Perimenopause is often missed or dismissed in women in their forties. Symptoms get put down to stress, age or being busy.
Symptoms often begin years before periods stop. We take them seriously, measure what can be measured, and talk through the options honestly.
Perimenopause affects more than your cycle. Many women notice several of these at once. Some of them overlap with thyroid, iron or mood problems, which is why we test before we treat.
Periods that are shorter, longer, heavier, lighter or irregular.
Trouble falling or staying asleep, often worse before a period.
Sudden heat, flushing and waking up drenched.
Irritability, anxiety or low mood that feels new.
Losing words, forgetting why you walked into a room.
Weight settling around the midsection even without eating differently.
Stiffness and aching without an obvious injury.
Dryness or discomfort, including during sex.
Less interest in sex than before.
These are the tests we would typically run.
Follicle-stimulating hormone, which rises as ovarian function changes.
The main ovarian hormones, timed to your cycle where possible.
Testosterone matters for women too, including for libido and energy.
TSH, free T4 and free T3, because thyroid problems can look like perimenopause.
Kidney and liver function, cholesterol, and three-month average blood sugar, which can shift around menopause.
A common deficiency that affects bone and mood.
Fat mass, lean muscle mass and where weight is changing.
Perimenopause is often a clinical diagnosis. Labs can be normal while your symptoms are real. We use the results to rule out other causes and to guide treatment choices, not to tell you whether your symptoms count.
Treatment is a choice we make together at consultation, based on your symptoms, history and risk. Options include systemic hormone therapy (patch, cream, gel or oral), pellets, and non-hormonal approaches.
For some women the right step is no hormones at all. We explain the trade-offs of each option before you decide.
Initial evaluation
$250
Self-pay
Follow-up visit
$150
Self-pay
We accept PPO plans from Aetna, AmeriHealth, Horizon and UnitedHealthcare, plus Medicare. HMO plans are not accepted. Lab and treatment costs depend on what is ordered.
See full pricing →Yes. Hormone levels swing from day to day during perimenopause, so a single blood test can look normal. It is often a clinical diagnosis based on your age, cycle changes and symptoms. We use labs to rule out other causes and to set a baseline.
Symptoms often begin in the early-to-mid forties, sometimes earlier, and can start years before periods stop. Menopause is confirmed after 12 months without a period.
It depends on your age, how long since your last period, and your personal and family history, including breast cancer, blood clots and heart disease. We go through these with you before discussing any treatment, and some women are better suited to non-hormonal options.
No. Hormones can be given as patches, creams, gels, oral medication or pellets. Pellets are one option, not the default. We choose the delivery method with you based on your physiology and preferences.
Depending on your symptoms, options include changes to sleep, exercise and nutrition, targeted supplements, and certain non-hormonal prescription medications. We discuss these at consultation.
Yes, for consultations and follow-ups anywhere in New Jersey. Labs and the InBody scan need an in-person visit or a lab draw.
Book online or call us. Telehealth visits are available across New Jersey — learn more.