Personalized Perimenopause & Menopause Care
Support for hot flashes, sleep changes, low libido, and midlife weight concerns.
Perimenopause and menopause can affect how you sleep, feel, and function—not just your menstrual cycle. At Full Spectrum Health & Wellness, we combine individualized bioidentical hormone therapy with thyroid and metabolic care to help address your symptoms and support your overall health. Your plan may include hormone treatment, medical weight management, and practical nutrition and lifestyle guidance, based on your needs.
You work directly with Dr. Karina Angiletta, PhD, FNP-C—a board-certified Family Nurse Practitioner with a UCSF PhD, more than 25 years in healthcare, and advanced WorldLink Medical BHRT training. From your initial evaluation through ongoing follow-up, your care evolves with your response and goals.
Telehealth throughout Idaho and Washington.
Could Your Symptoms Be Related to Perimenopause?
Perimenopause often begins years before the final menstrual period. Hormone levels can fluctuate significantly during this transition, and symptoms may appear even while periods are still regular.
Common concerns include:
Hot flashes or night sweats
Changes in menstrual cycles
Difficulty sleeping
Fatigue or reduced stamina
Brain fog or difficulty concentrating
Mood changes, irritability, or anxiety
Vaginal dryness or discomfort
Reduced libido
Changes in body composition
Loss of muscle or strength
Hair or skin changes
Headaches
Palpitations
Joint or muscle discomfort
Not every symptom in midlife is caused by menopause. Thyroid disease, iron deficiency, nutritional deficiencies, sleep disorders, metabolic dysfunction, medications, and other medical conditions can produce overlapping symptoms.
That is why careful evaluation matters.
Is hormone therapy safe?
For many appropriately selected patients, the benefits can outweigh the risks. Safety depends on the medication, dose, route, age, and personal history. A history of certain cancers, blood clots, unexplained bleeding, or other significant conditions may change the recommendation.
In February 2026, the FDA approved updated labeling for an initial group of six menopause hormone therapy products, removing cardiovascular disease, breast cancer, and probable dementia statements from their boxed warnings—the most prominent safety warnings on medication labels.
The updated guidance supports more individualized treatment decisions, with attention to your age, time since menopause, and the therapy selected. Cardiovascular and breast cancer risk information remains in systemic therapy labeling, and the endometrial cancer boxed warning remains for systemic estrogen-only products.
Is Hormone Therapy Right for Everyone?
No. The decision to use systemic hormone therapy should take into account your age, symptoms, time since menopause, personal and family history, cardiovascular risk, breast health and other medical factors.
Hormone therapy may not be appropriate for some women, including those with certain histories of:
Breast or endometrial cancer
Unexplained vaginal bleeding
Blood clots
Stroke or heart attack
Significant liver disease
Other circumstances may require additional evaluation or coordination with another clinician.
For healthy women with bothersome menopausal symptoms who begin treatment before age 60 or within approximately 10 years of menopause onset, major menopause organizations generally find that the benefit-risk profile is favorable when there are no contraindications.
Your treatment decision is always individualized.
What to Expect During the First Few Months
Hormone therapy is not simply a prescription that is handed over and forgotten.
Treatment often requires observation, communication and adjustment.
After therapy begins, we follow your response and consider:
Which symptoms are improving
Sleep and energy
Bleeding patterns
Breast tenderness or headaches
Mood changes
Libido and sexual function
Possible androgen-related effects when testosterone is used
Blood pressure and metabolic considerations
Laboratory monitoring when clinically indicated
Whether doses or formulations should be adjusted
Finding the appropriate regimen sometimes takes trial and adjustment
A More Complete Approach to Menopause Care
Your care begins with understanding you, not simply looking at a hormone number.
Evaluation may include:
Your current symptoms and priorities
Menstrual and reproductive history
Previous hormone therapy
Personal and family medical history
Cardiovascular and metabolic risk factors
Breast and gynecologic screening history
Thyroid function
Iron and nutritional status when appropriate
Current medications and supplements
Sleep, stress, nutrition and exercise
Relevant laboratory testing
Laboratory testing can be valuable when evaluating other medical or metabolic concerns, monitoring certain therapies, or clarifying a particular clinical question.
