Menopause & Hormone Health
Menopause care that actually listens
Perimenopause and menopause symptoms, hormone optimization, thyroid and metabolic shifts — from a physician who is Menopause Society Certified (MSCP) and has the time to take your symptoms seriously.
- MSCP certified Menopause Society Certified
- Hormone therapy evidence-based, where appropriate
- In Full DPC $249/mo membership
- CA + NY 100% virtual care
You're not imagining it
Perimenopause and menopause rarely announce themselves cleanly. They arrive as fatigue, sleep disruption, weight changes, brain fog, mood shifts, flushing, and a body that no longer feels predictable — and they're too often dismissed as stress, age, or anxiety.
As a Menopause Society Certified physician, Dr. Misra treats these symptoms as the connected, hormonal picture they usually are — with evidence-based options including hormone therapy where appropriate.
Emotional and nervous system dysregulation in perimenopause
Two of the most common — and most dismissed — experiences of perimenopause have real medical names: emotional dysregulation and nervous system dysregulation. They are not "just stress," and they are not a lack of resilience.
Emotional dysregulation is difficulty returning to baseline after something sets you off — feeling flooded, reactive, tearful, or irritable, and unable to steady your mood the way you used to. Nervous system dysregulation is a shift in the autonomic nervous system that keeps the body in a heightened fight-or-flight state — racing heart, shallow breathing, disrupted sleep, feeling on-edge, or at the other extreme, shut down and unable to function.
The two are related but distinct, and both are strongly influenced by the hormonal changes of perimenopause. As estrogen and progesterone fluctuate, so do the neurotransmitters and stress-response systems they help regulate — which is why so many women feel like a different person during this transition. These experiences are common, medically recognized, and treatable. If this sounds like you, the "Why Do I Feel This Way?" consultation is built to look at the whole hormonal and nervous-system picture together.
What we treat
Perimenopause & menopause
Symptom evaluation and management across the whole transition.
Hormone optimization
Evidence-based hormone therapy and optimization where clinically appropriate.
Thyroid & metabolic
Thyroid disorders and the metabolic shifts that ride alongside hormonal change.
Sleep, mood & cognition
The fatigue, brain fog, and mood changes that hormones drive — addressed directly.
How it's offered
Menopause and hormone care is included in Full DPC membership ($350 consult + $249/month). If you'd rather start with a single deep-dive instead of membership, the "Why Do I Feel This Way?" 90-minute consultation is built for exactly this kind of complex, overlapping picture.
Menopause FAQ
Why do I feel emotionally overwhelmed all the time?
Persistent emotional overwhelm can reflect emotional dysregulation — trouble returning to baseline after something sets you off. In perimenopause it is frequently driven by fluctuating estrogen and progesterone, which affect the neurotransmitters and stress systems that regulate mood. It is common and treatable.
Why do I feel like my body is stuck in fight-or-flight?
Feeling wired, on-edge, or unable to fully calm down often reflects nervous system dysregulation — a shift in the autonomic nervous system that keeps the body in a heightened state. Hormonal changes in perimenopause can drive this, and it can be evaluated and addressed.
Why do I feel paralyzed, like I can't function, and why does everything suddenly feel harder?
When the nervous system is dysregulated, some people swing toward feeling shut down and unable to function rather than keyed up. Combined with the sleep, mood, and cognitive effects of shifting hormones, it can make everyday demands feel much harder. This is a recognized part of the perimenopause picture — not a personal failing.
Why can't I regulate my emotions anymore — could this be perimenopause?
For many women, yes. As hormones fluctuate, so do the brain chemicals and stress-response systems they help regulate, which can directly affect emotional regulation. A proper evaluation can confirm whether perimenopause is the driver and what will help.
Do you prescribe hormone therapy?
Yes, where it's clinically appropriate and after a proper evaluation. Hormone therapy is one of several evidence-based options Dr. Misra may recommend.
Is this part of membership?
Yes — menopause and hormone health is part of Full DPC membership. A standalone 90-minute consultation is also available.
Be seen as a whole picture
Request a free 15-minute meet & greet to find the right path for you.