We are dedicated to providing high-quality, supportive, compassionate, individualized care to patients seeking care for menopausal symptoms, as well as for premature and early menopause. While menopause is a normal occurrence in the process of aging, some women may experience symptoms as they approach and enter menopause. These symptoms include hot flashes, night sweats, poor nighttime sleep, vaginal dryness, reduced libido, and fatigue. Some women may also experience weight gain, thinning of scalp hair, and even depressive symptoms and new onset anxiety. Our program addresses other health concerns caused by menopause, such as bone loss, increased risk for bone fractures, and problems with blood sugar and cholesterol control. Both early and premature menopause present unique challenges. Our menopausal services include: Diagnosis and management of bothersome menopausal symptoms with use of hormonal, nonhormonal, and alternative treatment options Diagnosis and management of premature and early menopause Management and reduction of health risks associated with menopausal years, such as osteoporosis, diabetes, and heart disease, and mood symptoms Donor egg IVF to address fertility needs of early menopausal women

The Sexuality, Intimacy, and Menopause Program is one of the only clinics of its kind in the country. By combining both medical and psychological interventions, it is designed to help women who experience sexual dysfunction after cancer. Sexual dysfunction after cancer is common; however, sexual side effects often go untreated after having successfully treated a patient’s cancer. Our doctors look to manage not only the physical issues, but also any psychological concerns that may arise. Founded by Elena Ratner, MD, MBA, associate professor of Obstetrics, Gynecology & Reproductive Sciences and co-chief for the Section of Gynecologic Oncology, and Mary Jane Minkin, MD, clinical professor of Obstetrics, Gynecology & Reproductive Sciences, the clinic began nearly a decade ago. Psychologist Dwain Fehon, PsyD, associate professor of Psychiatry and chief psychologist of Psychiatric Services at Yale New Haven Hospital, is a vital member of the team. He and his staff provide essential emotional care that helps improve our patients’ relationships and personal health. Many women have concerns related to intimacy and menopause because of cancer surgery or treatment. Our specialists consult with patients to address the difficult physical and emotional aspects of cancer care and treatment, and create a personalized care plan for each patient. We have developed a unique focus on menopause management for cancer survivors and “previvors”—healthy women who have their breasts or ovaries removed because of a genetic risk of developing cancer. What types of patients do we see? Women who experience: Changes in sexual function as a result of chemotherapy, radiation, or surgery for cancer Menopause symptoms as a side effect of cancer treatment Early menopause or sexual changes after surgery for cancer risk reduction What we provide: Menopause symptom management Resources for cancer survivors on maintaining sexual health Access to complementary and supportive services Access to individual and couples counseling What to expect from an appointment: Our team will first discuss each patient’s medical and cancer history, as well as what type of treatment they have had. They will be asked about symptoms of menopause and sexual problems, such as hot flashes, night sweats, changes in sexual desire, painful intercourse, vaginal dryness, or changes in mood or sleep patterns. Depending on their symptoms, patients may have a gynecologic exam. The team will then discuss options for symptom management and improving their sexual health. They will also have the opportunity to talk about emotional and relationship issues affecting their life. Women are welcome to bring their partners to the appointment.

Polycystic Ovarian Syndrome (PCOS) is a lifelong disorder that is often misdiagnosed and relatively poorly understood. In fact, PCOS is the most common hormonal reproductive problem in women of childbearing age. This condition not only affects a woman's menstrual cycle, fertility, and appearance, but also her overall health.Our goal is to help diagnose, manage, and treat this condition and reduce the lifetime health risks related to PCOS.We provide a comprehensive and individualized evaluation of each patient's unique profile and risks. Our multidisciplinary team focuses on managing PCOS through a combination of metabolic need assessment, lifestyle modifications, psychological support, and medical interventions based on her individual needs. There is no single test used by doctors to diagnose PCOS. Our specialists will use a number of diagnostic tools, including medical history, Body Mass Index (BMI) measurement, ultrasound, and lab tests to determine if our patients have PCOS. Our treatment strategies include: Managing irregular periods through hormonal and nonhormonal treatment options Managing excess hair growth, hair loss, and acne through hormonal and nonhormonal treatment options Managing infertility in women with PCOS Risk reduction strategies are critically important for any women with PCOS to help reduce lifetime risks of diabetes, heart disease, depression, and uterine cancer. Our risk reduction strategies include: Lifestyle modification. This includes attention to diet and regular physical activity for all women with PCOS. Psychological support. This includes on-site consultations for pregnant women with PCOS who face a number of challenges before, during, and after their pregnancies. In addition, depression and anxiety are commonly seen in women with PCOS and seeking appropriate help is strongly encouraged. Uterine protection. This includes attention to irregular menstrual periods and the absence of ovulation in women with PCOS who can be at risk for abnormalities of the uterine lining (endometrium). Polyps and hyperplasia of the endometrium cause not only heavy or irregular bleeding, but can also lead to precancerous conditions and even cancer. Sleep study and sleep hygiene. This includes strategies for women experiencing difficulty going to sleep or interrupted night sleep. As part of our commitment to ensuring the health of women with PCOS, Yale Medicine’s PCOS Program conducts research into this disorder in an effort to understand its underlying mechanisms, as well as to advance treatment intervention to improve the overall health and pregnancy outcomes of women with this condition.