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Menopause & Perimenopause


man standing behind woman with arms on her shoulders smiling
We can help you understand signs of
change of life in your body to ease the

What is Menopause?

Menopause is a natural stage in a woman’s life characterized by the absence of a monthly period and the absence of ovulation. It is a process that begins gradually; the ovaries cease production of the sexual hormones estrogen, progesterone and testosterone. The average age of menopause in America is 52.

What is Perimenopause?

Perimenopause refers to the years prior to the cessation of menses when the ovaries gradually diminish their production of estrogen, progesterone and testosterone.

What are the Symptoms of Menopause?

  • Hot flashes
  • Night sweats
  • Insomnia (due to night hot flashes)
  • Lack of energy
  • Mental haziness
  • Mood swings
  • Depression
  • Decreased libido
  • Decreased ability to achieve orgasm
  • Vaginal dryness
  • Breast tenderness

Menopause is also associated with:

  • Irregular periods or abnormal vaginal bleeding
  • Bone loss
  • Elevation of cholesterol, decrease in good cholesterol (HDL) and
  • increase in bad cholesterol (LDL)
  • Deregulation of carbohydrate metabolism
  • Frequent vaginal and urinary infections
  • Weight gain
  • Hair loss
  • Hypothyroidism
  • Skin dryness

The signs and symptoms of menopause and their onset vary significantly between women.

Women today experience much more stress than ever before. Many have children later in life, and balance the symptoms and stresses of menopause with the challenges of caring for small or teenage children. Women often hold jobs with higher pressures than their partners. Sometimes, they are at the head of single parent families. Many single women, living in an age of higher divorce rates, feel pressure to stay young, sexually attractive, and energetic in order to attract new partners.

Women have options for how to handle the increasing burden of menopause:

  • Conventional hormone replacement therapy (HRT)
  • Bioidentical or natural hormone therapy
  • Herbal therapy (i.e. black cohosh)
  • Nutritional support, as well as suggestions for behavioral changes to decrease stress

Many women prefer to take a proactive approach to the management of menopause.




Dr. Inga Zilberstein, MD, PLLC
1317 Third Avenue 4th Floor
Upper East Side of Manhattan

New York, NY 10021
Phone: 830-254-5941
Fax: 855-768-9821

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