Women’s Health Care for Perimenopause, Menopause, and PMDD
Support for Perimenopause, Menopause & PMDD
When your menstrual cycle, sleep, physical health, mood, or sense of well-being begins to change, it can be difficult to understand what is happening. You may know that you do not feel like yourself, even if you cannot identify a single cause.
At Restoring Wellness Solutions, we provide focused care for physical and emotional concerns related to perimenopause, menopause, and premenstrual dysphoric disorder, or PMDD. Treatment options may include hormone replacement therapy, nonhormonal treatments, medication management, lifestyle recommendations, nutritional guidance, and additional evaluation when appropriate.
You do not need to be experiencing anxiety, depression, or another pressing mental health concern to seek care. We welcome women who want informed support for physical symptoms, preventive health needs, mental health changes, or a combination of concerns.
Collaborative Care for Physical and Emotional Changes
Perimenopause and menopause can affect many areas of health. Some women primarily notice physical symptoms. Others experience changes in mood or previously stable mental health. Many experience a combination of concerns that affect sleep, work, relationships, daily comfort, or overall quality of life.
Our approach is respectful and collaborative. We create space for you to describe what has changed, ask questions, and discuss appropriate options without feeling rushed or dismissed.
Care is based on your symptoms, health history, stage of the menopausal transition, risk factors, preferences, and goals. Rather than assuming every concern has the same cause or requires the same treatment, we consider your full experience.
Physical Health Changes During Perimenopause and Menopause
The menopausal transition can affect your menstrual cycle and many aspects of your physical health. Symptoms vary widely, and not every woman experiences the same changes.
Physical concerns may include:
- Hot flashes or night sweats
- Changes in menstrual timing, flow, or predictability
- Difficulty falling asleep or staying asleep
- Vaginal dryness or discomfort
- Urinary urgency, frequency, or leakage
- Joint or muscle discomfort
- Changes in body composition
- Concerns about bone health
Some women experience mild symptoms that do not require treatment. For others, physical changes become disruptive or raise questions about long-term health.
Midlife care may also include attention to bone health, breast health, nutrition, physical activity, and other preventive needs. Bone density scans, mammograms, or additional evaluation may be recommended when appropriate based on factors such as age, medical history, symptoms, prior results, and individual risk.
You Do Not Need a Mental Health Concern to Seek Care
This service is available to women seeking help with physical symptoms and health concerns, including those who are not experiencing anxiety, depression, or another active mental health condition.
You may seek care because you:
- Have questions about perimenopause or menopause
- Are experiencing hot flashes, night sweats, or sleep disruption
- Have noticed menstrual changes
- Want to discuss HRT or nonhormonal treatment
- Are concerned about physical changes during midlife
- Want nutritional or lifestyle guidance
- Need help reviewing preventive health needs
- Want an informed, collaborative relationship with a provider
Mental health support remains available when it is relevant, but it is not a requirement for receiving care.
Perimenopause and Menopause
Perimenopause
Perimenopause is the transition leading up to menopause. During this time, menstrual cycles may become less predictable as hormone levels change.
Some women experience few symptoms. Others notice hot flashes, night sweats, sleep problems, menstrual changes, vaginal or urinary symptoms, joint discomfort, difficulty concentrating, or changes in mood. The type and severity of symptoms can vary over time.
Symptoms should not automatically be attributed to hormones. Physical or emotional changes may have multiple contributing factors, and further evaluation may be appropriate.
Menopause
Menopause is reached after 12 consecutive months without a menstrual period when another medical or physiological cause is not responsible. It is a normal stage of life, not a disease.
Menopause symptoms can still affect sleep, work, relationships, physical comfort, and emotional well-being. Changes associated with aging and lower estrogen levels may also make bone health and other preventive health needs increasingly important.
Professional care may be appropriate when symptoms interfere with daily life, when you have concerns about your physical health, or when you want help understanding available treatment options.
PMDD Is More Than Typical Premenstrual Discomfort
Premenstrual dysphoric disorder is a serious cyclical condition that causes emotional and physical symptoms before menstruation. PMDD is related to the menstrual cycle, but it is more severe than typical premenstrual syndrome.
