Symptoms we evaluate
Perimenopause often starts in your 40s, sometimes earlier, and menopause is confirmed after 12 months in a row without a period. Hormone shifts around this time can cause:
- Hot flashes and night sweats
- Irregular periods during perimenopause
- Trouble sleeping
- Mood changes, anxiety or irritability
- Brain fog or trouble concentrating
- Vaginal dryness, discomfort or low libido
- Weight changes and fatigue
- Hair thinning and skin changes
Not every symptom is hormonal. Thyroid problems, anemia, sleep apnea, depression and medications can look similar, so Dr. Pabona evaluates the whole picture.
Physician-led care for women
Women’s care at Embrace Eternal Beauty is led by Dr. Pabona, board certified in internal medicine (ABIM), with advanced training in bioidentical hormone therapy and a published research background in molecular and reproductive endocrinology. Treatment decisions are based on your symptoms, labs and safety, and tailored to your life stage.
Care may include hormone therapy, metabolic evaluation, peptide therapy when appropriate, and individualized medical guidance. Specific treatments are recommended only after consultation and diagnostic review.
Treatment options
FDA-approved hormone therapy
Estrogen-based hormone therapy is FDA-approved to treat moderate to severe hot flashes and night sweats, and low-dose vaginal estrogen treats vaginal dryness and discomfort. If you have a uterus and take estrogen, you also need progesterone or a progestin to protect the uterine lining. FDA-approved bioidentical estradiol and progesterone are available.
Pellets and compounded hormones
Dr. Pabona also offers bioidentical pellet therapy using the EvexiPEL® Method. Compounded hormones, including pellets, are not FDA-approved, and a pellet’s dose can’t be adjusted once it’s placed.
Testosterone for women
Testosterone is sometimes considered for postmenopausal women with low sexual desire that causes distress. There’s no FDA-approved testosterone product for women in the US, so this use is off-label and needs careful monitoring.
Non-hormonal options
If hormones aren’t right for you, non-hormonal options exist, including FDA-approved non-hormonal medicines for hot flashes, along with sleep, nutrition and activity changes. Dr. Pabona can explain them.
Who shouldn’t use hormone therapy
Estrogen-based therapy usually isn’t recommended if you have, or have had:
- Breast cancer or another estrogen-sensitive cancer
- Blood clots in the legs or lungs
- A stroke or heart attack
- Liver disease
- Unexplained vaginal bleeding
Risks also depend on your age, how long it’s been since menopause, the type of hormone and how it’s taken. Starting therapy after 60, or more than 10 years after menopause, generally carries more risk, so a careful review matters even more for women in that group.
What to expect and follow-up
Consultation and labs
Your first visit covers your symptoms, cycle history, health history, medications and goals, plus baseline blood work such as a blood count, metabolic panel, thyroid panel, vitamin D and B12.
Your plan
About two weeks later, Dr. Pabona reviews your results and explains whether treatment is appropriate and which options fit. If you choose pellet therapy and it’s appropriate, insertion happens at this visit.
Follow-up
Repeat labs about four weeks after pellet insertion, then regular check-ins, help adjust your plan. Tell us right away about any new vaginal bleeding, breast changes or leg swelling.
Menopause, skin and the rest of your plan
Falling estrogen affects skin too, and many women notice dryness and a loss of firmness after menopause. Because Embrace Eternal Beauty is both an aesthetics and wellness clinic, your plan can include biostimulators that stimulate collagen, along with medical weight loss or B12 shots when they fit. For every hormone option in one place, see hormone replacement therapy.
The clinic is on Central Avenue in Hot Springs, about 35 minutes from Hot Springs Village, and open until 8 PM, Tuesday–Saturday.
Whole body
Works throughout the body rather than in one skin layer.
Questions
Common questions about women’s wellness
Do you treat perimenopause and menopause symptoms?
Yes. Dr. Pabona provides physician-led care for women with perimenopause and menopause symptoms, including hot flashes, night sweats, sleep changes, mood shifts and vaginal dryness. Care starts with a consultation and baseline labs, and hormone therapy is prescribed only when it’s appropriate for your health history. Non-hormonal options can be discussed too.
What are the first signs of perimenopause?
Often the first sign is a change in your periods: cycles that come closer together or further apart, or that are heavier or lighter than usual. Hot flashes, night sweats, trouble sleeping, mood changes and brain fog can start around the same time. Perimenopause usually begins in your 40s, though it can start earlier, and it can last several years.
Is hormone therapy safe after 60?
It depends on your health and when you started. Beginning hormone therapy after age 60, or more than 10 years after menopause, generally carries higher risks of heart disease, stroke and blood clots. Some women who started earlier continue past 60 after a careful review of benefits and risks. Dr. Pabona weighs your history, labs and symptoms with you.
Do I need labs before starting hormone therapy?
Menopause is usually diagnosed from your age and symptoms, so hormone levels aren’t always needed to confirm it. At Embrace Eternal Beauty, baseline labs still come first, including a blood count, metabolic panel, thyroid panel, vitamin D and B12. They help Dr. Pabona rule out other causes of your symptoms and choose a safe plan.
Can hormone therapy help with weight gain during menopause?
Hormone therapy isn’t a weight loss treatment. Some women find that easing hot flashes and sleep problems makes healthy habits easier, but weight changes around menopause usually need their own plan. Our physician-led medical weight loss program looks at metabolism, nutrition and lifestyle, and can work alongside hormone care when appropriate.
Do you offer peptide therapy for women?
Peptide therapy is available when it’s appropriate after a physician evaluation. Some peptide medicines are FDA-approved for specific uses, while many peptides promoted for wellness have limited research and aren’t FDA-approved. Dr. Pabona will explain what’s known, what isn’t, and whether a peptide makes sense alongside your hormone or metabolic care.
