Perimenopause & Menopause
Hot flashes, broken sleep, and fog are not something you have to wait out.
Menopause is not a disease. It is a change, and like any change it goes better when the body is well cared for. Diet and exercise have more effect on hot flashes, sleep, mood, and weight than most women are told. They also protect the two things that matter most in the decades after: your heart and your bones.
Book a Consultation →What is actually going on.
As estrogen falls, the body's thermostat becomes touchy, sleep gets lighter, fat shifts toward the middle, cholesterol rises, and bone begins to thin. None of that is imaginary, and none of it is a sign that something has gone wrong. It is the body adjusting to a new hormonal setting.
Hormone therapy is one option, and for some women it is the right one. I will talk it through with you, risks and benefits, and coordinate with your gynecologist. Whether or not you use it, how you eat, move, and sleep changes how this season feels and how the next thirty years go.
What the research shows
What you eat affects hot flashes, and exercise protects bone.
In the WAVS trial, postmenopausal women with two or more hot flashes a day were randomized either to a low-fat vegan diet with half a cup of cooked soybeans daily, or to no change. After twelve weeks, moderate-to-severe hot flashes had fallen by 84% in the diet group, from about five a day to fewer than one, and total hot flashes by 79% (Barnard, Menopause 2021). A larger second phase with 84 women found the same thing: an 88% drop in moderate-to-severe hot flashes, along with an average eight-pound weight loss (Barnard, Menopause 2023). That is in the same range as hormone therapy. The trial was small and could not be blinded, so I hold the exact numbers loosely. The direction is clear.
For bone and muscle, the evidence points to resistance training: lifting something heavy enough to be hard, two or three times a week. It is the best-established way to slow bone loss and keep the strength and balance that prevent falls later. Walking helps the heart and mood; it does less for bone. For sleep and mood, regular morning light, a consistent bedtime, and fewer late evenings in front of a screen do more than most people expect.
The same low-fat, whole-food, plant-based eating pattern that calms hot flashes also lowers cholesterol and blood pressure. Heart disease is what women after menopause die of most, far ahead of anything connected to hot flashes.
How it works
Three steps.
Book a consultation
We meet by video for an hour. I go through your symptoms, your history, your labs, and what you have already tried.
Get a plan
You leave with a written plan: what to eat, how to train, how to sleep, and an honest discussion of hormone therapy if you want one.
Follow up
We check in regularly, track symptoms and labs, and coordinate with your gynecologist or primary doctor.
From the medical literature
Cases doctors have written up.
Two findings from the WAVS trial.
In the first WAVS group, the more a woman cut fat and increased fiber and carbohydrate from whole plant foods, the more her severe hot flashes fell. The effect tracked the diet change itself, not weight loss alone.
Barnard et al., Menopause, 2021 · Read the summaryOne participant in the trial described her hot flashes starting to go away within ten days of beginning the diet. Twelve weeks was the study length. The difference was noticed well before that.
Participant reports, WAVS trial · Read the releaseWhat is possible
Most women notice a difference within a few weeks.
Hot flashes and sleep often change within two to four weeks of a real diet change. Weight and cholesterol move over two to three months. Bone takes a year or more to show on a scan, which is why we start now.
Many women get nearly all of their symptoms under control this way. Women who also use hormone therapy do better on it for having changed the rest.
Ways to work together
Ways to work together.
First Visit
A one-hour first visit by video.
$45.000 CLP · US$50
Plan of 5 Follow-Ups
Five 30-minute follow-up visits after your first visit, while you make the big changes.
$105.000 CLP · US$115
Follow-Up Visit
A 30-minute check-in to review progress and labs.
$25.000 CLP · US$30
Group Program
Small online groups working through the same changes together.
Video visits for patients located in Chile. Booking and payment through Encuadrado.
Video visits for patients located in Chile. Booking and payment through Encuadrado.