Perimenopause & Menopause Care,Centered Around You
Hot flashes, changing periods, disrupted sleep, anxiety, brain fog, weight changes, and vaginal symptoms can feel disconnected. Often, they are part of the same hormonal transition.
At Mulberry, Andrew Nyein, DO, offers comprehensive, physician-led evaluation and individualized treatment that looks at the full picture, with one-on-one visits, evidence-based options, and a care plan that evolves with you.
Could This Be Perimenopause?
These changes often appear one at a time, which is why they are so easily dismissed. Seen together, they tell a more recognizable story.
One Transition, Evaluated as a Whole
Perimenopause is the transition leading up to menopause, when estrogen and progesterone begin to fluctuate unpredictably—often beginning in the 40s and lasting several years. Menopause itself is defined as twelve consecutive months without a period; the years that follow bring their own hormonal and health considerations.
Because hormones fluctuate rather than simply decline, symptoms may be inconsistent and confusing—even when routine laboratory results appear normal. Symptoms that seem unrelated may be connected through the hormonal, metabolic, and life changes of midlife.
Diagnosis begins with listening. A careful history of your cycles, symptoms, and their timing is often more informative than any single blood test. Evaluation at Mulberry begins with a one-on-one conversation, with targeted laboratory testing and imaging used when they add meaningful clinical information.
Bleeding changes receive particular attention. As a gynecologic surgeon, Andrew Nyein, DO, can evaluate abnormal bleeding comprehensively, using transvaginal ultrasound, endometrial sampling, and in-office hysteroscopy when clinically indicated.
What Your Care May Address
Rather than treating each symptom on its own, Andrew Nyein, DO, looks at how they connect across four related areas.
Symptoms & Quality of Life
Hot flashes and night sweats, disrupted sleep, mood changes, anxiety, and brain fog are evaluated together because they often influence and amplify one another. Treatment options are available, and your plan is tailored to you.
Periods & Gynecologic Health
Cycles commonly become irregular during perimenopause, but very heavy, prolonged, or between-period bleeding—and any bleeding after menopause—warrants proper evaluation by a gynecologic surgeon.
Advanced Gynecology →Metabolic & Preventive Health
Midlife weight change deserves medical context, not blame. Evaluation looks beyond the scale to consider thyroid function, glucose and lipid health, body composition, nutrition, movement, sleep, and other contributing factors.
The menopause transition is also an important prevention window. Bone health, cardiovascular and metabolic risk, and appropriate screening are reviewed and coordinated by Andrew Nyein, DO.
Sexual & Genitourinary Health
Vaginal dryness, discomfort with intimacy, and urinary symptoms are very common after menopause and may persist or worsen without treatment. At Mulberry, they are addressed with the same clinical seriousness—and discretion—as every other aspect of your health.
Sexual Health & GSM →Treatment Designed Around You
There's no single protocol. After your evaluation, Andrew Nyein, DO, builds an individualized plan and revisits it as your transition evolves. Depending on your symptoms, goals, and history, that plan may draw on:
- Hormone therapy — discussed based on your history, risks, and benefits. Learn more on our Hormone Therapy page →
- Non-hormonal options — when hormones are not preferred or appropriate.
- Vaginal therapies — for dryness, discomfort, and urinary symptoms, discussed at your visit.
- Lifestyle & preventive care — sleep restoration, protein and strength to protect muscle, and bone and cardiovascular protection.
- Coordinated care — respectful referrals when additional support adds value.
Menopause Care Pricing
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Menopause Consultation$350
A comprehensive, one-on-one consultation with Andrew Nyein, DO, and an individualized plan.
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6-Month Menopause Program$1,200 total$200/mo
Six monthly follow-up visits, treatment plan review, lab and imaging review, and screening coordination.
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Individual Follow-Up Visit$225
For patients not enrolled in the 6-month program.
One Transition,
Seen as a Whole
Midlife symptoms are often managed by several different clinicians. At Mulberry, the connections are the point.
This is medicine designed around who you are now — and who you will continue to be.
Evidence-Based Hormonal Care
Grounded in current clinical evidence and informed by ongoing education in menopause care.
Diagnosis by Listening
Careful history-taking comes first. Labs and imaging are used where they add clarity, not as a substitute.
Surgical-Level Bleeding Evaluation
Abnormal bleeding evaluated thoroughly by a gynecologic surgeon — in the same practice.
Prevention Built In
Bone, cardiovascular, and metabolic protection woven into your ongoing care.
Physician-Led Care
Your visits are with Andrew Nyein, DO, from your first consultation through follow-up.
Andrew Nyein, DO, is a member of The Menopause Society and stays current with evolving evidence and education in menopause and midlife women’s health.
What To Expect
During Your
Consultation
Your consultation is one-on-one and comprehensive. As an osteopathic physician, Andrew Nyein, DO, considers the whole picture, not hormones alone. Your consultation may explore six interconnected dimensions of midlife health:
You Do Not Have to
Figure This Out Alone
You do not need to wait until symptoms become severe—or until you are certain they are caused by menopause. A thoughtful evaluation can help clarify what is changing, rule out other concerns, and identify the options most appropriate for you.