I will be hosting a "Your Guide to Menopause" talk at the Branford Blackstone Library Thursday, Dec 18. Click here for event details >>

Treatments & Services

Stages of Menopause & Conditions We Treat:

Every woman deserves to feel validated and supported through these life stages. At Dahlia Midlife Health, You will never be told “ your labs are normal, there is nothing you need to do” OR “ you just need more sleep and to reduce stress”. Together, we’ll design a treatment plan that helps you restore balance, improve your quality of life, and feel like yourself again.

Perimenopause

Perimenopause is the transition leading to menopause. It is not just hot flashes! For many, this is a time of fluctuating hormones. This often begins in women in their mid 40s, though it can start earlier. Estrogen receptors are located throughout the body and affect different systems. Your body feels different as you experience hormonal changes - you are not losing your mind!

How do I know if I am in “Perimenopause”?

The transition begins with cycle irregularities and menopause symptoms. A menopause specialist can help navigate you through the stages of perimenopause. It is best to determine where you are with a comprehensive gynecologic & medical history intake focusing on your cycles & symptoms.

Perimenopause Duration:

Average length is variable. This may occur for a period longer than four years. As “early” perimenopause is of variable length, we work together to navigate your perimenopausal needs.

If you are struggling with perimenopausal symptoms, Dahlia Midlife Health specializes in evidence-based interventions to help you rebalance and rediscover improved quality of life.

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Menopause

Menopause is the point in time when you have gone 12 months without a period. Many women do not have menstrual periods due to various factors.

Determining menopausal status is not always straightforward. Progesterone releasing IUDs, surgeries to reduce bleeding or remove the uterus or ovaries, use of certain medications, or a history of chemotherapy or radiation for cancer treatment are factors that could impact your menstrual cycles.

If you do NOT have menstrual cycles, a provider experienced in the treatment of menopause can help determine your menopausal status with a comprehensive gynecologic & medical history focusing on symptoms and ordering lab work.

When does Menopause occur:

The average age of natural menopause is around 51 years old. However, it can vary!

Most women experience menopause between ages 45 - 55.
Early menopause occurs before age 45.
Premature menopause occurs before age 40.
Late menopause occurs after age 54

Postmenopausal Duration:

Early postmenopause can span 6-8 years, late postmenopause continues over the lifespan.

If you are struggling with symptoms of menopause, we are here to help. Dahlia Midlife Health specializes in evidence-based interventions to help you rebalance and rediscover improved quality of life.

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Symptoms of Perimenopause & Menopause (Not All Inclusive)

Menstrual cycle irregularity or missed periods (perimenopause)
Missed periods (12 mos or >)
Hot flashes / night sweats
Fatigue
Weight changes
Mood changes
Hair, skin, nail changes
Decreased mental clarity “brain fog”
Vaginal changes (dryness, irritation, discomfort)
Sexual changes (decreased libido, arousal)
Insomnia, sleep disturbance

Genitourinary Syndrome of Menopause (GSM):

GSM involves symptoms associated with a decline in estrogen affecting the vulva, vagina, urethra, and bladder with menopause.

Symptoms can include: dryness, burning, irritation, pain with intercourse, decreased lubrication during sex, pain with urination, urgency, recurrent UTI’s, reduced sexual satisfaction

Treatment Options:

Vaginal Moisturizers, Lubricants
Vaginal Estrogen Cream, Tablet, or Insert
Vaginal Estrogen Ring
Vaginal DHEA Insert (precursor hormone to restore tissue health)
Oral Ospemifene (non-estrogen pill option)
Lifestyle: Pelvic Floor Therapy

GSM symptoms typically do NOT improve without treatment and may worsen over time.

If you are struggling with symptoms of menopause, we are here to help. Dahlia Midlife Health specializes in evidence-based interventions to help you rebalance and rediscover improved quality of life.

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Genitourinary Symptoms of Lactation (GSL):

Vulvovaginal and urinary symptoms that occur in breastfeeding individuals due to low circulating estrogen levels. This hormonal shift can cause symptoms that mimic menopausal vaginal atrophy.

Symptoms: vaginal dryness, irritation, burning or itching, painful intercourse, decreased lubrication, tissue sensitivity, urinary urgency or burning, susceptibility to UTI’s. Symptoms are most prominent in the early postpartum period, particularly in women who are breastfeeding.

Treatment Options:

Vaginal Moisturizers, Lubricants
Pelvic Floor Therapy
Local Vaginal Hormone Therapy - Low dose vaginal estradiol (cream, tablet, inserts)

If you are struggling with symptoms of GSL, we are here to help. Dahlia Midlife Health specializes in evidence-based interventions to help you rebalance and rediscover improved quality of life.

Our Approach & Treatment options

At Dahlia Midlife Health, we believe menopause and midlife should not diminish your quality of life. We listen, validate your experience, and provide treatment options backed by science and delivered with compassion.

