Dr. Wheeler and staff offer the most up-to-date advances in the management of menopause in a comfortable and reassuring office setting.  The number of women entering menopause every year is at an all time high following the baby boomers into this natural transition of life. 

Our philosophy is that menopause is a natural state and management starts with the basics in natural health.  Multiple modalities will be addressed starting with lifestyle evaluation, risk factors and finally, the potential need for hormone therapy.  A comprehensive evaluation of nutrition, weight, body mass index and basic labs will be performed to evaluate the health and well being of the patient.  The next step will be to address exercise, nutrition, sleep, vitamins and any supplements so that we can best optimize women health through their transition years.  The office has a state of the art GE bone density machine in the office to assess bone mineral densities in women.

Bioidentical Hormones

Many women will be able to transition menopause with simple modifications in their lifestyle, diet and nutrition, but for some hormone therapy may be indicated. Many of these products can be purchased through commercial pharmaceutical products and may help reduce the costs for menopausal women.  In the event that compounded pharmaceuticals are covered or requested by the patient, Dr. Wheeler has affiliations with local compounding pharmacists to combine estrogens, progesterones and androgens into a simple single dose formulation.  We understand that modifications may be necessary and will make ourselves readily available to discuss these either by phone or in person once the patient has initiated hormone therapy.  Given the complex nature of hormone therapies, we ask that patients come in for an initial consultation and evaluation so that we may find the best products to suit your needs.

Dr. Wheeler has been prescribing Bioidentical hormones for the twenty years he has been in practice. Estradiol is the natural form of Estrogen made in the ovaries during a womans ovulatory cycle. It is produced from Mexican wild yam or soy and has been commercially available in numerous forms including transdermal gels, cream, patches, and rings. It also is available in oral and injectible forms.

Natural Progesterone is available in a Micronized form which can be delivered orally in commercial forms and transdermally with compounded forms. It too is produced from plant extracts. A little known study called the PEPI study in 1992 showed no increase in Breast Cancer if Micronized progesterone was used instead of Provera (a synthetic progestin) for Hormone Replacement Therapy (HRT) . Ten years later, the WHI study confirmed a  slight increase in Breast Cancer in women on premarin and provera (a synthethic progestin). For these reasons, Dr. Wheeler has employed natural Progesterone in all of his hormone replacement protocols since 1992.

Hormone Replacement Therapies are FDA approved for the treatment of vasomotor symptoms (Hot flashes), vaginal dryness (atrophy) and prevention of osteoporosis. Many women feel that there are additional benefits derived from them including, improved sense of well-being, increased libido, improved hair and skin appearance as well as many others.

DEXA

Dr. Wheeler has a state of the art bone density machine called DEXA readily available in his office.  The GE DuoPro is one of the most current DEXA machines used in the detection of osteoporosis and osteopenia.  The average DEXA takes 15 to 20 minutes and most DEXAs will be covered by insurance based on risk factors elicited at the time of the patient’s visit.   These procedures are done in the comfort of your doctor’s office rather than in a hospital or large radiology laboratory.  The nurses performing the DEXA procedures are trained in counseling and treating patients with osteoporosis or those who may be at risk for osteoporosis. 

A full history will be obtained from the patient.  This will include family history, medications, nutrition, calcium and vitamin D intake and exercise as well as numerous other risk factors for osteoporosis.  In the event that the patient is at risk for osteoporosis or finds that their bone density is at high risk of fracture, they will be advised on proper nutrition and exercise. If medications are required, the patient will leave the office with  a prescription for the latest medications available. This service is also offered to all patients who present from other doctors’ offices and their bone assessments will be forwarded to their primary physician upon patient request.