Symptoms may include:
- Intense irritability
- Anxiety or tension
- Depressive symptoms
- Significant mood changes
- Difficulty concentrating
- Low energy
- Sleep disruption
- Feeling overwhelmed or out of control
PMDD symptoms generally appear during the week or two before menstruation and improve shortly after the period begins. This recurring timing can help distinguish PMDD from mental health symptoms that occur throughout the month.
PMDD can disrupt work, relationships, responsibilities, and everyday functioning. Care may involve medication management, hormonal or nonhormonal treatment, lifestyle support, mental health medication optimization, psychotherapy referral, or a combination of approaches based on the individual patient.
Hormonal Changes and Mental Health
Some women experience new or worsening emotional symptoms during perimenopause or menopause. Anxiety or depression may appear for the first time, return after a period of stability, or become more difficult to manage.
Menopause symptoms and mental health symptoms can also overlap. Disrupted sleep may affect energy, concentration, resilience, and mood. Physical symptoms, stressful circumstances, previous episodes of depression, medications, and other health factors may contribute at the same time.
A careful approach recognizes that:
- Not every mood change is caused by hormones.
- Depression is different from occasional sadness or irritability.
- Significant anxiety or depression may require dedicated mental health treatment.
- Addressing disruptive physical symptoms may support overall well-being without replacing mental health care.
- More than one type of care may be appropriate.
When mental health concerns are part of your experience, care may include medication optimization or a referral for psychotherapy.
Treatment Options for Perimenopause, Menopause, and PMDD
Treatment should reflect your symptoms, medical history, risk factors, preferences, and goals. Not every patient will need or be appropriate for every option.
Hormone Replacement Therapy
Hormone replacement therapy, also called menopausal hormone therapy, may help manage certain symptoms associated with perimenopause and menopause for appropriately selected patients.
HRT is not right for everyone. A provider should consider potential benefits and risks, personal and family health history, current symptoms, stage of the menopausal transition, and individual preferences when discussing treatment.
HRT should not be presented as a universal solution or as a general treatment for anxiety, depression, PMDD, or every concern associated with menopause.
Nonhormonal Treatments and Medication Management
Hormone therapy is not the only possible treatment. Some women cannot take HRT, prefer not to take it, or may benefit from another approach.
Depending on the symptoms being addressed, care may include:
- Nonhormonal treatments
- Medication management
- Review and adjustment of existing medications
- Mental health medication optimization
- Psychotherapy referral
Specific recommendations depend on the individual patient and the concern being treated.
Lifestyle Recommendations and Nutritional Guidance
Daily habits can influence sleep, energy, muscle and bone health, cardiovascular health, and general well-being during midlife.
Individualized recommendations may address areas such as:
- Physical activity
- Strength and mobility
- Sleep habits
- Nutrition
- Weight-related concerns
- Stress management
- Bone-supportive health habits
Lifestyle and nutritional guidance may complement medical treatment, but they should not be presented as a substitute for appropriate evaluation or necessary care.
Laboratory Evaluation and Preventive Screening
Laboratory evaluation may be used when appropriate to investigate symptoms, assess related health concerns, or help guide treatment.
Hormone testing is not automatically necessary for every patient. Hormone levels can fluctuate substantially during perimenopause, so laboratory decisions should be based on the patient’s age, symptoms, medical history, and clinical circumstances.
Care may also include recommending or coordinating:
- Bone density scans
- Mammograms
- Additional laboratory evaluation
- Other preventive health services when appropriate
The need for screening depends on factors such as age, individual risk, health history, symptoms, and previous test results.
Care That Considers Your Full Experience
Menstrual changes, physical symptoms, sleep problems, anxiety, depression, and daily stress can affect one another. A respectful conversation may consider symptom timing, reproductive changes, physical and mental health history, current medications, previous treatment experiences, and personal goals.
You should have room to ask questions and understand the reasoning behind the options being discussed. Collaborative care means that your experience, concerns, and preferences remain part of the conversation.
A Welcoming Office for Sensitive Conversations
Talking about hormonal, menstrual, physical, or emotional changes can feel vulnerable, especially if you have previously felt rushed, dismissed, or unheard.
