Menopause is a natural stage of life with shifting hormone levels and changing physiology. Even though these changes are expected, they often cause women to have physical and emotional symptoms that can affect sleep, energy, temperature regulation and overall comfort. While menopause is a normal transition, the symptoms associated with it can be a disruption.
At Premiere Center for Health and Wellness, we work with patients in the Cincinnati area to make this stage of life more manageable. We are here to support your healthy lifestyle choices while also offering medical options, including hormone therapy, when symptoms begin to interfere with day-to-day life.
What Is Menopause?
The word menopause simply means “pause of months”, or the end of monthly cycles. Medically, it describes the point at which women permanently stop menstruating because of a natural decline in ovarian hormone production. At this time, the ovaries begin producing less estrogen and progesterone, two hormones that influence the menstrual cycle and many other systems in the body.
Stages of the Menopausal Transition
The hormone transitions that cause menopause happen gradually rather than all at once. Women progress through three different stages in the menopausal transition:
Perimenopause
This stage begins in a woman’s mid-to-late 40s, though it can start earlier for some women. During this time, hormone levels may fluctuate rather than steadily decline. This stage is often marked by irregular menstrual cycles, changes in cycle length, heavier or lighter periods, and some of the classic signs of menopause like hot flashes and mood changes. Everyone’s experience is unique, but some people experience more severe symptoms during perimenopause.
Menopause
Once a woman has gone 12 consecutive months without a period, they are considered to have reached menopause. By this point, the ovaries have significantly reduced hormone production and menstrual cycles no longer resume. Symptoms can continue through this stage.
Postmenopause
Postmenopause is the years following menopause, during which hormone levels remain consistently low. Some women find relief from symptoms during this time, while others may still experience vaginal dryness and bone density changes without the right support. During this stage, we shift our focus toward long-term health considerations such as bone and heart health.
What Causes Menopause?
As women age, their ovaries become less responsive to the brain signals that stimulate hormone release, which leads to lower and less predictable production of estrogen and progesterone that menopause is known for. As the number of functioning ovarian follicles decreases, ovulation becomes less consistent and eventually stops altogether.
Sometimes, medical factors outside of age can cause menopause to happen earlier. This can include surgical removal of the ovaries, cancer treatments and certain autoimmune or genetic conditions. When menopause happens under these circumstances, symptoms may appear more abruptly.
What Happens During Menopause?
During menopause, the body adjusts to operating with lower levels of hormones like estrogen. These hormonal changes influence how the brain communicates with other systems, like those involved in temperature control and sleep regulation. Many women notice changes in how their bodies respond to heat, stress and daily energy demands. Lower estrogen levels also affect tissues throughout the body. The lining of the vagina and urinary tract can become thinner and less elastic, and joints may feel stiffer.
Common Symptoms of Menopause
Physical Symptoms
- Hot flashes and sudden feelings of warmth
- Night sweats that may interrupt sleep
- Changes in sleep patterns, including difficulty falling or staying asleep
- Fatigue or reduced stamina during daily activities
- Joint stiffness or muscle aches
- Changes in weight distribution or metabolism
Cognitive and Emotional Symptoms
- Difficulty concentrating or staying focused
- Memory lapses or feeling mentally “foggy”
- Increased irritability or emotional sensitivity
- Changes in stress tolerance
- Disruptions in mood related to poor sleep or hormonal shifts
Sexual Health Changes
- Vaginal dryness or reduced natural lubrication
- Discomfort during intimacy
- Changes in sexual desire or arousal
- Increased sensitivity of vaginal and urinary tissues
What Is the Average Age of Menopause?
The age of menopause varies from person to person, but most women reach this stage between 45 and 55 years old. In the United States, the average age is around 51. While this range is considered typical, some women experience menopause earlier or later without it signaling a health concern. Medical treatments, surgical removal of the ovaries, smoking history and certain health conditions can all affect menopause age.
Why Menopause Symptoms Should Not Be Ignored
Just because menopause symptoms are common and a normal part of aging does not mean you have to suffer through your symptoms without help from a doctor. If you are uncomfortable enough to not enjoy the same activities, or you do not have the same energy and vitality as before, it is important for you to get evaluated and find a solution to help you feel like yourself again. Early hormonal intervention can also improve your cardiovascular health and help your bones to stay strong.
Supporting Menopause Through Hormone Therapy
Comprehensive Hormone Evaluation
Hormone evaluation starts with a detailed review of all of your symptoms, plus a thorough medical history and discussion about your menstrual patterns. During your appointment, we order specific lab tests to measure the levels of estrogen, progesterone and testosterone in your blood, along with any other relevant markers.
Bio-Equivalent Hormone Replacement Therapy
At our practice, we use a therapy called Bio-Equivalent Hormone Replacement Therapy. During this treatment, we use the information gathered during your hormone evaluation to supply your body with the hormones it needs to continue functioning normally. For women, this usually involves pellets with customized amounts of estrogen, though some patients also require testosterone and progesterone.
Bio-equivalent hormones are simply the exact chemical structure that our bodies naturally synthesize. Many people are more familiar with the term “Bio-identical” when referring to hormone treatments, but the FDA has requested that the term “bio-equivalent” be used instead. Bio-equivalent Hormone Balancing uses single or multiple bio-equivalent hormones to help men and women achieve the healthy state of hormone balance that is typically present in persons in their 30s.
