Perimenopause & Menopause Hormone Therapy in Farmington, MI
For women who’ve been told their labs are normal and know that something isn’t. In-person evaluation with a physician who takes the time, and a counselor down the hall if it turns out to be more than hormones.
You’re sleeping badly, or waking at 3 a.m. for no reason. Your patience is thinner than it used to be. Words go missing mid-sentence. Your body is changing in ways the usual effort doesn’t touch. Maybe you were told it’s stress, or offered an antidepressant, or told you’re too young for menopause.
Perimenopause can begin in your late 30s or 40s, years before periods stop, and hormones can swing widely from week to week. A single blood test often misses it. At Azoth Health, a physician and a licensed counselor work in the same practice. Your hormonal and emotional symptoms get sorted out together, instead of being split between offices that never talk to each other. Dr. Jason Hawkins, DO, has been practicing medicine for over 10 years, and he takes the time to hear the whole pattern of what you’re experiencing.
What treatment can help with
- Hot flashes and night sweats
- Sleep disruption
- Mood changes, irritability, and anxiety
- Brain fog and concentration
- Low libido and vaginal dryness
- Joint aches and changes in body composition
Outcomes vary.
Treatment options
Research on menopause hormone therapy has changed a lot, and many women were steered away from it based on outdated interpretations. Dr. Hawkins walks you through current evidence and your own risk factors. Treatment options for you are based on a clinical evaluation with Dr. Hawkins. Below are examples:
- Estrogen: patch, topical, or oral
- Progesterone: protects the uterine lining and may support sleep
- Testosterone for women: may be considered for certain women experiencing distressing low sexual desire after an individualized assessment of potential causes, benefits, and risks.
- Non-hormonal options if hormones aren’t right for you
Where counseling fits
Shifting estrogen affects mood, sleep, focus, and stress tolerance, so perimenopause is often mistaken for depression or anxiety. Dr. Hawkins treats the hormonal side. When mood or anxiety is also part of the picture, counseling is in the same practice.
If you have ADHD: many women find their symptoms intensify in perimenopause, because estrogen and the brain’s attention systems are closely linked. Dr. Ghoul specializes in neurodivergent adults.
Dr. Zeina Ghoul, PhD, LPC, works with women on:
- Anxiety or low mood that doesn’t fully lift with treatment
- ADHD strategies that stopped working
- Sleep and stress, the focus of her published research
- Libido, intimacy, and relationship changes
For depression that hasn’t responded to other treatment, ketamine-assisted therapy is also available.
Things to Consider Before You Start
- It needs monitoring. Regular labs keep it safe.
- It’s usually long-term, not a short course.
- The goal is how you feel, not the highest number on a lab report.
Appointments
For women in their late 30s to 50s noticing changes in sleep, mood, focus, or their cycle; women who were dismissed or offered only an antidepressant; and women with ADHD, anxiety, or depression whose symptoms shifted with hormones.
- Consultation (30–45 min, in person). Symptoms, cycle history, sleep, mood, family history, and goals. Bring recent labs.
- Individualized labs. No one-size-fits-all panel. Dr. Hawkins often goes beyond traditional panels (thyroid, micronutrients, B12, blood sugar). Labs guide treatment; they don’t override what you’re experiencing.
- A clear plan. Options, timeline, risks, and alternatives in plain language.
- Ongoing monitoring. Labs about every three months, mostly in-person follow-ups, some by telehealth. Same physician every time.
We’re cash pay, so there’s time to listen, adjust, and follow up without insurance limits. Call or ask when you book for pricing.
Get a straight answer about your hormones
In-person evaluation with a physician who takes the time, and a therapist down the hall if it turns out to be more than hormones.