We believe clinical care can be thoughtful and professional without feeling cold or impersonal. Our Winston-Salem office offers a warm, comfortable setting where sensitive concerns can be discussed with dignity and respect.
You do not need to arrive with the correct terminology, a self-diagnosis, or a preferred treatment already selected. You can begin by explaining what you have noticed and how it is affecting you.
What does the first visit cost?
A new patient women’s health evaluation is $225. If we are in network with your insurance plan, your costs may differ. Our team can help you verify coverage.
Who May Consider a Consultation?
A consultation may be appropriate when you:
- Are experiencing physical symptoms associated with perimenopause or menopause
- Want to discuss whether HRT or a nonhormonal treatment may be an option
- Have questions about bone health, breast screening, nutrition, or preventive care
- Experience severe emotional or physical symptoms in a recurring premenstrual pattern
- Have questions about PMDD
- Notice new or worsening anxiety or depressive symptoms
- Feel that your previously stable mental health has changed
- Want care that considers physical and emotional health together
Seeking a consultation does not mean that a diagnosis or treatment has already been determined. It is an opportunity to discuss your concerns and explore what may be clinically appropriate.
Frequently Asked Questions
No. We welcome women seeking support for physical symptoms, preventive health concerns, perimenopause, menopause, PMDD, or questions about HRT and other treatment options.
Mental health care can be included when relevant, but an anxiety or depression diagnosis is not required.
Women may experience changes in menstrual cycles, hot flashes, night sweats, sleep disruption, vaginal dryness, urinary symptoms, joint or muscle discomfort, and changes in body composition.
Symptoms vary from person to person. A provider can help consider whether further evaluation or treatment may be appropriate.
Depending on your symptoms and clinical needs, options may include HRT, nonhormonal treatments, medication management, lifestyle recommendations, nutritional guidance, laboratory evaluation, mental health medication optimization, or psychotherapy referral.
Bone density scans, mammograms, and other preventive services may also be recommended when appropriate.
No. Laboratory evaluation may be helpful in some circumstances, but routine hormone testing is not necessary for every patient experiencing perimenopause or menopause symptoms.
Testing decisions depend on factors such as age, symptoms, menstrual history, medical history, and other possible causes of the concerns being evaluated.
Not every patient needs the same screening at the same time. Bone density scans and mammograms may be recommended based on age, health history, risk factors, symptoms, and previous screening results.
No. HRT may be an option for some patients with perimenopause or menopause symptoms, but its potential benefits and risks vary.
A provider should consider individual symptoms, health history, stage of menopause, treatment goals, and personal preferences when discussing whether HRT may be appropriate.
Some women experience new or worsening anxiety, irritability, sadness, or depression during perimenopause. Hormonal changes may contribute, but sleep, stress, physical symptoms, mental health history, and other medical factors may also play a role.
Significant or persistent mental health symptoms should not be dismissed as simply part of menopause.
Begin a Respectful Conversation About Your Health
You should not have to ignore significant changes or accept that feeling unlike yourself is something you must manage without support.
We offer focused care in Winston-Salem for women seeking help with physical symptoms, mental health changes, preventive needs, or questions about treatment. Whether you are concerned about perimenopause, menopause, PMDD, HRT, or another related health change, we are here to listen.
Medical Disclaimer
Scientific Resources
- What Is Menopause?, National Institute on Aging, National Institutes of Health, accessed 2026.
- The Menopause Years, American College of Obstetricians and Gynecologists, accessed 2026.
- Hormone Therapy for Menopause, American College of Obstetricians and Gynecologists, accessed 2026.
- Should I Have Hormone Testing Before Starting Hormone Therapy?, American College of Obstetricians and Gynecologists, accessed 2026.
- Osteoporosis to Prevent Fractures: Screening, U.S. Preventive Services Task Force, 2025.
- Breast Cancer: Screening, U.S. Preventive Services Task Force, 2024.
- Depression in Women: 4 Things to Know, National Institute of Mental Health, National Institutes of Health, accessed 2026.
- Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations, Menopause, 2018.
- Management of Premenstrual Disorders: ACOG Clinical Practice Guideline No. 7, American College of Obstetricians and Gynecologists, 2023.
- The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society, Menopause, 2023.