Menopause & Perimenopause

Perimenopause often begins years before the last menstrual period, marked by fluctuating estradiol, declining progesterone, and a cascade of symptoms that affect sleep, mood, cognition, cardiovascular health, and bone density. Menopause, defined as 12 consecutive months without menstruation, typically occurs between ages 45 and 55. The hormonal changes are real, measurable, and treatable.

At Manus Solis, we build menopause protocols around your Vis Viva Score: tracking how you feel (Sensus), what your labs show (Pulsus), and how your body performs (Virtus). Bioidentical estradiol, progesterone, and where indicated testosterone are prescribed at physiological doses, titrated against your symptoms and bloodwork until we reach the right balance for your body.

Bioidentical hormone therapy is the foundation: transdermal estradiol, micronized progesterone, and topical or injectable testosterone when clinically appropriate. Dosing begins conservatively and is adjusted based on symptom response and lab results at 6–8 week intervals. We address sleep, metabolic health, and bone density as part of the same protocol. Menopause affects every system, so the treatment accounts for every system.

Women in perimenopause or menopause who want a thorough, evidence-based hormone protocol with ongoing medical oversight. Whether symptoms are recent or you have been managing them for years without adequate relief, we are prepared to help.