Perimenopause & Menopause
Perimenopause & Menopause Care in Northern Virginia
If you are experiencing hot flashes, sleep disruption, mood changes, weight gain, brain fog, or irregular cycles, you may be navigating perimenopause or menopause. These transitions affect every woman differently, and too often, symptoms are dismissed or inadequately addressed.
At Prima Medicine Concierge Care, Dr. Mandana Shafai provides comprehensive perimenopause and menopause care for women in Fairfax, Tysons Corner, Merrifield, South Riding, and surrounding communities in Northern Virginia.
What Is Perimenopause & Menopause Care?
Perimenopause can begin years before menopause and often brings subtle but disruptive changes. Many women are told their labs are “normal” despite persistent symptoms.
Comprehensive menopause care looks at underlying contributors such as:
- Hormonal fluctuations
- Estrogen and progesterone imbalance
- Thyroid function
- Insulin resistance
- Sleep disruption
- Chronic stress
- Inflammation
- Cardiovascular risk factors
Dr. Shafai combines internal medicine expertise with evidence-based hormone therapy and lifestyle strategies to support women through this transition safely and effectively.
Symptoms Commonly Treated
Patients frequently seek menopause care for:
- Hot flashes and night sweats
- Mood changes and anxiety
- Weight gain during midlife
- Sleep disturbances
- Brain fog
- Low libido
- Vaginal dryness
- Irregular or heavy cycles
- Fatigue
- Increased cholesterol or blood sugar changes
- Joint pain and stiffness
- Hair thinning
If you feel unlike yourself and suspect hormones may be involved, a personalized evaluation can provide clarity.
Why Concierge Medicine Is Essential for Menopause Care
Hormone optimization requires ongoing communication, monitoring, and thoughtful adjustment.
It requires:
- Extended visits to review symptom patterns
- Detailed hormone and metabolic lab interpretation
- Thoughtful discussion of hormone therapy options
- Ongoing monitoring and dose adjustments
- Preventive screening for bone and heart health
- Individualized nutrition and weight strategies
The concierge model at Prima Medicine is designed to give you the time and attention you need during this important life stage.
Frequently Asked Questions About Perimenopause & Menopause
What age does perimenopause typically begin?
Perimenopause often begins in the early to mid-40s, though some women notice changes earlier. The transition can last anywhere from a few years to over a decade before menopause is reached. Symptoms can fluctuate significantly during this time, which is why ongoing monitoring and care plan adjustments are important.
Is hormone therapy safe?
For many women, when properly evaluated and monitored, hormone therapy can be both safe and highly effective. Dr. Shafai conducts a thorough risk-benefit assessment before recommending hormone therapy and monitors you closely throughout treatment.
Why am I gaining weight despite no changes in diet?
Hormonal shifts during perimenopause and menopause can affect metabolism, insulin sensitivity, and body composition. Declining estrogen promotes fat storage around the midsection, while changes in cortisol and thyroid function can further slow metabolic rate.
I’m experiencing brain fog. Is that related to menopause?
Cognitive changes including difficulty with word recall, concentration, and short-term memory, are among the most commonly reported perimenopausal symptoms. Estrogen supports cognitive function, and its fluctuation during perimenopause can affect mental clarity. While brain fog during menopause is typically temporary and treatable, it should be evaluated to rule out other contributing factors such as thyroid dysfunction, sleep deprivation, or nutrient deficiencies.
Do I need hormone therapy to feel better?
Not always. Treatment may include nutrition, stress management, sleep optimization, supplements, or hormone therapy depending on your needs. Dr. Shafai evaluates your full clinical picture and discusses all available options so you can make an informed choice about your care.