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You're 46-55

You’re hot. You’re cold. You’re happy. You’re sad. You’re wondering, “What does normal even mean anymore?” The truth is this natural and gradual transition may not always feel natural and gradual to you. Let WHA’s specialists help you anticipate and manage your symptoms as you move through the transition to menopause.

You good?

One of the most important things we’ll cover at your wellness visit is what you’re doing for YOU. That starts with the well-being assessment you’ll complete in MyHealth before your visit. Of course, you don’t have to answer questions you’re uncomfortable with—but the more candid you can be with us, the more we can do to help. Eating healthy and being active play a big role in health and wellness, even more so as we age—but ultimately, you’ll define what wellness means to you. We are here to help you achieve whatever that is. If you’re having problems reaching your health goals, ask your provider if a visit with one of our behavioral health specialists might be right for you.

Hormones or…?

Entering the late 40s, many people begin wondering if changes they’re experiencing are related to perimenopause. The short answer is: maybe. Mood changes, sleep disturbances, weight gain, vaginal dryness and declining interest in sex are all common concerns during this time and can be linked to hormonal changes. People in this age range can also have many outside stressors—raising teenagers, caring for aging parents, job and relationship stress—that can cause or contribute to at least some of these symptoms. Your provider will want to explore these issues and work with you on the best plan for managing your symptoms—now and into the future. If there isn’t enough time at your wellness exam, your provider may recommend a follow-up office visit to do a more detailed evaluation.

When it's menopause

Menopause is defined as 12 months without a spontaneous period. In the United States, the average age of menopause is 51. To determine where you’re at in the transition, your provider will want to talk to you about whether or not you’re having regular menstrual cycles and other symptoms, such as discomfort with sex, hot flashes or trouble sleeping. If you’re post-menopausal, your provider will want to find out how you’re doing; are your symptoms manageable? Are you sleeping? Do you feel depressed?

Your symptoms, your plan

About 20% of people will go through menopause essentially symptom-free. Another 60% will have mild symptoms and 20% will have more severe symptoms that seriously impact their quality of life. The good news is: if you have symptoms, we can help. Many people have heard for years that hormone replacement therapy (HRT) poses too many health risks. But there are more recent, respected studies that show the benefits of HRT in people under 60 can outweigh the risks.

HRT is not a one-size fits all remedy; if we recommend something that you find doesn’t work, we will work together to find the right solution for you. And, we’re not going to pressure you into HRT—there are non-hormonal options we can discuss to improve your sleep and quality of life.

Expanding your care team

While we would love to see you for everything, now is an important time to establish a relationship with a primary care provider if you haven’t already. We can recommend the most important health screenings and even take care of many of them for you in our office—but if an issue arises with blood sugar, cholesterol or something else outside our realm of expertise, we may need to refer you to a primary care provider or other specialist to help.

What matters right now

Here are some topics your provider may bring up.

Pregnancy prevention

Although fertility declines as we age, you can still get pregnant until menopause. Talk to your provider about your current health and risk of breast cancer to decide what type of contraception might be right for you.

Breast cancer screening

If you’ve chosen to wait to begin having mammograms to screen for breast cancer or have been–or have been on the every-other-year plan—your provider will recommend annual screening by age 50.

Cervical cancer screening

Pap smears with combined HPV testing continue until age 65. If your results are normal, your provider will likely recommend screening every three to five years, depending on what type of testing you’ve had in the past and your past results.

Sexually transmitted infections

Talk to your provider if you’ve had a new partner since your last screening. You should also be tested for HIV at least once. There is no agreement among medical professionals about how often re-testing should occur; your provider may assess your risk and recommend re-testing.

Early osteoporosis screening

Screening for osteoporosis is recommended for people of average risk beginning at age 65, but talk to your provider about starting earlier if you have had broken bones as an adult; you have a biological parent who has had a hip fracture; or if you smoke, drink excessively or are underweight. Also discuss screening frequency, which can vary from person to person.

Colon cancer screening

The U.S. Preventative Services Task Force recommends screening for colorectal cancer beginning at age 50, but talk to your WHA or primary care provider about starting screening earlier if you:

Have had a close relative with colorectal polyps or colorectal cancer

You have an inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis.

