We have a passion for women’s health and for filling the gaps where traditional healthcare falls short: specifically, the health management of perimenopause, which are the years before menopause, as well as the years following menopause.

How these years are managed greatly influences the short and long-term health outcomes for every woman. We can help with many hormonal problems that women face, including other hormonal dysfunctions like thyroid disorders and PCOS.

Our Women’s Health & BHRT program is spearheaded by Melissa Abendroth, RN, under the supervision and medical direction of Dr. Matthew Abendroth.

Perimenopause can start just a few years to over 10 years before menopause. It is difficult to diagnose as there is no single test that definitively says you are in perimenopause, but there is a constellation of symptoms that can be highly suggestive. Bioidentical hormone replacement therapy (BHRT) is important in perimenopause, not just to control these symptoms and improve your quality of life, but also to protect your health for the future, especially your bone health. During perimenopause, your progesterone levels begin to decrease first, and estrogen levels may fluctuate wildly and rapidly, sometimes being far too low, and sometimes overcorrecting too high. By using hormones intelligently, we can correct your progesterone level and help put a “floor” to how low your estrogen levels will go, which will also help prevent such dramatic over-corrections. This therapy smooths out hormone levels, reducing symptoms and protecting your bones, brain, heart, and more.

Symptoms commonly experienced in perimenopause include:

Vasomotor symptoms: Hot flashes, night sweats, heat intolerance

Menstrual changes: Irregular periods, heavier or lighter bleeding, shorter or longer cycles, skipped periods

Sleep disturbances: Insomnia, difficulty staying asleep, poor sleep quality

Mood changes: Irritability, anxiety, depression, mood swings, emotional sensitivity

Cognitive issues: Brain fog, difficulty concentrating, memory lapses

Physical changes: Weight gain (especially around the midsection), joint and muscle aches, headaches

Vaginal and urinary symptoms: Vaginal dryness, painful intercourse, urinary urgency or frequency, increased UTI risk

Sexual health: Decreased libido, reduced sexual satisfaction

Skin and hair changes: Dry skin, thinning hair, brittle nails

Fatigue: Persistent tiredness, low energy levels

Heart palpitations: Racing or irregular heartbeat

Breast tenderness

Perimenopause

Menopause marks the 366th day after a woman’s final menstrual period. The years of fluctuating hormones leading up to this day (perimenopause), are often the most symptomatic. After this day, a woman is said to be post-menopausal, and your body dramatically reduces production of hormones like estrogen, progesterone, and testosterone. Many women continue to have symptoms, but some women get relief from some of the most bothersome symptoms like hot flashes and brain fog. But all women experience increased cardiovascular risk, cognitive risk, and decreased bone health as a result of this transition, leading to increased rates of heart disease, stroke, dementia, and fractures as you age. For these reasons, we recommend hormone replacement therapy for all women in whom it is not contraindicated.

Key benefits of postmenopausal hormone therapy:

Vasomotor symptom relief: Eliminates or significantly reduces hot flashes and night sweats

Improved sleep quality: Better rest due to reduced night sweats and hormonal stabilization

Bone health: Prevents osteoporosis and reduces fracture risk by maintaining bone density

Genitourinary health: Relieves vaginal dryness, atrophy, and painful intercourse; reduces urinary symptoms and UTI frequency

Sexual function: Improves libido, arousal, orgasm, and overall sexual satisfaction

Mood stabilization: Reduces irritability, anxiety, and depressive symptoms related to hormonal decline

Cognitive support: May improve brain fog, memory, and concentration

Cardiovascular benefits: When started early (within 10 years of menopause), may provide heart protection

Skin and tissue health: Maintains skin elasticity, collagen production, and tissue integrity

Joint and muscle comfort: Reduces aches and stiffness

Weight management support: Helps counteract metabolic changes that promote abdominal weight gain

Quality of life: Overall improvement in energy levels, well-being, and daily functioning

Potential disease prevention: May reduce risk of colorectal cancer and type 2 diabetes

After Menopause

Concierge Women’s Health & BHRT

Our concierge hormone optimization program is designed to help women navigate the complex physiologic changes that can accompany the natural transition of perimenopause and menopause. We use a concierge model for our women’s health and BHRT patients, just like we do for our full Concierge Medicine patients. The reason is simple — we want our patient to feel free to reach out to us at any time, directly, to ask questions, report a side effect, request an appointment, or for any other reason, without waiting until their next appointment. Especially as you are starting, you will have questions after you get your medicines that you didn’t think to ask during your appointment or couldn’t have anticipated.

