Most women in perimenopause or menopause never get treated. National surveys show roughly 7 in 10 women aged 40–65 aren’t currently treating their symptoms, and among those who do ask for help, as many as 1 in 5 say they were dismissed or told their symptoms weren’t a priority.
That’s not what care should look like. I’m Reshma Patel, PA-C, MMS — a member of The Menopause Society and a PHRT® Certified Provider through the Women’s Hormone Network — and I treat menopause and perimenopause as their own specialty, not an afterthought tacked onto a routine physical. Every visit is by telehealth, so you can get real, individualized care from wherever you are in California.
What we treat
Hot flashes and night sweats, sleep disruption, mood changes and brain fog, joint pain, low libido, vaginal dryness and urinary symptoms, irregular cycles in perimenopause, and the longer-term effects of estrogen loss on bone, heart, and metabolic health.
Why see a menopause-trained provider
Most primary care training includes very little on perimenopause and menopause. A menopause-trained provider has gone looking for that education specifically and stays current as the clinical guidance evolves. That’s the difference between being told your symptoms are “just aging” and getting an actual evaluation.
How treatment works
Hormone therapy remains the most effective treatment available for hot flashes, night sweats, and the genitourinary symptoms of menopause, according to The Menopause Society’s 2022 position statement — and it’s prescribed individually, not as a one-size-fits-all dose. At Ananda Integrative Medicine, that means Physiologic Hormone Restoration Therapy® (PHRT®) — restoring hormones with the right type, at the right levels, in the right rhythm — using both:
- Commercial, FDA-approved bioidentical hormones — patches, pills, gels, or vaginal rings available at any pharmacy.
- Compounded bioidentical hormones — prepared specifically for you at a compounding pharmacy, when you need a dose, strength, or delivery route that isn’t available commercially.
Non-hormonal options are also available for women who can’t or don’t want to use hormone therapy. See the Bioidentical Hormone Replacement Therapy page for the full protocol, testing, and current pricing.
Because hormone shifts in menopause also affect weight, body composition, and biological aging, this often connects to Precision Metabolic Optimization or a Biological Age Assessment as well, if that’s relevant to you.
What a visit looks like
Your first visit runs longer than a standard appointment — there’s a real history to take: symptoms, cycle and reproductive history, personal and family risk factors, current medications. Labs are typically done through a local draw site or an at-home kit, no in-person visit required. From there, we build a treatment plan together and adjust it over time with short telehealth follow-ups, not another long visit every time a dose needs tweaking. All visits are conducted by telehealth — see Telehealth Services – California for how that works and who’s eligible.
Cost
This practice does not bill insurance; visits are self-pay. See Pricing for current rates, or ask during a consultation.
Ready to start?
Schedule An Appointment → or call (424) 259-2089.
This page is for general informational purposes and does not constitute medical advice. An individualized evaluation with a licensed provider is required before starting any treatment.
