Perimenopause & Menopause Care
Helping you feel better
You deserve time to talk about what’s changing—and understand your options. Personalized perimenopause and menopause care built around your symptoms, health history, and goals.
Virtual care throughout Tennessee
Patients must be physically located in Tennessee at the time of each appointment.
SYMPTOM RECOGNITION
You're Not Alone In What You're Feeling.
Common Symptoms of Perimenopause & Menopause
Sleep & Recovery
Trouble falling asleep, waking during the night, feeling less rested, or noticing that your body does not recover from activity the way it once did.
Mood & Concentration
New anxiety, irritability, changes in mood, difficulty concentrating, or the feeling commonly described as brain fog.
Cycles & Bleeding
Periods that become heavier, lighter, longer, shorter, less predictable, or begin skipping altogether.
Body Changes and Energy
Joint and muscle aches, changes in body composition, and changes in energy.
Sexual and Urinary Health
Changes in sexual desire, vaginal dryness or discomfort, and urinary symptoms, including waking at night to urinate.
Hot Flashes and Temperature Changes
Hot flashes and night sweats.
ABOUT VANESSA
Meet Vanessa Armenise, MSN, APRN, FNP-C, MSCP
Nurse Practitioner | Menopause Society Certified Practitioner
A Clinical Career Built Around Complex Care
For nearly two decades, I have cared for patients through complex and deeply personal health experiences. My clinical career has included nationally recognized institutions and surgical oncology programs, from Memorial Sloan Kettering Cancer Center in New York City to advanced-practice roles in Memphis. Through this work, I developed a deep appreciation for thoughtful clinical decision-making, careful symptom management, survivorship, and helping patients maintain quality of life—not simply treating a diagnosis.
Why Midlife Care Became Personal
My interest in perimenopause and menopause care eventually became personal. When I began navigating my own symptoms, I experienced how difficult it could be to find care that brought the whole picture together. I wanted to better understand what was changing, what might be related to the menopause transition, what might not be, and which treatment options were supported by evidence. That experience changed how I viewed midlife healthcare and ultimately led me to create Balance Hormone & Wellness—a practice where women have the time and space to tell their full story, with care that begins with careful listening rather than a predetermined protocol.
Member, International Society for the Study of Women’s Sexual Health (ISSWSH)
CLINICAL APPROACH
Our Approach to Perimenopause & Menopause Care
Evidence Based Medical Care for Women in Perimenopause and Menopause
Thorough, comprehensive care during perimenopause and menopause begins with a conversation about what you’re experiencing, what has changed, and your medical and menstrual history, current medications, family history, and goals.
From there, we consider the complete clinical picture. Many symptoms that appear during perimenopause and menopause can have more than one explanation. We consider your symptoms and health history together, with testing when indicated, to develop an individualized care plan.
We Start With Your Story, Not a Predetermined Treatment
Good menopause care is not simply about prescribing hormones.
Your first step is a comprehensive conversation about what you are experiencing, what has changed, your medical and menstrual history, current medications, previous hormone use, family history, risk factors, lifestyle, and what you hope to improve.
From there, we consider the complete clinical picture.
We do not assume every symptom is hormonal. We also do not dismiss hormonal changes simply because your symptoms do not fit a textbook description of menopause.
Time to Understand Your Care
Understanding your care is an essential part of feeling supported. At Balance, we make time to explain how hormonal changes may relate to your symptoms, why symptoms can shift over time, and what your treatment options mean for you. When medication is part of your plan, we discuss why it is being considered, how to use it, potential benefits and risks, and what to watch for along the way. Your questions, preferences, and understanding help shape each decision.
HOW IT WORKS
The Balance Journey, Care That Evolves With You
I created the Balance Journey because perimenopause and menopause are not single moments; they are a journey. Good care should evolve as symptoms, health, treatment response, and priorities change.
01
Discover
Begin with a free 15-minute discovery call to learn about the practice, or book your initial consultation when you’re ready.
02
Understand
During your 60-minute video consultation, we explore your symptoms, health history, and labs when indicated, with time to explain what may be contributing to your symptoms, discuss your options, and answer your questions.
03
Personalize
We develop your individual Balance Plan and use the first six months to begin care, learn about your response, and make changes along the way when needed.
04
Optimize
During months six through twelve, the journey continues, and we work together to refine the plan as your needs and goals evolve.
05
Thrive
Renewable six-month care periods provide continuity, monitoring, and thoughtful adjustments as your care continues.
WHOLE-PICTURE CLINICAL MESSAGE
You Don’t Need to Know Whether Hormones Are the Cause.