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Benefits of Hormone Treatments
- Fewer Appointments: Hormone pellet therapy only requires a visit every three to four months and is convenient for patients with busy schedules.
- Consistent Hormone Levels: Pellets provide consistent release of hormones and avoid the fluctuations that may come with other methods.
- No Daily Maintenance: Once inserted, pellets work continuously, and there is no need to remember a daily dose.
- Regular Monitoring: Follow-up labs and symptom reviews can be coordinated with scheduled visits to check how effective the treatment is.
- Discreet and Long-Acting: Pellet therapy is placed just under the skin and requires no ongoing action from the patient until the next insertion cycle.
What Treatments Are Like
At Premiere Center for Health and Wellness, we partner with SottoPelle for our bio-equivalent hormone therapy. During the insertion process, we make a small incision in the upper hip area. We place customized pellets that contain the correct dosage of hormones for you into the incision location using special insertion tools. Once the pellets are inserted, there is usually no need for sutures. We place a bandage over the area and send you home with aftercare instructions.
The pellets will gradually dissolve and release hormones into your bloodstream over the next few months. They do not need to be removed at the end of this time. You can resume most activities, but you will want to avoid submerging the insertion site until the incision has completely healed.
Vaginal Laser Therapy (MonaLisa Touch)
Have you experienced changes in your vaginal health since menopause? Did you know that over 40% of post-menopausal women experience symptoms such as dryness, itching, burning, painful urination or pain during intercourse? MonaLisa Touch™ delivers gentle laser energy to the vaginal wall that stimulates a healing response, generating new collagen in the tissue and enhanced moisture levels in the vaginal canal. A typical course of treatment is three procedures over 12 weeks.
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Benefits of MonaLisa Touch
- No Hormones Required: MonaLisa Touch™ is a non-hormonal treatment and is an option for those with vaginal discomfort who want to avoid estrogen-based therapies.
- Minimally Invasive: The treatment uses gentle laser energy and does not involve surgery, incisions or anesthesia.
- Quick Office Visits: Each session typically takes just a few minutes and is performed in a standard office setting without downtime.
- Gradual Tissue Rejuvenation: The laser stimulates natural collagen production and tissue renewal for long-term improvement in vaginal tone and moisture.
- Minimal Recovery Time: Most patients return to normal activities the same day, with only a few short-term restrictions.
- Improves Tissue Quality: Treatments can increase elasticity, thickness and hydration of the vaginal lining for better tissue health and comfort.
What Treatments Are Like
The MonaLisa Touch device is a thin probe that can be inserted without pain or the need for anesthesia. The device delivers 360° energy, making the treatment faster. During your treatment, we will insert the device into the vaginal canal and slowly move it until the entire canal and external areas are treated. You will feel a mild vibration or warmth during the treatment, which takes less than five minutes. You may have some mild irritation or soreness for several days after your treatment. We recommend waiting 72 hours to have intercourse after your treatment.
Lifestyle and Supportive Therapies
We will also encourage you to maintain healthy habits to support your body during menopause. Simple routines such as daily exercise help to support your mood and keep your metabolism healthy. Weight-bearing exercises like walking and strength training are helpful for joint mobility and bone strength, and regular activity will support better sleep and energy levels.
Maintain a healthy diet during menopause including lean proteins, healthy fats, fruit and vegetables, plus calcium-rich foods to protect against bone loss. Stay hydrated and limit alcohol and caffeine to reduce hot flashes and sleep disruptions.
Frequently Asked Questions About Menopause
Is BHRT Suitable for Everyone?
Bio-equivalent hormone replacement therapy is not appropriate for every patient. Women with a history of hormone-sensitive cancers, certain clotting disorders or liver disease may be advised against hormone therapy. We will review your health history, lab results and risk factors before recommending any treatment.
Can MonaLisa Touch Be Used With Hormone Therapy?
MonaLisa Touch can be used alongside hormone therapy or other treatments. Some women benefit from both approaches because hormone therapy supports the entire system while MonaLisa Touch focuses directly on the vaginal tissue.
How Long Do Menopause Treatments Take to Work?
With hormone therapy, improvements often begin within a few weeks, but it may take up to two to three months to see full effects as hormone levels stabilize. For MonaLisa Touch, you may notice some changes after the first treatment. You will see the best results after a full three-treatment series.
When to Seek Professional Care for Menopause Symptoms
If you are experiencing symptoms that disrupt your life, sleep, relationships or ability to focus, it may be time to consider a professional evaluation. It is not necessary to wait until your discomfort becomes more severe. Even mild symptoms can be treated to help you have a smoother transition into postmenopause.
About Us
Premiere Center for Health & Wellness was founded in 2002 to serve women seeking care beyond what traditional gynecology often provides. Linda Evans, MD, and Sally Lake, RN, BSN, provide hormone therapy, gynecology services and minimally invasive treatments in a comfortable, patient-centered setting. As a small office, we take time to build lasting relationships with each of our patients.
Support Your Body Through Menopause With Treatments in Cincinnati, OH
Menopause brings real physiological changes, and addressing them with accurate evaluation and consistent treatment options can support long-term comfort and daily function. At Premiere Center for Health and Wellness, we provide medical oversight, hormone therapies, and supportive options for patients seeking informed menopause care in Cincinnati, OH. To take the next step, complete our online form or schedule an appointment by phone at 513-985-0950.