Menopause & Perimenopause Care in Delhi
Symptom control, bone and heart protection, and clear advice on hormone therapy.
What menopause & perimenopause care involves
Perimenopause often begins in the early forties with erratic cycles, disturbed sleep, hot flushes, mood changes and vaginal dryness. Many women are told this is simply to be endured. It does not have to be.
Management covers symptom relief, bone density, cardiovascular risk and genitourinary symptoms, with an honest appraisal of what menopausal hormone therapy does and does not do — the risks are far more nuanced than the headlines suggested.
Who this is for
- Hot flushes, night sweats and disturbed sleep
- Irregular cycles in the forties
- Vaginal dryness, discomfort with intercourse, urinary symptoms
- Premature ovarian insufficiency before 40
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Assessment
Symptom review, hormone profile where the picture is unclear, thyroid function and metabolic screening.
Bone and heart
Vitamin D, calcium and lipid assessment, with DEXA scanning where indicated.
Symptom management
Menopausal hormone therapy where appropriate, or non-hormonal options where it is not.
Review
Reassessed annually, with the risk-benefit balance revisited as you age.
Your results, in writing
Whatever the outcome of menopause & perimenopause care, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: Told to put up with it at 46
46, Greater Kailash · perimenopause · sleep and mood
What she came in with
Waking four or five times a night drenched, irritable to the point of straining her marriage, and struggling at work. Her previous doctor had told her this was natural and would pass.
What the workup showed
Cycles had become erratic over eighteen months. Thyroid function was normal, vitamin D was low at 14 ng/ml, and there was significant genitourinary dryness. There were no contraindications to hormone therapy — no clot history, no breast cancer history, normal blood pressure.
What we did
Transdermal oestradiol with micronised progesterone, chosen over oral for a lower clot risk, plus vaginal oestrogen for the local symptoms and vitamin D replacement. Risks and benefits were set out individually rather than generically.
Outcome
Night sweats resolved within six weeks and sleep normalised. Reviewed annually with the risk-benefit balance revisited each time.
The point of this case
For a healthy woman starting within ten years of menopause, the benefits of hormone therapy generally outweigh the risks. 'It is natural' is not a treatment plan.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Individual risk-benefit assessment rather than blanket advice
Local vaginal oestrogen offered for genitourinary symptoms, which is safe for almost everyone
Bone health addressed early rather than after a fracture
Premature ovarian insufficiency managed actively, since it needs treatment to 51
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about menopause & perimenopause care
Is hormone therapy safe?
For most healthy women starting within ten years of menopause and under 60, benefits generally outweigh risks. The assessment is individual and takes account of breast, clot and cardiovascular history.
How long will symptoms last?
On average four to seven years, though a minority have hot flushes for longer. There is no reason to endure them untreated.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.