Many symptoms that appear during perimenopause and menopause can have more than one cause. Low estrogen, testosterone, or progesterone may play a role, alongside sleep, stress, medications and other health conditions. We look at your symptoms and health history together to create a care plan that fits you.
What You Can Expect
- Time to explain what you have been experiencing.
- A comprehensive review of your symptoms and history.
- Evidence-informed recommendations rather than a one-size-fits-all protocol.
- A clear discussion of hormonal and nonhormonal treatment options when appropriate.
- Personalized education about your symptoms, treatment options, and medication plan, with time for questions at each visit
- Follow-up and reassessment as your needs change.
- Coordination with other healthcare professionals when additional expertise is needed.
- A collaborative relationship in which your questions and priorities matter.
You must be physically located in the state of Tennessee at the time of every appointment. If you will be outside Tennessee, please contact us to reschedule.
Your Patient Journey
Comprehensive Evaluation
We begin by understanding your symptoms, health history, menstrual and reproductive history, medications, prior hormone use, risk factors, lifestyle, and goals. The objective is to understand the whole picture before recommending treatment.
Early Treatment & Reassessment
If treatment is started, we follow how you respond. This stage is about learning what is helping, identifying concerns or side effects, and making appropriate adjustments rather than assuming the first plan will remain unchanged.
Ongoing Midlife Care
As you move through the menopause transition, your symptoms, health risks, priorities, and treatment needs may evolve. Ongoing care allows us to reassess the plan over time and continue making informed decisions together.
Ready to Start the Conversation?
Book Your 60-Minute Consultation
$300
Balance is a telehealth practice serving Germantown, Greater Memphis, and patients throughout Tennessee. All launch appointments are virtual; in-person visits are not currently offered. You must be located in Tennessee at the time of every clinical appointment. Prescription medications, supplements, laboratory testing, and care provided by outside clinicians or referrals are not included. A prescription, hormone therapy, or any specific treatment is not guaranteed.
Compounded Medication Disclosure:
Some treatments may involve compounded medications prepared by licensed compounding pharmacies. Compounded medications are not reviewed or approved by the U.S. Food and Drug Administration (FDA) in the same manner as commercially manufactured medications. Compounded medications may be prescribed when clinically appropriate based on patient needs and medication availability. Patients will receive additional information and provide informed consent prior to the use of compounded medications.
Ready to Start the Conversation?
Book Your 60-Minute Consultation
$400 • Clinician-selected core labs included
Balance is a telehealth practice serving Germantown, Greater Memphis, and patients throughout Tennessee. All launch appointments are virtual; in-person visits are not currently offered. You must be located in Tennessee at the time of every clinical appointment. Prescription medications, supplements, specialty testing outside the included core labs, and care provided by outside clinicians or referrals are not included. A prescription, hormone therapy, or any specific treatment is not guaranteed.
FREQUENTLY ASKED QUESTIONS
What happens during the free 15-minute discovery call?
This is a brief conversation to learn about Balance, ask questions about our services and pricing, and see whether the practice fits your needs. It is not a medical visit; diagnosis, treatment recommendations, and prescriptions require an appointment.
What can I expect at my first appointment?
Your first appointment is a 60-minute video consultation with Vanessa. We’ll discuss your symptoms, health history, goals, lab results, and review treatment options. You’ll have time to ask questions and leave with next steps tailored to you.
What does bioidentical hormone therapy mean?
“Bioidentical” describes hormones with the same molecular structure as hormones your body produces. Some FDA-approved hormone medications are bioidentical; the term does not mean a treatment must be custom-compounded or is automatically safer. Vanessa will explain the available options and help you consider their benefits and risks in the context of your health history.
Can I get help with menopause symptoms if I’ve had cancer?
A history of cancer does not mean you have to manage menopause symptoms without support. The type of cancer, past treatment, and your individual history guide which options may be appropriate. Hormone therapy may not be suitable, particularly after hormone-sensitive breast cancer, but nonhormonal options may help. Vanessa will review your history and coordinate with your oncology team when appropriate.
What if I’m not sure my symptoms are related to perimenopause or menopause?
You don’t need to know the cause of your symptoms before starting the conversation. Vanessa will listen to what’s changed, review your health history, and consider hormonal and nonhormonal explanations. Together, you’ll discuss appropriate next steps, which may include further evaluation or referral..
Can I get care if I don’t want—or can’t take—hormones?
Yes. A conversation about menopause care does not commit you to hormone therapy. Vanessa will consider your preferences and health history and discuss appropriate options, which may include nonhormonal treatments and lifestyle support. If your needs fall outside the practice’s scope, she can recommend further evaluation or referral.
NOT SURE WHERE TO START?
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Understanding hormones, symptoms and when it may be time to seek help.
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