include nonhormonal prescription therapies, vaginal moisturizers or lubricants, pelvic-floor care, sleep strategies, and practical changes involving movement, nutrition, alcohol, smoking, and temperature triggers.
Midlife is an important time to protect bone density, muscle mass, balance, and future independence. Dr. Alexander can help patients think through appropriate screening, resistance and weight-bearing activity, protein and calcium intake, vitamin D, and treatment when clinically indicated.
Blood pressure, cholesterol, glucose regulation, body composition, activity, sleep, and family history all matter increasingly through midlife. Menopause care at Women First connects symptom relief with prevention and healthy aging rather than treating the transition in isolation.
Dr. Alexander completed menopause fellowship training through Harvard Medical School, supporting a thoughtful, evidence-informed approach to midlife women’s healthcare and shared decision-making.
Common Questions
There is no single answer for every patient. Safety depends on factors such as age, time since menopause, symptoms, medical history, uterine status, and individual risks. A visit allows those factors and reasonable alternatives to be reviewed together.
No. Perimenopause symptoms can begin while periods are still occurring. New or unusually heavy bleeding still deserves appropriate evaluation rather than being assumed to be “just menopause.”
Yes. Vaginal and urinary tissues are hormone-sensitive, and symptoms such as dryness, pain with intercourse, urgency, and recurrent urinary discomfort are common and treatable.
No. This stage is also an opportunity to review bone health, cardiovascular and metabolic risk, strength, nutrition, sleep, and other factors that influence long-term health and independence.
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