Perimenopause & Menopause Care

You're in your late 30s or 40s and something feels off. Your mood shifts without warning, sleep is harder to come by, and you're more anxious or irritable than you used to be. Maybe you've written it off as stress or aging, but the symptoms keep building. For many women, this is perimenopause, and it can start years before your period actually stops.

Hormonal shifts during perimenopause and menopause can affect mood, energy, sleep, focus, and motivation. Because these symptoms may overlap with anxiety and depression, they're often misdiagnosed or dismissed. You may feel unlike yourself without a clear explanation, and unsure where to turn for answers.

At Waypoint, our Women's Health Nurse Practitioner provides both mental health care and hormone therapy in a single visit. Rather than coordinating between separate providers for psychiatric medication and hormonal treatment, you receive integrated care from one provider who evaluates the full picture. Your first appointment is a comprehensive evaluation that may include a clinical assessment, lab work, and hormone testing. From there, we build a personalized treatment plan that may include hormone replacement therapy, psychiatric medication, lifestyle recommendations, or a combination.

Our goal is to help you understand what's driving your symptoms and treat them directly, so you can feel more like yourself again.

 

Treatment Modalities

 

Your treatment plan is built around your symptoms, your history, and your preferences. Your provider may use one or more of the following approaches.

• Hormone Therapy

• Psychiatric Medication Management

• Non-Pharmacological Support (nutraceuticals, etc.)

 

Clinical Guidelines We Follow

Perimenopause and menopause care at Waypoint is grounded in current professional guidelines. Rachel's approach is informed by:

• The Menopause Society (formerly NAMS) 2022 Hormone Therapy Position Statement, the primary evidence-based framework for hormone therapy decisions.

• Clinical guidance from the American College of Obstetricians and Gynecologists (ACOG) on perimenopause, menopause, and related women's health topics.

• Resources and training from Postpartum Support International (PSI) for patients whose mental health concerns began in the perinatal period and continue into perimenopause.

 

Frequently Asked Questions

 

Can I get hormone therapy and mental health care in the same appointment?

Yes. Rachel VanBree, our Women's Health Nurse Practitioner, provides both psychiatric care and hormone management in a single visit. Your treatment plan addresses the full picture from the start, with no need to coordinate between separate providers.

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Do I need a referral?

No. You can request an appointment directly through our website or by calling 919-275-1405.

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Is this available virtually?

Yes. Right now perimenopause and menopause care is available both in person at our Durham and virtually throughout North Carolina.

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What symptoms does perimenopause care treat?

Common symptoms include mood swings, anxiety, depression, sleep disruption, brain fog, hot flashes, fatigue, irritability, and changes in weight or motivation. Many women experience these for years before connecting them to hormonal changes.

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Is hormone therapy safe?

For most healthy women within 10 years of their last period, current evidence supports that the benefits of hormone therapy outweigh the risks when used for symptom management. Safety depends on individual factors including personal and family history. Your provider  will review your history thoroughly before recommending hormone therapy.

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How is perimenopause care different from menopause care?

Perimenopause is the transition period, often lasting years, when hormones fluctuate unpredictably and periods are still occurring. Menopause begins 12 months after your last period. Treatment approaches can differ. Perimenopause sometimes calls for cyclic or lower-dose approaches, while postmenopausal treatment is often more stable. Rachel will tailor the plan to where you are.

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How long until I feel better?

Many women notice improvement in vasomotor symptoms (hot flashes, night sweats) within a few weeks of starting hormone therapy. Mood and sleep improvements may take four to eight weeks, similar to psychiatric medications. Your provider will schedule follow-up visits to monitor your response and make adjustments.

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Do I have to be in perimenopause or menopause to be seen?

No. If you are noticing changes in your mood, energy, sleep, or cycle and wondering whether hormones might be a factor, that is a valid reason to book. You do not need a diagnosis or confirmation before coming in. Your provider can help you figure out what is going on.

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Can your Nurse Practitioner prescribe hormone replacement therapy and psychiatric medications?

Yes. Our NP is licensed to prescribe both HT and psychiatric medications. If your evaluation indicates that hormone therapy, a psychiatric medication, or both are appropriate, she can prescribe and manage them directly as part of your care.

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How often will I need to come in?

Visit frequency depends on your symptoms, treatment plan, and how you respond to any medication adjustments. Your provider will work with you to determine a schedule that fits your care.