Condition + Location

Menopause & Perimenopause Treatment in Washington

34 holistic practitioners in Washington who can help with Menopause & Perimenopause. Gabriel's evidence-based protocols, matched to local practitioners.

34 Practitioners

2 Treatments

1+ Supplements

Gabriel's Approach to Menopause & Perimenopause

Gabriel treats menopause as hormonal transition, not disease, but symptoms can be debilitating—natural support effective. Conventional offers: synthetic HRT (Premarin, Provera—increased cancer, heart disease risk, Women's Health Initiative), Bioidentical HRT (BHRT—identical to body's hormones, safer...

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Recommended Treatments

IV Nutrient TherapyPeptide Therapy

Key Supplements

Phytoestrogens (plant estrogens—weak estrogenic activity, helpful for mild symptoms): Black Cohosh 40-80mg 2x/day (most studied for hot flashes—reduces frequency/severity, takes 4-8 weeks), Red Clover 40-80mg (isoflavones—phytoestrogenic), Soy isoflavones 50-100mg/day (genistein, daidzein—but avoid if thyroid issues, some controversy), Dong Quai 500mg 3x/day (traditional for women's health—\"female ginseng\"), Progesterone support: Vitex (Chasteberry) 400mg (supports progesterone production—for perimenopause heavy bleeding, anxiety), Progesterone cream (bioidentical—20-40mg transdermal, days 14-28 of cycle if still cycling, or daily if menopausal, discuss with doctor), Hot flash relief: Sage 300mg 3x/day or tea (traditional—reduces sweating, hot flashes), Rhubarb extract (Siberian rhubarb—reduces hot flashes), Maca 1500-3000mg (Peruvian root—hormone balancing, energy, libido), Vitamin E 400-800 IU (reduces hot flashes in some), Evening Primrose Oil 1000mg 2-3x/day (GLA—hormone balance), Adaptogenic herbs (stress, cortisol affects hormones): Ashwagandha 500mg 2x/day (reduces cortisol, anxiety, improves sleep), Rhodiola 400mg morning (energy, mood, mental clarity), Panax Ginseng (libido, energy), Mood/Brain support: Omega-3 2-4g/day (brain health, mood, reduces inflammation, hot flashes), B-Complex (methylated—energy, mood, methylation), SAMe 400-800mg (mood—natural antidepressant), 5-HTP 50-200mg bedtime (serotonin precursor—mood, sleep, don't combine with SSRIs), St. John's Wort 300mg 3x/day (depression—but interactions with many drugs, check with doctor), Bone support (prevent osteoporosis—estrogen loss accelerates bone loss): Calcium 1000-1200mg/day (food sources best, or citrate/hydroxyapatite supplement), Vitamin D3 5000 IU (critical—without D3, calcium not absorbed, optimal 60-80 ng/mL), Vitamin K2 MK-7 200-300mcg (directs calcium to bones not arteries—CRITICAL, often overlooked), Magnesium 400-600mg (bone formation, most deficient), Boron 3-6mg (bone metabolism), Strontium citrate 680mg (increases bone density—controversial but effective), Sleep support (insomnia common in menopause): Magnesium 400-600mg before bed (relaxes), Melatonin 3-10mg (estrogen affects melatonin—often low in menopause), L-Theanine 200-400mg, Valerian Root 500mg, 5-HTP 50-200mg, Progesterone cream (calming, improves sleep), Vaginal health (dryness, atrophy from estrogen loss): Vaginal moisturizers (hyaluronic acid, vitamin E—Replens, Yes), Coconut oil (natural lubricant), Local estrogen (Estriol cream 0.5-1mg—bioidentical, very low systemic absorption, safe, effective—prescription), DHEA vaginal suppositories (Prasterone/Intrarosa—converts to estrogen locally, prescription), Sea buckthorn oil (oral 1-2g/day—improves vaginal moisture), Libido support: DHEA 10-25mg (testosterone precursor—libido, energy), Maca (libido, energy), Panax Ginseng, Testosterone cream (bioidentical—low dose, 1-5mg, prescription, discuss with doctor), Metabolic support (insulin resistance worsens in menopause): Berberine 500mg 3x/day (insulin sensitizer), Alpha-Lipoic Acid 600mg 2x/day, Chromium 200-600mcg, Cinnamon 1-3g/day, Omega-3 (insulin sensitivity), BHRT (Bioidentical Hormone Replacement Therapy—if symptoms severe, natural approaches inadequate): Estradiol (bioidentical estrogen—transdermal patch or cream preferred over oral, individualized dose 0.025-0.1mg/day), Progesterone (bioidentical—Prometrium 100-200mg oral bedtime, or transdermal cream, CRITICAL if using estrogen and have uterus—prevents endometrial hyperplasia), Testosterone (bioidentical—cream 1-5mg/day, improves libido, energy, muscle), Estriol (weaker estrogen—vaginal cream 0.5-1mg for local symptoms, or oral/transdermal for systemic—safer than estradiol, less stimulating to breast/uterus), DHEA 10-25mg (precursor—converts to estrogen/testosterone as needed), Compounded (individualized ratios—Biest Estradiol/Estriol 80:20 common, plus progesterone, adjust based on symptoms/labs)

Key Lab Markers

Hormones (if considering BHRT or monitoring): Estradiol, Progesterone, Testosterone (total and free), DHEA-S, FSH, LH (elevated in menopause—confirms menopause if >1 year no period), SHBG (sex hormone binding globulin—affects free hormones), Pregnenolone (hormone precursor), Thyroid panel (TSH, Free T3, Free T4—hypothyroidism common in menopause, symptoms overlap), Fasting insulin and glucose (insulin resistance worsens—metabolic syndrome risk), HbA1c, Lipid panel (cholesterol rises after menopause—estrogen loss affects lipids, but don't automatically statin, address with diet/lifestyle/hormones), Vitamin D (optimal 60-80), Bone density scan (DEXA—baseline at menopause, repeat every 1-2 years, assess fracture risk), Bone turnover markers (CTX, P1NP—faster feedback than DEXA), CBC, Comprehensive metabolic panel, hs-CRP (inflammation), Homocysteine (cardiovascular risk, B vitamin status), Cortisol/DHEA 4-point saliva (adrenal function—stress affects menopause transition), Comprehensive stool test (gut health—affects hormone metabolism)

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