Menopause lasts years. Your care should, too.
Hot flashes, sleep, mood, bone density and heart health, managed together by clinicians trained in menopause medicine who look at the whole picture, not one complaint at a time.
Menopause isn't a single moment. It's a transition that usually begins in your 40s, can last close to a decade, and affects far more than hot flashes. Sleep, mood, memory, bone density, heart health, and sexual and urinary comfort all shift as estrogen declines.
Too often, each of those changes gets treated as a separate complaint by a separate clinician. Vanderbilt's Menopause & Midlife Health clinic takes the opposite approach. One clinician trained in menopause medicine looks at the whole picture and builds a plan that covers today's symptoms and your long-term health together.
Maybe you're noticing the first irregular cycles of perimenopause. Maybe you're years past your last period and want to protect your bones and heart. Either way, this is the team built for this chapter.
What We Treat
Every change, considered together
Menopause affects your whole body. Our care plans do, too.
Hot Flashes & Night Sweats
Hormonal and non-hormonal treatments for hot flashes and night sweats, matched to your health history and preferences.
Sleep Disruption
Evaluation of menopause-related insomnia and night waking, with medical and behavioral strategies that work together.
Mood, Memory & Focus
Support for anxiety, low mood, irritability and \"brain fog\" during the transition, with referral to behavioral health when helpful.
Bone Health
Bone density screening, fracture-risk assessment, and prevention or treatment of osteoporosis.
Heart & Metabolic Health
Blood pressure, cholesterol and weight changes reviewed in the context of menopause and coordinated with your primary care team.
Sexual & Urinary Health
Treatment for vaginal dryness, painful sex, low libido and urinary symptoms: the changes many women never mention.
Care by Stage
Where you are in the transition shapes what helps.
Menopause care isn't one-size-fits-all. Choose the stage that sounds most like you.
Perimenopause
Perimenopause: when things start to change
Perimenopause often begins in your 40s. Irregular cycles and the first symptoms appear as hormone levels fluctuate, and it can last several years.
- Cycle changes and heavier or lighter bleeding
- Early hot flashes, sleep changes and mood shifts
- Contraception is still needed until menopause is confirmed
Average age at menopause
in the United States · The Menopause Society
Median duration of hot flashes
SWAN study · JAMA Internal Medicine, 2015
Women over 50 who will break a bone due to osteoporosis
Bone Health & Osteoporosis Foundation
U.S. women who reach menopause each year
The Menopause Society
For two years I thought I was just tired and anxious. In one visit, my clinician connected my sleep, my mood and my bone scan, and gave me a plan I could actually follow. I feel like myself again.
Menopause & Midlife Health patient
Your First Visit
What to expect when you come in
Three steps, designed so you leave with answers, not a stack of referrals.
Step 1 · Before you arrive
Tell us what's actually happening
After you request a visit, we'll send a short symptom questionnaire through My Health at Vanderbilt. Two weeks of notes on sleep, cycles and hot flashes gives your clinician a head start.
Step 2 · Your consultation
A longer first conversation
New-patient menopause visits are booked as extended appointments. That gives your clinician time to review your history, symptoms, medications and risk factors in one sitting.
Step 3 · Your plan
Leave with a plan, not a pamphlet
You'll go home with a written plan covering symptom treatment, any screening you're due for, and a follow-up visit to check what's working and adjust.
Bleeding after menopause should always be checked
Common Questions
Menopause and midlife care, answered
Perimenopause is the transition leading up to menopause, when hormone levels fluctuate and cycles become irregular. It often starts in your 40s and can last several years. Menopause is confirmed once you've gone 12 consecutive months without a period. Everything after that point is called postmenopause.
Usually not. For most women over 45 with typical symptoms, menopause is diagnosed from symptoms and menstrual history. Hormone levels swing widely during perimenopause, so a single blood test is often unhelpful. Testing may be recommended if you're younger or if the picture is unclear.
For many healthy women under 60, or within 10 years of their last period, the benefits of hormone therapy for bothersome symptoms generally outweigh the risks. The right choice depends on your age, personal and family history, and the type, dose and form of therapy. Your clinician will review your history, including any history of breast cancer, blood clots or heart disease, before recommending an option.
There are effective non-hormonal options. These include FDA-approved non-hormonal prescription medicines for hot flashes, other prescription medications, cognitive behavioral therapy, and lifestyle strategies for sleep and temperature. Vaginal moisturizers and other local treatments can help with dryness and discomfort.
No referral is required to request an appointment with Menopause & Midlife Health. Describe your symptoms when you request a visit, and the intake team will schedule you with the right clinician. Check with your insurance plan about any referral requirements for coverage.
Estrogen helps protect bone and blood vessels. After menopause, bone loss speeds up, especially in the first few years, and heart disease risk rises. Your clinician will recommend bone density screening based on your age and risk factors and will review blood pressure and cholesterol as part of your plan.
Contact your clinician promptly about any vaginal bleeding after menopause, very heavy or prolonged bleeding during perimenopause, or symptoms of depression that affect daily life. For chest pain, sudden shortness of breath or other emergencies, call 911.
Important Information
This page provides general information about menopause and midlife health. It is not a substitute for personal medical advice. Talk with your clinician about the options that are right for you.
Statistics: average age at menopause and annual U.S. incidence, The Menopause Society. Median duration of hot flashes: Avis NE, et al., JAMA Internal Medicine, 2015 (Study of Women's Health Across the Nation). Fracture risk: Bone Health & Osteoporosis Foundation.
If you are experiencing a medical emergency, call 911.