Evidence-based women's midlife care from a Menopause Society-certified physician
Menopause and Perimenopause Care in San Diego
Perimenopause and menopause are not something to simply endure.
If you're living with sleep disruption, mood shifts, hot flashes, brain
fog, weight changes, low libido, or a body that just doesn't feel like
yours anymore, these symptoms deserve a real evaluation and a real plan.
At Marea MD, women across Central and East San Diego work with
Dr. Joyce Ildesa, a board-certified family medicine physician and
Menopause Society-certified provider, to understand what's happening
and what to do about it.
Your Symptoms Deserve Real Answers
Most women are told their menopause symptoms are normal, to be expected, or something to wait out. That's rarely the right answer. At Marea MD, appointments are long enough to evaluate symptoms in context, review labs in detail, and build a care plan that's tailored to your stage of life, your history, and your goals.
Because Marea MD operates on a membership model, visits aren't rushed and follow-up is built in. Your care isn't a single appointment. It's an ongoing relationship with one physician who knows your story.
Symptoms We Evaluate and Treat
Hot flashes and night sweats
Sleep disruption and insomnia
Mood shifts, anxiety, irritability, and depression
Brain fog and difficulty concentrating
Weight gain, especially around the midsection
Loss of muscle tone and changes in body composition
Fatigue and low energy
Low libido and changes in intimacy
Vaginal dryness and discomfort
Irregular, heavy, or prolonged periods
Hair thinning and skin changes
Joint pain and muscle aches
Treatment Approaches
Menopause care is not one-size-fits-all. Dr. Joyce's approach is evidence-based and tailored to each patient. Treatment may include:
Menopausal hormone therapy (MHT), when appropriate, using FDA-approved therapies
Non-hormonal options for symptom management
Lifestyle, nutrition, sleep, and stress interventions
Bone health evaluation and osteoporosis prevention
Cardiovascular risk assessment and management
Metabolic health monitoring
Mood-related condition support
Treatment Approaches
Menopause care is not one-size-fits-all. Dr. Joyce's approach is evidence-based and tailored to each patient. Treatment may include:
-
Menopausal hormone therapy (MHT), when appropriate, using FDA-approved therapies
-
Non-hormonal options for symptom management
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Lifestyle, nutrition, sleep, and stress interventions
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Bone health evaluation and osteoporosis prevention
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Cardiovascular risk assessment and management
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Metabolic health monitoring
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Mood-related condition support
Frequently Asked Questions About Menopause Care
You can see a menopause specialist as soon as symptoms begin affecting your sleep, mood, relationships, work, or quality of life. You do not need to wait until your periods have stopped. Perimenopause, the transitional phase before menopause, often begins in the mid-40s and can last several years. At Marea MD in San Diego, Dr. Joyce Ildesa evaluates symptoms at any stage, from early perimenopause through postmenopause.
Perimenopause is the transitional phase leading up to menopause, typically beginning in the mid-40s, when hormone levels begin to fluctuate. Symptoms often include irregular periods, sleep disruption, mood changes, and hot flashes. Menopause is officially diagnosed once you have gone 12 consecutive months without a menstrual period, usually between ages 45 and 55.
Menopause Society certification (MSCP) is a credential awarded by The Menopause Society, the leading North American organization focused on menopausal health. Certified providers have completed specialized training and passed an examination demonstrating expertise in evaluating and treating perimenopause, menopause, and related conditions. Fewer than 10% of primary care physicians hold this certification. Dr. Joyce Ildesa is Menopause Society-certified.
For most healthy women under 60 or within 10 years of menopause, the benefits of hormone therapy often outweigh the risks, according to current guidelines from The Menopause Society and the American College of Obstetricians and Gynecologists. Safety depends on individual factors, including personal and family medical history. Dr. Joyce Ildesa evaluates each patient individually and discusses the evidence-based options, both hormonal and non-hormonal, that fit their situation.
No. Treatment can begin during perimenopause, even if you are still having periods. Many perimenopausal symptoms, including hot flashes, sleep disruption, and mood changes, respond well to treatment. A full evaluation at Marea MD includes a review of your symptoms, medical history, and relevant labs to determine what options are appropriate.
Dr. Joyce Ildesa prescribes FDA-approved hormone therapies, including FDA-approved bioidentical hormones such as estradiol and micronized progesterone. Compounded bioidentical hormone formulations, which are not FDA-regulated, are generally not recommended by The Menopause Society and are not routinely used at Marea MD.
Family medicine physicians with menopause certification can offer something OB/GYNs often cannot: time to integrate your menopause care with the rest of your health, including metabolic, cardiovascular, mood, and bone health. At Marea MD, appointments are longer, follow-up is built in, and your menopause care is one part of an ongoing primary care relationship.
