In midlife, women experience the hormonal fluctuations of perimenopause and the transition into menopause. This can be a particularly challenging phase of life when individualized assessment geared to your particular symptoms and concerns is essential. It can be viewed as a sentinel event that opens a unique opportunity for a dialogue with an experienced specialist in menopause to evaluate and improve your health.  There are many treatment options, hormonal and non-hormonal

Dr. Krause takes the time to carefully review your history, discuss preferences and explain options. She is an expert in menopause medicine, has been a longstanding member of the North American Menopause Society ( the professional organization focused on menopause in the U.S.) and is credentialed as a NAMS Certified Menopause Practitioner.

Menopause counseling includes a discussion of physiologic changes, assessment of menopause-related symptoms and treatment options, review of screening recommendations and discussion of disease reduction strategies and psychosocial issues.  Dr. Krause has a personal commitment to helping each of her patients make informed decisions and maximize their health.

Frequently Asked Questions

Should I take hormones for my menopause symptoms? 
This is one of the most important decisions that women make when they go through menopause.  It is crucial to come into the office for an in depth discussion of your experience and review your history, your family history and your concerns. Each woman’s decision about whether to take HT (estrogen with or without progesterone) is unique, and she must always weigh the benefits against the risks. Hundreds of studies show that HT can help with hot flashes, night sweats, vaginal dryness and bone loss. Women often experience benefits including resolution of hot flashes as well as improved sleep, sexual relations and quality of life. There is also emerging evidence of cardiovascular benefits. Also, the major WHI study on postmenopausal hormone use showed that overall mortality is lower in women on hormone therapy.

Many individual factors will go into the decision about whether to take hormones including age, family history , symptoms and personal preferences. Please come in for a consultation to discuss it further.

What are bioidentical hormones and are they safer? 
Bioidentical hormones are hormones that identical to those our body makes naturally.  Bioidentical estrogen and progesterone are now, in fact,  available through prescriptions in a variety of preparations (gel, patch and ring) and can be individualized. They are FDA approved and are produced with rigorous quality control. They are often covered by insurance, depending on your pharmacy plan.

Compounded estrogen and progesterone does not offer any advantage, as they are the same compounds. Professional organizations strongly discourage the use of compounded hormones because when they have been tested, the actual dosage was quite variable and often not what was prescribed.  In addition, they are not covered by insurance.

In contrast to estrogen and progesterone, testosterone is available only in compounded form. Testosterone for women , usually prescribed for low libido, has not yet been approved by the FDA due to lack of long term studies.

Is it normal to bleed in perimenopause?
It is common to experience a change in menstrual cycle intervals, but any irregular bleeding should be evaluated. The incidence of uterine abnormalities is increased at the menopause transition because estrogen concentrations are intermittently elevated and progesterone production is diminished.

Periods can shorten to as low as 21 days apart (from the first day to the first day of the next period). They also frequently skip and become less frequent. However, if any prolonged or heavy bleeding occurs, this should be evaluated thoroughly.

Natural menopause is recognized retrospectively 12 months after a woman’s last period.