Menopause & Hormone Therapy

Menopause marks the natural end of menstrual cycles and is officially reached when you have gone 12 consecutive months without a period. For many women, the transition, often called perimenopause, can bring hot flashes, sleep problems, mood changes, vaginal dryness, and changes in bone or heart health.

At The Medical Group of New Jersey, our Ob/Gyn team provides supportive, evidence-based care to help you navigate this stage with confidence, comfort, and clear guidance. Treatment plans are highly individualized and may include lifestyle strategies, non-hormonal options, or hormone replacement therapy when safe and appropriate.

Symptom Onset & Initial Evaluation

Menopause does not happen all at once. Symptoms may start gradually and vary greatly between individuals. Some women experience only mild changes, while others notice symptoms that significantly affect daily life, relationships, and sleep.

During your initial evaluation, your Ob/Gyn provider will take time to understand your symptoms, health history, and personal goals, whether that includes symptom relief, improved quality of life, or protection of long-term bone and heart health.

Common Symptoms

• Hot flashes or nighttime sweats
• Difficulty sleeping
• Vaginal dryness or discomfort during intercourse
• Mood swings, irritability, or anxiety
• Fatigue or concentration changes (“brain fog”)
• Irregular or heavy periods during perimenopause
• Weight gain or changes in metabolism
• Decreased libido

Evaluation

Your evaluation may include:

• Detailed discussion of symptoms and their impact
• Review of menstrual patterns and perimenopause timeline
• Assessment of bone health and cardiovascular risk
• Evaluation of medical history (including clotting disorders, migraines, or cancer risk)
• Medication and supplement review
• Discussion of personal preferences regarding hormone or non-hormonal therapy

This helps determine which treatment options align best with your needs and safety considerations.

Diagnosis & Risk Assessment

Menopause is typically diagnosed based on symptoms and changes in your menstrual cycle. Lab tests are not always necessary, but may be used when symptoms are unclear or occur earlier than expected. Commonly used tests and evaluations are listed below.

Assessment of Menopause Status

• Change in menstrual cycle regularity
• Full year without a menstrual period
• Onset of vasomotor symptoms (hot flashes/night sweats)

Bloodwork (when indicated)

• Follicle-stimulating hormone (FSH)
• Thyroid testing (to rule out thyroid disorders)
• Lipid panel and glucose testing to assess metabolic health

Bone Health Screening

• Bone density test (DEXA scan), especially if you are at risk for osteoporosis

Cancer Screening Review

• Breast cancer screening (mammography)
• Cervical cancer screening (Pap Smear and HPV tests)
• Colon cancer screening

Your OG/GYN provider will use these findings to help determine which symptom-management options are appropriate and safe.

Treatment & Management

Treatment during menopause focuses on relieving symptoms, protecting long-term health, and honoring your preferences. Options range from lifestyle adjustments to hormone therapy depending on symptom severity, medical history, and personal comfort level.

A key part of care is ensuring you understand the benefits and risks of each option so you can make informed decisions.

Lifestyle & Non-Hormonal Approaches

Many patients begin with supportive, non-hormonal strategies that can significantly improve daily comfort:

• Cooling techniques and layered clothing for hot flashes
• Regular physical activity to improve mood, sleep, and bone health
• Balanced diet emphasizing whole foods, calcium, and vitamin D
• Limiting caffeine, alcohol, or spicy foods that worsen symptoms
• Stress reduction methods such as mindfulness, yoga, or therapy
• Lubricants and moisturizers for vaginal dryness

These approaches can be used alone or alongside medical therapy.

Hormone Therapy (HT)

When symptoms are moderate to severe, hormone therapy (HT), also called hormone replacement therapy, may provide powerful relief. HT replaces declining estrogen, and sometimes progesterone, to ease hot flashes, improve sleep, and relieve vaginal dryness.

Forms of hormone therapy include:

• Estrogen therapy
• Estrogen + progesterone therapy
• Estrogen + testosterone + progesterone
• Vaginal estrogen (cream, ring, or tablet) for dryness and urinary symptoms

These come in pill (oral), gel/cream (topical), and pellet (inserted under the skin) forms.

Research shows that starting hormone therapy within about 10 years of entering perimenopause can offer several important long-term health benefits.¹ Benefits of HT may include:

• Reduced hot flashes and night sweats
• Improved sleep and mood
• Less vaginal dryness and discomfort
• Preventing bone loss

Safety Considerations

Your clinician will review important factors such as:

• Family or personal history of breast cancer
• History of blood clots or stroke
• Cardiovascular risk
• Age and time since last menstrual period

At The Medical Group of New Jersey, we follow the most current evidence-based guidelines to determine whether hormone therapy is safe and appropriate for you.

Non-Hormonal Medication Options

For those who cannot or prefer not to use hormone therapy, several non-hormonal treatments may help reduce symptoms:

• SSRIs or SNRIs for hot flashes and mood support
• Gabapentin for nighttime symptoms
• Clonidine for hot flash reduction
• Non-estrogen vaginal therapies for dryness

Your clinician will explain the role, benefits, and potential side effects of each medication.

1. Makary, Martin A, et al. “Updated Labeling for Menopausal Hormone Therapy.” JAMA, 10 Nov. 2025.

Monitoring & Follow-Up

Ongoing care is an important part of menopause management. Your follow-up visits at The Medical Group of New Jersey may include:

• Reviewing symptom improvements and addressing new concerns
• Adjusting hormone or non-hormonal treatments
• Monitoring breast health, cardiovascular risk, and blood pressure
• Evaluating bone health over time
• Providing ongoing counseling about sexual health, mood, and sleep
• Supporting lifestyle goals and wellness plans

Regular follow-up ensures that your treatment continues to match your needs as your symptoms change.

Menopause is a natural transition, and with the right support, most women experience significant relief and improved well-being. Our goal is to help you feel your best, remain active, and maintain confidence through every stage of your life.