You have certain genetic conditions.

General health screenings

We may be able to help with some of these when we see you. Otherwise, see your primary care provider for screening related to:

High blood pressure. Get your blood pressure checked every year. Optimal blood pressure in healthy people assigned female at birth is less than 120/80.

Diabetes. Screening for diabetes is recommended if you are overweight or obese, have high blood pressure, high cholesterol or have had diabetes during pregnancy.

Thyroid disease. Periodic screening is recommended beginning at age 45.

Cholesterol/lipids. Screening tests for high cholesterol are recommended periodically for all women, but may be done more frequently if you are overweight, obese or have other risk factors.

Don't forget your vaccines

We can help with seasonal flu and Tdap if you’re in to see us.

Seasonal flu vaccine is especially important for people with chronic health conditions, pregnant people, and older adults.

Tdap vaccine (if you’ve never had one) or a Td (tetanus, diphtheria) booster shot every 10 years.

Shingles vaccine. Healthy adults aged 50 years and older should get a zoster vaccine to prevent shingles and complications from the disease.

COVID vaccine. Stay up to date with current guidelines here >

Let’s talk about it

Recent articles from the WHA blog.

Additional Resources

Accepted Insurance

WHA takes Medicaid, Medicare and most commercial insurance plans. Check the list of insurance companies WHA is contracted with here.

ACOG Disorders of the Vulva

From the American College of Obstetricians and Gynecologists, answers to frequently asked questions about vulvar health and care options.

ACOG Patient Resources

From the American College of Obstetricians and Gynecologists, find links to frequently asked questions on a wide range of women's health, pregnancy and childbirth and gynecology questions.

Advocates for Youth

Online resources for parents.

Anemia in Pregnancy

Michael P. Smrtka, MD. Perinatal Progress, Volume 9, Number 1. April, 2016.

Antenatal Surveillance Guidelines

July 2021

Approach for Determining Gestational Age

August 2013

Baby Center

A comprehensive online resource for pregnancy and parenting, offering expert articles, week-by-week guides, community forums and tools.

Bedsider

A website about birth control and STDs.

Billing and Collection Practices

What you need to know--before you need to know it.

Billing and Payments During Pregnancy

Expecting parents often have questions about how much care may cost, how much they may be responsible for and when payments will be due. Here's a handy summary of how it all works!

Breastfeeding Articles

It's International Breastfeeding Week and we've collected all of our past blog articles here.

CDC.gov

The website of the Centers for Disease Control and Prevention – this is a great resource for vaccination and disease screening and prevention recommendations.

CDC.gov – Pregnancy

Particularly useful for steps you can take to reduce your risk of problems.

Cell-free Fetal DNA in Maternal Blood

Thomas Lee, MD and Wendy Busch, MS, CGC. Perinatal Progress, Volume 5, Number 1. September 2012.

Checking Your Insurance Benefits for Genetic Testing

Information to help you check your insurance coverage and benefits for genetic screening.

Comfort Measures and Over-the-Counter Medications During Pregnancy

From allergies and backaches to constipation, gas and heartburn (fun!), here are safe strategies for coping with or treating what ails you during pregnancy--straight from our providers!

Contemporary Management of Sonographic Aneuploidy Markers

2018-09-20; Thomas Lee, MD, MBA, 16:17

COVID-19, Pregnancy, and Breastfeeding (ACOG)

The latest information from the American College of Obstetricians and Gynecologists on COVID-19.

Delivery of Twins

2018-09-20; Lisa Farkhouh, MD, 14:12

Diabetes Mellitus

Barbra M. Fisher, MD, PhD
Perinatal Progress Volume 11, Number 1
April 2018

Diabetes Mellitus Quick Reference Guide

April 2018

Endometriosis Foundation of America

A nonprofit focused on endometriosis awareness, education, advocacy and research that also offers opportunities to get involved with events and community support related to this chronic reproductive health condition.

Enfermedad por coronavirus (COVID-19), embarazo y lactancia (ACOG)

La información más reciente del Colegio Americano de Obstetras y Ginecólogos sobre COVID-19.

