The perimenopause is marked by the onset of menstrual irregularity, but many women begin to experience other symptoms of menopause before this, even as early as in their mid-thirties. Common symptoms include hot flashes, night sweats, changes in menstrual flow, vaginal dryness, decreased libido, or changes in stamina or concentration. The perimenopause is an important transition time, which can encompass on average a period of four years or more, during which symptoms can fluctuate in their presence and severity. Menopause is by definition our last menstrual period, a diagnosis made a year hence. Many women enter into discussions and decisions about hormone therapy before that year has passed.

At Avenues For Health, we specialize in helping women in perimenopause or menopause feel their best and turn their health care decision making attention in directions that optimize their health. We believe that changes in lifestyle, including diet and exercise, stopping smoking, and reducing unnecessary stress are important keys to addressing a woman's total wellbeing. We are familiar with and utilize on a daily basis recommendations regarding specific food choices, dietary parameters, weight control, and nutritional supplementation. We identify types and duration of exercise for strength, balance, and bone health and stress reduction. Relaxation techniques can also be recommended involving biofeedback, massage, or meditation.

When medicinal intervention is appropriate, we are experienced in the use of herbal remedies, natural hormonal therapies, and conventional hormone regimens. Herbal medicine is an exciting and dynamic field. We help women maneuver through the information available and provide recommendations based on clinical experience and investigative science. Acupuncture is an effective intervention for menopausal symptoms including hot flashes, insomnia, and mood changes. Hormonal therapies can be divided into the use of natural or synthetic, and native or nonnative compounds delivered most commonly in orally, topically/transdermally, or sublingually. We can advise a woman about the symptoms for which hormones are successfully used, the disorders they can potentially treat, and what hormones are known or not known to provide in terms of preventative health of many organ systems. This expertise requires the decades of cumulative experience of our physicians.

There are times when a woman has a condition requiring surgery. Dr. DeNevi is a surgical gynecologist experienced in both minimally invasive surgeries and conventional surgical techniques. Dr. DeNevi can provide skillful surgical intervention when it is the best choice of treatment for conditions such as heavy bleeding, fibroids, endometriosis, urinary incontinence, genital organ prolapse, and cancer. Dr. DeNevi works closely with subspecialists in the fields of gynecologic cancer and pelvic reconstruction.

We are a unique collection of physicians with a deep and sincere interest in understanding the perimenopause and menopause transitions. We devote ourselves to maintaining the most current and effective knowledge about our specialty, and to sharing it with you.

General Women's Health Care - Menopause and Perimenopause Consultations
Comprehensive Gynecology - Medical Acupuncture
Nutritional and Herbal Therapies - Preventative Medicine
Urinary Incontinence Evaluation and Treatment