Female Hormone Imbalance (Perimenopause, Menopause & PCOS)

About This Condition

Female hormonal dysfunction spans a wide clinical spectrum: polycystic ovary syndrome (PCOS) in reproductive-age women — affecting 1 in 10 and driven primarily by insulin resistance and androgen excess — and perimenopause/menopause in mid-life women, characterized by declining estrogen and progesterone with significant systemic consequences including bone loss, cardiovascular risk, cognitive changes, mood instability, sleep disruption, and genitourinary atrophy. Both are frequently undertreated: PCOS patients are offered birth control or Metformin without metabolic correction; menopausal women are told to "manage symptoms" or prescribed low-dose antidepressants.

Our Approach

For PCOS, we assess the full androgenic and metabolic profile: free and total testosterone, DHEA-S, LH:FSH ratio, fasting insulin, HOMA-IR, and 24-hour urine cortisol. Treatment targets the root insulin resistance with structured nutritional protocols, inositol (myo + D-chiro), berberine, and when appropriate, Metformin — with monitoring of metabolic response, not just cycle regularity. For perimenopause and menopause, we provide evidence-based bioidentical hormone therapy (estradiol, progesterone, testosterone) individualized to symptom burden, cardiovascular risk profile, and patient preference. We use the DUTCH urine hormone panel when indicated to assess hormone metabolism pathways. Bone density is tracked via iDXA. This is hormone optimization designed to protect long-term health span, not just manage short-term discomfort.