Especially for Teens

A resource from the American College of Obstetricians and Gynecologists.

Fundamentals of Obstetric Ultrasound

Thomas Lee, MD, MBA
Perinatal Progress Volume 11, Number 2
August 2018

Genetic Carrier Screening

2018-03-21; Karen Hansen, MS, CGC; 15:11

Genetic Testing

2018-01-24; Karen Hansen, MS, CGC, 16:24

Genetic Testing Specifications

August 2014

Gestational Diabetes – Insulin Made Simple

2018-01-24; Michael Smrtka, MD, 14:49

Getting Disability, FMLA and Other Forms Completed

Oh those pesky forms...from how long they take to how much it costs, here's everything you need to know.

GoodRx

A website to compare the cost of prescription medications.

Healthy Weight Gain in Pregnancy

Wondering how much weight you should be gaining during pregnancy? We've got you covered.

Hemoglobinopathies

2018-03-15; Barbra Fisher, MD, PhD and Jeri Milanovich, MS, CGC, 8:15

Hypertensive Disorders in Pregnancy: An Update

Mark W. Tomlinson, MD, MBA and Lisa J. Farkouh, MD
Perinatal Progress Volume 8, Number 1
April 2015

Hystersisters

On online resource and forum for women having bleeding issues, fibroids, pelvic pain, etc.

Incidence of Significant Chromosomal Abnormalities

Hook EB, Cross PK, Schreinemochers DM

Information on Genetic Screening in Pregnancy

An overview of different genetic and chromosomal conditions for which screening is available, who they are most likely to affect and how often they occur.

Insurance and Billing Information

Does it sometimes feel like you need a degree in insurance to even understand your statement? Think of this as a crash course to help you understand how we bill for services and what questions to ask your insurance provider.

International Urogynecological Association | YourPelvicFloor.org

YourPelvicFloor.org is the patient-centered website of International Urogynecological Association where you can find patient information leaflets, videos, FAQs and more.

La Leche League

Information and support related to breastfeeding—including local support groups.

Language Access & Non-Discrimination Policies

Learn more about WHA’s free translation services and our commitment to non-discrimination.

Late Preterm Steroids: An Update

2018-03-15; Meredith Williams, MD, 13:22

Magnesium Sulfate Uses and Abuses

2018-03-15; Sophia Lannon, MD, MPH, 12:08

Management of Intrauterine Growth Restriction/Fetal Growth Restriction

July 2021

Management of Migraine Headaches in Pregnancy

2018-09-20; Ashlie Tronnes, MD, 16:34

Managing Women at Risk for Preterm Birth

Barbra M. Fisher, MD, PhD and Meredith Williams, MD
Perinatal Progress Volume 6, Number 1
August 2013

Marijuana Use in Pregnancy

2019-05-29; Thomas Lee, MD, MBA; 17:28

Medical Record Amendment Request

If you think the information in your medical or billing record is incorrect, you can request a change, or amendment, to your record using this form.

Medical Records Release Form

If you would like to transfer your records to provider outside of WHA, download and complete this form. If you have a MyHealth account, you can also request your records there.

Menopause Preparedness Toolkit

A downloadable educational guide from the Society for Women’s Health Research designed to support individuals through the menopause transition with information on symptoms, midlife health, care planning, wellness and preparing for conversations with health care providers and loved ones.

MiddlesexMD Blog

A good resource for articles on sex after 40. Also includes various products, but this is not a specific endorsement of those.

National Association for Continence

Fecal and urinary incontinence information for patients, caregivers and healthcare professionals.

National Friendship Day Giveaway

Enter to win a manicure for two on our Facebook page in honor of #NationalFriendshipDay.

National Vulvodynia Association

An educational resource from Oregon Health & Science University about vulvar conditions, with guidance for patients experiencing vulvar discomfort or concerns.

New Patient Checklist

Remember when mom made sure you had everything you needed? Think of this as mom’s checklist—only shorter.

No Surprise Billing

Learn more about your rights and protections against surprise medical bills.