Being able to reach to your provider by text or have a phone call virtually any time allows us to get you feeling your best as soon as possible by eliminating all delays and closing the feedback loop rapidly. And, it lets our patients know that we are truly partnered with them in this process, knowing we are here for you whenever you need us. With a concierge program, we address your questions and concerns the moment you have them, with no billing hassle, no receptionist or on-call nurse hotline, no barrier at all between you and your provider.

Why concierge?

We begin with a comprehensive lab evaluation to identify common and treatable conditions that can mimic perimenopausal symptoms, such as iron deficiency contributing to fatigue or thyroid dysfunction affecting cognition and weight. Labs are also used to assess for hormone imbalances, though with perimenopause, hormone levels are highly unpredictable and not diagnostic of perimenopause. We do not mark up your labs; in fact, you don’t even pay us, you pay the lab company. It costs around $155 for our initial comprehensive labs.

Following your lab draw, Melissa will meet with you to review your symptoms, discuss your concerns and goals, and provide individualized education. Together with our medical director, Dr. Abendroth, we develop a personalized, physician-guided treatment plan tailored to your needs. You will be able to stay in close contact with Melissa throughout your time in our care, reaching out to her any time you have any questions or concerns. You will have direct access to her personal cell phone, and can have as many appointments as you need. We will repeat labs as needed and as indicated. Everyone is different, so we are unable to elaborate on exactly how often or which labs will be needed. Generally, there are more labs in the first year while we are getting everything dialed in, and labs become less and less frequent as time goes on.

Treatment plans emphasize foundational lifestyle strategies and, when appropriate, bioidentical hormone replacement therapy (BHRT). This may include transdermal (through-the-skin) estradiol, testosterone (yes, women need testosterone, too!), and/or oral micronized progesterone, as well as vaginal hormones when indicated. We do not use hormone pellets for a variety of reasons — they are invasive, the levels cannot be adjusted once they are inserted, they have a much higher complication rate, including extrusion and infection, they cause scar tissue, they are expensive, etc. We place a strong emphasis on patient education, ensuring you understand your options, the risks, and the benefits, and can make informed decisions about the approach that best aligns with your health goals. Hormone therapy is highly individualized and requires thoughtful adjustments over time. Many patients come to us seeking a more personalized approach after having experienced the more ubiquitous cookie-cutter hormone mill style available in many med-spas and online.

How our program works

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FAQ

  • Initial consultation is $120 paid to us, plus about $160 paid to the lab

    If you become a patient after the consultation, the consultation fee covers your first month of membership.

    Membership is $120 per month, or can be paid annually with a 10% discount

  • We do not take insurance payment of any kind. By keeping insurance out of our practice, we can provide you with the level of quality, attention, & time we think is best, perform the testing we think is important for you, and provide the treatments we think you need.

  • Medicare patients pay an annual retainer fee for services not covered by Medicare, plus we must bill Medicare for services covered by Medicare. Please contact us to join our Medicare waitlist.

  • Melissa Abendroth, RN has many years of experience in women’s health and has a passion for this work. She has countless hours of education in women’s health and hormonal therapy. She is currently enrolled in a nurse practitioner program at Allen College and will graduate in 2026. While she is the face of our Women’s Health and BHRT program, all lab results, consultation reports, and treatment plans are developed and overseen by Dr. Abendroth. When she graduates, her role will become more primary, with Dr. Abendroth serving in a consultative capacity as medical director for this program.