Your care plan may include:
Bioidentical Hormone Therapy
Menopause Hormone Therapy (MHT)
Hormone Replacement Therapy for Premature, Early, or Surgical Menopause
Local Vaginal Hormone & Non-Hormonal Therapies (for GSM & GSL)
Non-Hormonal Therapy Options
Testosterone Support for Sexual Health & Wellness
Sexual Medicine & Integrative Approaches

Hormone Therapy Options

Bioidentical & Menopause Hormone Therapy (MHT)

Perimenopause and postmenopause symptoms — Perimenopause and postmenopause symptoms can dramatically affect daily life. Hormone therapy is one of the most effective ways to restore balance and reduce symptoms.

What are bioidentical hormones?
Bioidentical hormones are chemically identical to those naturally produced in the human body, such as estradiol and progesterone. FDA-approved options are plant-derived, regulated, and tested for safety, purity, and consistency.

Treatment Options:

Transdermal Patch
Topical Gel or Spray
Oral Tablet (pill)
Vaginal Ring
Vaginal Estradiol (cream, tablet, inserts)
Bioidentical Progesterone Therapy
Combination Therapy (estrogen + progesterone)
Compounded Bioidentical Hormones (not FDA-approved; considered when appropriate under expert supervision)

Your plan is always personalized, balancing symptom relief with safety.

Non-Hormonal Therapies for Menopause

Not every woman can — or wants to — use hormone therapy. Effective non-hormonal therapies are available.

Treatment Options:

Fezolinetant & Paroxetine (FDA-approved)
Low Dose SSRIs & SNRIs (that ease hot flashes)
Gabapentin
Oxybutynin
Lifestyle Strategies
Cognitive Behavioral Therapy Referral
Review of Supplements

Sexual Health & Wellness Therapies

Sexual health is an important part of overall well-being. At Dahlia Midlife Health, we provide care for low libido, reduced arousal, & discomfort or pain with intercourse - associated with menopause.

Treatment Approaches:

Lifestyle & psychosocial support (referrals to sex therapy or counseling)
Non-prescription therapies (lubricants & moisturizers)
Medical therapies: hormone therapy, testosterone support, vaginal therapies, non-hormonal medications
Eros Therapy (medical device option)
Pelvic Floor Physical therapy referrals

We provide therapy for the following categories of Female Sexual Dysfunction:

Low Libido
Hypoactive Sexual Desire Disorder
Female Sexual Interest / Arousal Disorder

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Frequently Asked Questions

What is a visit like?

Shared decision-making - we make choices together. I bring my clinical expertise and the latest evidence-based research; you bring your lived experience, values, and preferences.

I am here to listen & provide a thorough intake. We take the time to discuss your options— hormone therapy, non hormone therapy, supplements, lifestyle changes, or lab testing—so you understand the risks, benefits, and what feels right for you.

There’s no one-size-fits-all plan!

You’ll leave the visit with clarity, confidence, and a plan that aligns with your goals and lifestyle.

What to expect:

Finding the right fit takes time! Depending on where you are starting when we begin working together, you will return for follow up as needed.

If you are just getting started on menopausal hormone therapy, we will need to see each other 2 - 3 times over several months to make sure you have the dose, formulation & delivery method that works for you.

Do you prescribe hormone therapy?

Yes, absolutely!

Are lab work evaluations done?

Yes, we are contracted with Quest Diagnostics.

Quest will be able to bill your labs through your insurance provider.
We may send you for labs if deemed appropriate based on your history, treatment plan & follow-up needs.
Quest has numerous convenient patient service centers nationwide.

Can we talk about sex?

Yes, we can talk about sex!

I would like to transition off of pellets - Are you able to help?

Transitioning off pellets requires a close relationship with a provider who understands the process. Pellets are hard to titrate and can result in overdosing of hormones which can lead to other issues. I can assist you with transitioning off pellets onto menopause hormone therapy.

Can you give me a second opinion?

Yes! Often doctor visits don’t provide adequate time for all of your questions to be addressed. I provide unbiased evidence-based information to support your decision making around your menopause care.

I am not sure I want to use hormones. Are there any other options that I can consider to feel better?

Yes, absolutely! I work with women who do not want to use hormones or may have contraindications. There are non-hormonal therapies that can help with your symptoms. Let’s talk!

Cancellation Policy:

In order to maintain the highest quality of care for all, we enforce a 100$ late cancellation, reschedule & no-show charge for all appointments canceled or rescheduled less than 48 hours in advance.

We kindly ask that you cancel your appointment online 48 hours or more in advance to avoid cancellation fee. Thank you for your understanding. We look forward to seeing you.

Do you take insurance?

I do not bill insurance directly, but I will gladly provide a superbill that you can submit to your insurer for possible out of network reimbursement or to your HSA/FSA.

PRICING

Dahlia Midlife Health is a self-pay practice, which allows me to provide high-quality, personalized care that insurance-based models simply don’t allow. I choose to work as an out-of-network provider which enables me to dedicate the time to prioritize you.

Initial Visit - $325 (Initial comprehensive medical intake, 60 min visit)

Follow-Up Visit - $170 (follow-up, established patient, 30 min visit)

A superbill can be provided that you can submit to your insurance company for possible out-of-network reimbursement, HSA or FSA. It is the patient’s responsibility to handle this process.

Ready to discover where you are in your menopause journey?

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Designed with compassion, privacy, and clarity in mind
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