Menopause
What Is It?
Natural cessation of menstruation (12 months without a period). Perimenopause transition causes hot flashes, night sweats, irregular periods, vaginal dryness, mood changes, and sleep disturbance.
How Is It Diagnosed?
Clinical diagnosis if age >45 with typical symptoms. FSH >40 IU/L and low estradiol confirm if needed. Rule out thyroid disease.
How Is It Treated?
Hormone therapy (estrogen plus progesterone) most effective for vasomotor symptoms in eligible women. Non-hormonal: SSRIs, SNRIs, gabapentin, fezolinetant. Vaginal estrogen for genitourinary symptoms.
Tests and Imaging Typically Needed
FSH, estradiol, TSH, CBC, lipid panel, mammogram and DEXA scan as indicated.
Approximate Self-Pay Costs
Office visit: $95-$150. Hormone levels: $40-$80. HRT medications: $20-$100/month.