Hormonal changes during perimenopause and menopause can affect nearly every aspect of a woman’s health, including energy, mood, sleep, weight, cognition, and sexual function. Symptoms such as hot flashes, night sweats, brain fog, and fatigue are common, but they are not something women need to simply accept. These changes reflect shifts in estrogen, progesterone, and other hormones that play a critical role in overall health and well-being.

Dr. Smith’s approach to menopausal hormone therapy is individualized and based on a comprehensive evaluation of symptoms, hormone levels, and overall metabolic health. Treatment is designed to safely restore hormonal balance while considering cardiovascular health, bone health, and long-term risk factors. His focus is not simply to manage symptoms, but to restore function, improve quality of life, and support long-term health.

Treatment options may include:

• Estrogen therapy (oral, sublingual, transdermal, topical, or pellet-based)

• Progesterone therapy (oral or sublingual)

• Combination hormone therapy tailored to individual needs

• Lifestyle and metabolic optimization to support hormonal balance

• Ongoing monitoring and adjustment based on response and goals

Testosterone is an essential hormone in women, playing a key role in libido, sexual function, energy, mood, muscle mass, body composition, and overall vitality. As levels decline with age or hormonal changes, many women experience decreased desire, reduced sexual responsiveness, fatigue, diminished strength, and a loss of overall sense of well-being. Despite its importance, testosterone is often overlooked in women’s health.

Dr. Smith’s approach to testosterone therapy in women is individualized and based on a comprehensive evaluation of symptoms, free testosterone levels, SHBG, and the broader hormonal and metabolic picture. Treatment is carefully tailored and monitored to ensure appropriate dosing, effectiveness, and safety. His focus is not simply to manage symptoms, but to restore function, improve performance, and help women feel like themselves again.

Treatment options may include:

• Testosterone therapy (topical, sublingual, injectable, or pellet-based)

• Integration and optimization of testosterone therapy in conjunction with estrogen and progesterone

• Adjustment of other hormone therapies to support overall balance

• Lifestyle and metabolic optimization to enhance outcomes

• Ongoing monitoring and adjustment based on response and goals

Genitourinary Syndrome of Menopause (GSM) is a common condition caused by declining estrogen levels that affects the vaginal and urinary tissues. Many women experience vaginal dryness, irritation, urinary symptoms, and pain with intimacy, which can significantly impact comfort, sexual health, and overall quality of life. Despite how common these symptoms are, they are often dismissed as a normal part of aging and left untreated. Left untreated, GSM can progress beyond discomfort and sexual symptoms, increasing the risk of recurrent urinary tract infections and, in more severe cases, complications such as urosepsis.

Dr. Smith provides a comprehensive, targeted approach to GSM that focuses on restoring tissue health, function, and comfort. Evaluation includes overall hormone status, local tissue health, and contributing metabolic factors, allowing for a personalized treatment plan. His focus is not simply to manage symptoms, but to restore function, improve comfort, and support long-term vaginal and urinary health.

Treatment options may include:

• Local vaginal estrogen or androgen therapy

• Systemic hormone therapy when indicated

• Non-hormonal therapies, including medications, moisturizers, and other supportive treatments

• Vaginal support therapies to improve tissue health and function

• Lifestyle and metabolic optimization to support overall tissue health

• Ongoing monitoring and adjustment based on response and goals

Female sexual dysfunction can involve challenges with desire, arousal, orgasm, or pain with intimacy. These concerns are often multifactorial, involving hormonal changes, vascular and neurological factors, vaginal tissue health, and the psychological and relational aspects of sexual health. Despite how common these issues are, they are frequently overlooked or dismissed, leaving many women without answers or effective treatment.

Dr. Smith takes a comprehensive, evidence-based approach to female sexual health, focusing on identifying and addressing the underlying causes rather than treating symptoms in isolation. Evaluation includes hormone status, metabolic health, vascular function, and contributing local tissue factors such as GSM, allowing for a personalized and targeted treatment plan. His focus is not simply to manage symptoms, but to restore function, improve sexual response, and rebuild confidence and intimacy.

Treatment options may include:

• Hormone optimization, including estrogen, progesterone, and testosterone when indicated

• Local vaginal therapies to improve lubrication and tissue health

• Treatment of underlying GSM when present

• Referral to pelvic floor physical therapy when indicated

• Lifestyle and metabolic optimization to support vascular and hormonal health

• Ongoing monitoring and adjustment based on response and goals

Regenerative Medicine options may include:

• Focused Low-Intensity Shockwave Therapy (F-LiSWT)

• Platelet-Rich Plasma (PRP) therapy

• Regenerative biologics (e.g., exosomes, Wharton’s jelly)