Individualized care for perimenopause and menopause symptoms, including FDA-approved hormone options when appropriate. Decisions are based on your symptoms, menstrual and medical history, preferences, and testing when clinically useful.
Jane always ran on a full tank: career, family, weekend hikes up the Gorge. Lately, something shifted. She's tired no matter how much she sleeps. Her moods turn on a dime. Her once-sharp mind feels fogged over. Then come the rest: stubborn weight gain, hot flashes, achy joints, dry skin, and a fading interest in intimacy.
She starts to wonder. Is this just aging, or is something actually going on?
Jane is an illustrative composite, not an actual patient. The photograph features a model.
These changes are real, and they deserve a careful evaluation.
Perimenopause and menopause can affect quality of life, but fatigue, weight change, low mood, concentration problems, hair changes, joint pain, and sexual concerns can also have other causes. The goal is to understand what is contributing and discuss treatments whose benefits and risks fit your situation.
Menopausal hormone therapy is selected for a specific symptom and patient. The right formulation depends on your uterus status, medical history, risks, preferences, and whether symptoms require systemic or local treatment.
Systemic estrogen is the most effective treatment for hot flashes and night sweats and can prevent early postmenopausal bone loss. Local vaginal estrogen can treat vaginal dryness and pain during sex.
A patient with a uterus who uses systemic estrogen generally also needs a progestogen to reduce the risk of endometrial cancer. The formulation and schedule are individualized.
Evidence supports a monitored trial only for selected postmenopausal patients with diagnosed hypoactive sexual desire disorder after a biopsychosocial assessment. Use in women is off-label in the United States, and long-term safety is uncertain.
Menopause symptoms can be disruptive, but symptoms alone do not prove a hormone deficiency. For most patients 45 or older, perimenopause is assessed from symptoms and menstrual changes rather than routine hormone panels. An evaluation helps identify what is contributing and whether testing is useful.
Not sure where to start? Use the free 15-minute call to ask general questions about the clinic and scheduling. Book one. The call does not include diagnosis or prescribing.
Hormone therapy is highly effective for some menopause symptoms, but it is not an anti-aging, cardiovascular-prevention, or weight-loss treatment. When an appropriate option exists, FDA-approved products are generally preferred over compounded products.
Systemic hormone therapy is the most effective treatment for bothersome vasomotor symptoms in appropriately selected patients.
Local or systemic estrogen can relieve vaginal dryness and painful sex; the route depends on whether systemic symptoms also need treatment.
Sleep may improve when hot flashes and night sweats are controlled. Persistent sleep problems still need evaluation for other causes.
Systemic estrogen can prevent bone loss and reduce fracture risk in appropriately selected patients while treatment continues.
Hormone therapy is not a primary treatment for depression or cognitive impairment. Some patients feel better when vasomotor symptoms and sleep improve.
Hormone therapy should not be used solely to prevent heart disease or stroke. Benefits and risks vary with age, timing, route, formulation, and health history.
Hormone therapy is not a weight-loss treatment. Weight concerns may have several contributors and should be evaluated separately.
Benefits, side effects, risks, formulation, and whether to continue are reviewed periodically. Separate weight-management support is available through our medical weight-management program.
Dr. Brown leads clinical evaluation and treatment decisions, while clinic staff may assist with intake, vitals, testing, scheduling, and records. Appointments are offered at both our Gresham and Beaverton clinics based on current availability.
Your new patient visit is $395. That covers the scheduled 60-minute appointment, focused examination when appropriate, and the baseline lab work specified for the visit. From there, a monthly membership covers the services specified for your plan. Included medications, formulations, monitoring, and any exclusions are confirmed before enrollment. Follow-up timing and cost are confirmed before scheduling. HSA and FSA cards are accepted for eligible expenses.
Medication is prescribed only when clinically appropriate. The exact product, approval status, expected benefits, risks, and alternatives are discussed before treatment.
Women's HRT with individualized monitoring
Hormone therapy is effective for many bothersome menopause symptoms, but it is not appropriate for everyone. The decision depends on symptoms, age and timing, uterus status, route and formulation, and personal and family history. Systemic therapy is generally not recommended during pregnancy or with unexplained vaginal bleeding, certain hormone-sensitive cancers, prior blood clots, stroke or heart attack, or liver disease. These conditions may contraindicate systemic therapy or require specialist review; current product labeling and individualized guidance apply. A patient with a uterus generally needs endometrial protection when using systemic estrogen. Benefits, risks, side effects, and whether to continue should be reviewed periodically.
Age alone does not determine eligibility. After 45, perimenopause is usually diagnosed from symptoms and menstrual-pattern changes; routine hormone panels are rarely needed. Testing may be appropriate when symptoms or bleeding changes occur before 45—especially before 40—or when another diagnosis is suspected. Treatment decisions are individualized and reviewed over time.
“Bioidentical” describes hormones that are chemically identical to hormones produced by the body. Some FDA-approved estradiol and micronized progesterone products meet that description. The term does not mean safer or more effective. FDA-approved products are generally preferred when available; compounded products are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, quality, or dosing consistency before marketing.
We care for women in perimenopause, menopause, and postmenopause. Symptoms outside that setting may need evaluation for another endocrine, gynecologic, medical, or medication-related cause. Ignite HRT also evaluates men's low testosterone using diagnosis-specific criteria rather than symptoms alone.
Start with a free 15-minute informational phone consult, or book a full evaluation in Gresham or Beaverton. The call does not include diagnosis or prescribing.
