Dear DrN-  I am 50 years old and am having symptoms of night sweats, anxiety, insomnia, joint pain, fatigue, leg cramps and yes… low libido.  I eat well and exercise regularly. I need a plan of action before I go insane!  signed 50

Dear Now 50-  Welcome to menopause.  There are over 34 symptoms of menopause and you sound like you’ve got quite a list.  This is where ‘tough it out’ just doesn’t seem like a good option if it is severely affecting your quality of life.  Your ovaries are shutting down so you have a hormone deficiency.  Some women can have symtoms or months, some years  and some it is forever.  I do not support hormone levels unless I am not sure of a diagnosis and do not know the appropriate treatment intervention.   In this case it is Menopause. I am certain.  The decisions center around YOU and how you want to proceed.  There are supplements that might lessen the symptoms but hormones are going to be the most physiological remedy.   I offer consultations to establish a treatment plan that you are comfortable with ranging from non-hormonal to the full spectrum of female hormones both FDA and non FDA approved options depending on your family history, medical history and personal beliefs. There are tablets, topicals, patches, vaginal rings, troches, and injections.  There are also some otc remedies that might help and nutritional interventions.    I would schedule an appointment with a provider that will offer a balanced view so you can make the best decision for you.  Short answer- get help!   DrN