Notice of Privacy Practices

Read WHA's Notice of Privacy Practices

NWP Antenatal Late Preterm Steroids Protocol

April 2017

NWP Referral Form

Updated 2017

NWP Ultrasound and Financial Disclosure

Updated 2017

NWP Ultrasound Patient Instructions

Updated 2017

Obesity in Pregnancy

2019-09-19; Ashlie Tronnes, MD; 16:55

Office of Women's Health – Pregnancy

Good basic content on pregnancy and women's health.

Oligohydramnios Measurement and Management

Michael P. Smrtka, MD
Perinatal Progress Volume 7, Number 1
June 2014

Opioid Use Disorder in Pregnancy

Meredith K. Williams, MD
Perinatal Progress Volume 12, Number 2
October 2019

Our Bodies, Ourselves

A book (and now an organization) that's been around for decades, revised often.

Our Moment of Truth

Learn more about midwifery care and women's health during pregnancy and beyond on this site from the American College of Nurse-Midwives.

Patient Rights and Responsibilities

Every good relationship has clear expectations—and we want this to be a very good relationship! Learn more about what you can expect from us and vice versa.

Patient Survey Program

If you have a visit in one of our offices, you could be asked to provide feedback through an online survey. Learn more about what we do with the information here.

PCOS Awareness Association

A nonprofit dedicated to increasing understanding of Polycystic Ovarian Syndrome (PCOS) and supporting those affected with educational materials, information on symptoms and treatment options, and links to community support and specialist directories.

Placenta Accreta Spectrum Diagnosis, Myths and Management

2019-03-21; Mark Tomlinson, MD, MBA; 15:29

Placenta Previa Diagnosis and Management

2019-05-29; Barbra Fisher, MD, PhD; 16:41

Planned Parenthood

Great information about all aspects of reproductive health.

Pre-pregnancy Care (ACOG)

From the American College of Obstetricians and Gynecologists, this FAQ includes ideas for optimizing your health before pregnancy, including preventive care, lifestyle guidance and preparation for conception.

Preconception Considerations for Patients Considering IVF

2019-09-19; Meredith Williams, MD; 22:20

Prenatal Education for New Pregnancies

By WHA providers, for WHA patients: here's the educational information we recommend to all our pregnant patients.

Prenatal Education Video

WHA's prenatal educational information, explained in 25 minutes!

Prenatal Patient Information

Here's all the information we covered with you at the beginning of your pregnancy and other helpful resources, including information from the CDC and American College of Obstetricians and Gynecologists on pregnancy and COVID-19.

Preparing for Your Office Visit

Masks are no longer required—but still greatly appreciated.

Preparing for Your Video Visit

Your clinician wants to be able to see and speak with you during your upcoming appointment, so please take a moment to make sure you're prepared.

Privacy & Security

Learn more about how we’re protecting you—and your health information.

Protocol for Managing Asymptomatic Patients at Risk for Preterm Birth

February 2024

Protocol for Managing Oligohydramnios and Borderline AFI

August 2014

Queer / LGBTQIA+ Menopause

A community-centered resource and support space focused on menopause experiences in LGBTQ+ communities, providing education, stories and connections related to aging and midlife health.

Recommendations for Genetic Screening in Pregnancy

Ashlie A. Tronnes, MD and Karen E. Hansen, MS, CGC
Perinatal Progress Volume 12, Number 1
May 2019

Recurrent Pregnancy Loss

Sophia M.R. Lannon, MD, MPH
Perinatal Progress Volume 10, Number 1
May 2017

Recurrent Pregnancy Loss Protocol for Targeted and Sequential Evaluation

March 2017

Routine Cervical Length Surveillance

2017-09-21; Thomas Lee, MD, MBA, 15:27

Scarleteen

A blog about lots of topics for teens.

Screening for Fetal Chromosomal Abnormalities

Wendy Busch, MS, CGC and Jeri Milanovich, MS, CGC
Perinatal Progress Volume 3, Number 3
October 2010

Sex, Etc.

A website for teens, by teens.