However, perimenopause itself is often diagnosed clinically rather than from a single hormone test, because hormone levels can fluctuate substantially during the transition.
How Bioidentical Hormone Therapy Can Help
Perimenopause and menopause can bring changes in sleep, comfort, sexual health, and daily well-being. Hormone therapy can help relieve bothersome symptoms, with treatment tailored to your health history, priorities, and stage of life. Bioidentical hormones have the same molecular structure as hormones your body naturally produces. Your personalized plan may include:
Estrogen: Symptom Relief & Bone Protection
Estradiol helps relieve hot flashes, night sweats, and vaginal dryness, and helps prevent menopause-related bone loss. Reducing nighttime symptoms may also improve sleep and daytime well-being.
Options include patches, gels, and oral medication. Low-dose vaginal estrogen can provide targeted relief for dryness, irritation, and painful intimacy, either alone or alongside systemic treatment.
Progesterone: Uterine Protection & Sleep Support
For women with a uterus who use systemic estrogen, progesterone helps protect the uterine lining from excessive growth. Oral micronized progesterone may also improve certain aspects of sleep in some women.
Your regimen is tailored to your menstrual patterns and treatment needs, including whether progesterone is taken daily or cyclically.
Testosterone: Sexual Desire & Satisfaction
Testosterone is a female hormone, too. For appropriately selected women with persistent, distressing low sexual desire, treatment may improve libido, arousal, pleasure, and sexual satisfaction.
The strongest evidence supports treatment in postmenopausal women. Prescribing is off-label in the United States and includes individualized dosing and monitoring. See the testosterone section below for more information.
Thyroid Care: Looking Beyond Menopause
Fatigue, cold intolerance, constipation, and changes in weight or hair can overlap with menopause concerns. Evaluating thyroid function when appropriate helps clarify whether a thyroid condition is contributing to your symptoms. When treatment is indicated, thyroid management is coordinated with your broader hormone and metabolic care.
DHEA: An Individualized Consideration
DHEA is produced primarily by the adrenal glands and contributes to the production of estrogen and testosterone. It may be discussed as part of your broader hormone evaluation. Supplementation is considered selectively, with attention to potential benefits and side effects.
Flexible Treatment, Ongoing Support
Treatment options may include patches, gels, oral medications, vaginal therapies, and selected compounded formulations when clinically appropriate. Bioidentical treatment includes FDA-approved options and does not necessarily require compounding.
Dr. Angiletta works directly with you to select an appropriate regimen, assess your response, and make adjustments over time. Your plan also considers sleep, nutrition, exercise, and metabolic health—because effective menopause care extends beyond a prescription.
Testosterone Therapy for Women
Testosterone is a female hormone, too. It contributes to sexual desire and plays a role in muscle and bone physiology. At Full Spectrum Health & Wellness, testosterone therapy may be considered as part of personalized hormone care following a thorough evaluation.
Renewing Sexual Desire & Satisfaction
Changes in libido can affect intimacy and quality of life. For appropriately selected women, testosterone therapy may improve sexual interest, arousal, pleasure, and orgasmic function while reducing distress associated with low desire.
The strongest evidence supports treatment for postmenopausal women with persistent, distressing low sexual desire.
Energy, Mood & Overall Vitality
Feeling tired, less motivated, or unlike yourself deserves attention. Dr. Angiletta evaluates hormone changes alongside thyroid health, sleep, medications, and other contributors to your symptoms.
Although some women report improvements in energy or well-being during treatment, testosterone’s benefits for fatigue, mood, and cognition have not been established.
Bone Health, Strength & Body Composition
Hormones play important roles in maintaining bone and muscle health throughout life. Your care considers these concerns alongside nutrition, resistance exercise, and appropriate menopause treatment.
Testosterone’s potential effects on bone and muscle remain under investigation. At physiologic female doses, studies have not established improvements in bone density, muscle strength, or body composition.
Personalized Treatment & Ongoing Care
When testosterone is appropriate, Dr. Angiletta provides individualized dosing, laboratory monitoring, and follow-up based on your response. Treatment aims to maintain levels within the normal physiologic range for women.
Testosterone therapy for women is off-label in the United States. Benefits, risks, and limitations are discussed before starting treatment.
