Menopause or perimenopause symptoms
Assess vasomotor symptoms (hot flashes, night sweats), mood changes, sleep disturbance, vaginal dryness, bone health
Non‑hormonal therapy (SSRIs/SNRIs, gabapentin, clonidine, fezolinetant), hormone therapy (estrogen ± progesterone), vaginal estrogen
FSH and estradiol levels (optional), lipid panel, TSH, bone density (DEXA) when indicated
None routinely; bone density scan for osteoporosis risk
Severe hot flashes disrupting life, mood changes, vaginal dryness with dyspareunia, new bleeding after menopause
Annual evaluation; monitor hormone therapy regularly; bone density every 2 yrs for high risk
Lifestyle adjustments: layer clothing, avoid triggers (spicy foods, caffeine, alcohol), maintain healthy weight, exercise, yoga/relaxation techniques
Refer to gynecology or endocrinology for hormone management; mental health support; bone health specialist