perimenopause + menopause care

support for hormone changes — with time, intention, and individualized care

you deserve to feel like yourself again.

historically, women have been told to push through this phase of life — to sleep more, stress less, try harder, or just accept that things are changing. but many of these symptoms aren’t a mindset problem — they’re a biological shift.

hormones change. and when they do, it can affect everything — your energy, your mood, your sleep, your relationships, and how you feel in your own body.

at pomalo, we believe this stage of life deserves attention, not dismissal. we believe in giving you clear information, honest guidance, and the space to make decisions about your own body.

a closer look into perimenopause + menopause

  • menopause is defined as 12 consecutive months without a menstrual period.

    it’s the end point of a transition phase (perimenopause) where hormones gradually shift over time.

  • perimenopause is the years leading up to menopause, when hormone levels begin to fluctuate.

    this phase can last 7–10 years, and symptoms can start as early as your mid to late 30s.

    it’s often when women first notice:

    • brain fog

    • mood changes (anxiety, irritability, low mood)

    • sleep disruption

    • cycle changes

    • new or worsening PMS

  • the average age of menopause is 51, but the transition can begin years before that.

    every woman’s timeline is different.

  • the main hormone changes involve:

    • estrogen (declines and fluctuates)

    • progesterone (declines earlier in perimenopause)

    • testosterone (gradually declines over time)

    these hormones work together and influence:

    • brain function and mood

    • sleep

    • metabolism and body composition

    • energy and motivation

    • libido and sexual health

    • skin, hair, and collagen

    • vaginal and urinary tissue

    • bone health

    testosterone is often overlooked, but it plays an important role in:

    • desire and sexual function

    • energy and drive

    • muscle mass and strength

    • overall sense of well-being

  • during perimenopause, hormones don’t just decline—they fluctuate.

    this is why symptoms can feel inconsistent or confusing:

    • one month you feel fine

    • the next month everything feels off

    this is normal—but often not talked about enough.

  • as we move through perimenopause and menopause, our bodies go through quiet but powerful changes—especially in the tissues of the vulva, vagina, and urinary tract.

    one of the biggest shifts is loss of estrogen.

    within the first five years of menopause, we lose up to 30% of our skin’s collagen. this doesn’t just affect our face—it affects our vaginal and vulvar tissue, too.

    gsm can show up as:

    • vaginal dryness or irritation

    • burning or stinging

    • pain with intercourse

    • decreased lubrication

    • urinary urgency or frequency

    • recurrent “uti-like” symptoms

    gsm is very treatable, and you don’t need to wait until symptoms are severe.

  • probably not.

    many women are told they’re “too young” when symptoms start, but:

    • changes can begin in the mid–late 30s

    • most women experience symptoms well before age 51

    if something feels off, it’s worth paying attention to.

  • no.

    while menopause is a natural transition, suffering through it is not required.

    there are safe, effective ways to support your body through this phase—whether that’s through lifestyle, targeted therapies, or hormone support.

  • you don’t need to wait until things feel severe.

    you can reach out if you’re noticing:

    • changes in mood or mental clarity

    • sleep disruption

    • cycle changes

    • vaginal dryness or discomfort

    • low energy or motivation

    • feeling “not like yourself”

    early support can make a big difference.

a thoughtful approach

every plan is individualized — and may include a combination of the following:

  • sleep disruption is one of the most common (and most frustrating) symptoms.
    we address both the hormonal and behavioral contributors to help you get deeper, more restorative sleep.

  • hormonal changes can impact metabolism, blood sugar, and weight distribution.

    we focus on realistic, sustainable nutrition strategies that support energy, muscle mass, and overall health — without extreme restriction.

  • this phase of life often overlaps with high stress — careers, relationships, family, and more.

    we incorporate strategies to support your nervous system and reduce the impact of chronic stress on your body.

  • we address concerns like low libido, vaginal dryness, and discomfort with a combination of hormonal and non-hormonal options.

  • when appropriate, we may recommend supplements to support hormone balance, energy, mood, and overall wellness.

  • for some women, hormone replacement therapy (hrt) can help restore balance and improve symptoms like sleep disruption, mood changes, hot flashes, and low libido.


    we use a thoughtful, personalized approach and adjust over time based on how you feel.

your care plan is built around how you feel — not just lab values.

schedule your consultation today

begin your care