SMFM – Evaluation and Management of Polyhydramnios

Consult Series #46 - October, 2018

SMFM: Five Things Physicians and Patients Should Question

Choosing Wisely, An Initiative of the ABIM Foundation

SMFM: The Role of Ultrasound in Women Who Undergo Cell-free DNA Screening

Consult Series #42 - March, 2017

The Menopause Society

Find trusted information on menopause and midlife women’s health, including symptoms, treatment options and evidence-based guidance for patients and clinicians from a professional medical society.

Thromboembolism and Inherited Thrombophilia

Mark W. Tomlinson, MD, MBA
Perinatal Progress Volume 3, Number 2
June 2010

Thyroid Disease in Pregnancy

2017-09-21; Lisa Farkouh, MD, 12:35

Thyroid Disease in Pregnancy: An Update

Lisa J. Farkouh, MD
Perinatal Progress Volume 9, Number 2
August 2016

Twin-to-Twin Transfusion Syndrome: An Update

Juan Martinez-Poyer, MD
Perinatal Progress Volume 4, Number 2
September, 2011

Twins, the First Trimester

2017-09-21; Ashlie Tronnes, MD, 15:24

Ultrasound – Think Value!

2018-01-24; Mark Tomlinson, MD, MBA, 15:10

Up to Date

A searchable database of current medical information for both patients and providers.

Urgent Visits and After-hours Help

Life happens and we’re here when it does. Learn more about what to do when you think you need to be seen urgently or need help after hours.

Vaccines in Pregnancy

Santosh Pandipati, MD, FACOG
Perinatal Progress Volume 3, Number 1
February, 2010

Venous Thromboembolism in Pregnancy

2019-03-21; Michael P. Smrtka; 15:08

Vitamin D in Pregnancy: Should We Be Testing?

2018-05-29; Sophia M.R. Lannon, MD, MPH; 17:20

Voices for PFD

A great resource from the American Urogynecologic Society for women experiencing pelvic floor disorders, including bladder and bowel control issues and pelvic organ prolapse.

Voiding Diary

If you’re seeing one of our urogynecologists to talk about urinary incontinence, we may ask you to keep track of things for a while before your visit. Download a copy of the voiding diary here.

WebMD Baby

Good information on all things pregnancy.

Wellbeing Assessment and Other Online Forms

Help us get to know you before your visit or get reacquainted if it’s been a while. If you need to complete a wellbeing assessment, a urogynecology intake form—or any other online forms, you’ll have a notification in your MyHealth account.

What to Expect During a Physical Exam

This resource from the Oregon Medical Board provides more information on what to expect from various types of physical exams at the doctor's office, including how to advocate for your rights and what to know about medical chaperones.

Women's Healthcare Associates – Bridgeview

Women's Healthcare Associates – Gateway

Women's Healthcare Associates – Hillsboro

Women's Healthcare Associates – Newberg

1003 Providence Drive, Suite 340, Newberg, OR, 97132, (503) 538-2698

Women's Healthcare Associates – Oregon City

1508 Division Street, Suite 205, Oregon City, OR, 97045
Phone: (503) 657-1071 | Fax: (503) 657-3321

Women's Healthcare Associates – Peterkort North

9701 SW Barnes Road, Suite 200, Portland, OR, 97225. (503) 734-3700

Women's Healthcare Associates – Tabor

5050 NE Hoyt Street, Suite 230, Portland, 97213
Phone: (503) 249-5454 | Hours: M-F 8:30AM-5:00PM

Your Electronic Health Record

WHA is part of the Legacy Epic computer system for scheduling, medical records and billing. Learn more about what that means for you.

Your Test Results

Learn more about when--and how--you'll hear about your test results and how we'll work with you to adjust your treatment plan, if necessary.

Search providers, services, locations…

Schedule an Appointment

If you’re pregnant and want to begin care at WHA–or need to schedule an appointment during your pregnancy, call us! Find a provider and location here.

Please have your insurance information handy before you begin scheduling.

This will allow our teams to check whether your plan may require a referral for the care you need or to prepare benefits information to share with you at your visit. If you do not enter insurance information when scheduling, you may be asked to pay a $200-$500 deposit before receiving service.

What type of appointment do you need?