Menopausal hormone therapy
When appropriate, Dr. Malathi can discuss FDA-approved options, including benefits, risks, and your personal and family history.
Physician-Led Menopause Care
Menopause Specialist Serving San Francisco
Dr. Malathi Acharya, MD is a board-certified internal medicine physician who guides women through perimenopause and menopause. See her by telehealth from anywhere in California, or in person in Portola Valley.
5.0 rated on Google Reviews
Telehealth across CaliforniaOffice in Portola Valley
Board-certified internal medicine physician
Diplomate, American Board of Integrative Medicine
Fellowship-trained, University of Arizona
25+ years of clinical experience
Medically reviewed by Dr. Malathi Acharya, MD·Last updated
You Are Not Imagining It
Is It Perimenopause or Menopause?
If your sleep, mood, energy or cycle have changed and you have been told your labs look normal, you are not alone. Symptoms can begin years before your last period and continue well after it.
Dr. Malathi sees women at either stage. The goal is to understand the whole pattern, then choose the next step with you.
Looking for the full picture of how this care works? Read about perimenopause and hormone health care.
Symptoms rarely show up alone. The pattern matters more than any one of them.
Choosing Your Doctor
Five Questions to Ask Any Menopause Specialist
San Francisco has plenty of options, from gynecology practices to virtual clinics. Whoever you choose, these questions help you find the right fit. Here is how Dr. Malathi answers each one.
1
Will you look beyond hormone levels?
How we answerHormone levels fluctuate considerably during perimenopause, so Dr. Malathi does not rely on a single result. Your evaluation can include lipids, blood sugar, fasting insulin, thyroid function and blood pressure.
2
Do you discuss hormonal and non-hormonal options?
How we answerBoth, and combinations of the two. Hormone therapy is not automatically right for every patient, and the decision depends on your symptoms, history, risk factors and preferences.
3
How much time will we have?
How we answerA thorough initial consultation, not a 15-minute intake. Dr. Malathi reviews your full health timeline and priorities before deciding what happens next.
4
Will you work with my other doctors?
How we answerYes. Her care sits alongside your gynecologist and primary care physician, not in place of them.
5
What happens after the first visit?
How we answerThe menopause transition unfolds over time. Follow-up visits and the Ayur Membership allow Dr. Malathi to follow those changes with you.
Welcome to Ayur Integrative Medicine
Medicine Led by a Physician
Meet Dr. Malathi Acharya, MD
Dr. Malathi is a board-certified internal medicine physician and a Diplomate of the American Board of Integrative Medicine. She completed fellowship training at the Andrew Weil Center for Integrative Medicine, University of Arizona, and brings more than 25 years of clinical experience to her work.
As an internist, she looks at menopause as part of your whole health: heart, metabolism, bones, sleep and mood, together with your hormones.
Read Dr. Malathi’s Full Bio
The First Step
What a Menopause Evaluation Includes
There is no single menopause panel. Depending on your situation, your evaluation may include the items on the right.
Everything does not have to happen in one visit. Recommendations are based on what is clinically relevant to you.
Your storySymptoms, medical history, menstrual changes and lifestyle.
Lipid profileCholesterol often shifts during the transition.
Blood glucose and fasting insulinA look at metabolic health, not just weight.
Thyroid functionTo rule out look-alike symptoms.
Blood pressure and cardiovascular riskMidlife is a key window for heart health.
Sleep and body compositionMuscle, bone and rest matter as much as the scale.
Family historyContext that shapes every recommendation.
Hormone testing, when it helpsUsed when it would meaningfully inform care. The clinical picture comes first.
There Is No Single Protocol
Hormonal and Non-Hormonal Options
Some women want hormone therapy. Others prefer non-hormonal approaches, and many use a combination. The right choice depends on your symptoms, history and goals.
Non-hormonal medical options
Depending on the symptoms being addressed, non-hormonal medical options may also be considered.
Nutrition and metabolic care
Nutrition, resistance training, sleep, stress management and cardiovascular risk assessment.
Supplements and botanicals
Individualized recommendations, reviewed in the context of your medications and overall care.
Mind-body medicine
Breathing practices, mindfulness, stress regulation and clinical hypnosis where appropriate.
Ayurvedic principles
May inform nutrition, routine or botanical recommendations within a broader integrative framework.
“Hormone therapy is not automatically appropriate for every patient. The decision includes your symptoms, your history, and your preferences.”
Dr. Malathi Acharya
Telehealth Across California
Menopause Care for San Francisco Patients, by Video
You do not have to cross the Bay to see a physician who takes menopause seriously. Dr. Malathi sees patients by video from anywhere in California, including San Francisco.
- Meet from home, with no commute or waiting room
- Start with a free discovery call before you decide
- Follow your plan with check-ins through the transition
Telehealth is available to California residents. Some services need an in-person visit in Portola Valley, and Dr. Malathi will tell you when that applies.
Video visits with Dr. MalathiFor patients located anywhere in California
The Bigger Picture
Beyond the Next Hot Flash
Relief matters. So does what menopause means for your long-term health. Midlife is a key window for prevention, which is why menopause care at Ayur connects to metabolic and preventive medicine.
Heart & Cholesterol
Cholesterol and cardiovascular risk often change during the transition and deserve a close look.
Blood Sugar & Insulin
Insulin resistance and weight changes are part of the same conversation as sleep and stress.
Muscle & Bone
Resistance training and bone health help protect strength and independence as you age.
Healthy Aging
A plan that looks ahead, not only at today’s symptoms.
Preventive & Metabolic HealthEvery plan is individual and results vary.
Care Through the Whole Transition
If you want continuity rather than a single visit, the Ayur Membership is a 12-month relationship with Dr. Malathi, with follow-up visits and secure communication through the patient portal.
Patient Experiences
5.0 rated on Google Reviews
What Our Patients Say
★★★★★
“I cannot recommend Dr. Malathi highly enough. She combines deep expertise in integrative medicine and Ayurveda with genuine kindness, compassion, and presence. What sets her apart is how deeply she listens. She takes the time to understand your entire health history, connecting dots that other practitioners often miss. She is highly competent and deeply nurturing. I always leave feeling heard, supported, and empowered.”
J.K. · Google Review
★★★★★
“I absolutely love working with Dr. Malathi. She is very kind and caring, extremely detail oriented, and thorough in her research on medical issues. She knows how to create a safe space for you while helping you work through your health issues and treats you like family. I am so happy I have gotten the chance to be under her care!”
F.G. · Google Review
★★★★★
“Dr. Acharya's compassionate approach to medicine, coupled with meticulous attention to detail, sets her apart. Her holistic approach integrates mind-body remedies such as dietary adjustments, breathing techniques, meditation, and yoga. She excels as a collaborative partner in developing treatment plans and provides comprehensive care. I wholeheartedly endorse her services!”
A.S. · Google Review
Visit the Office
In-Person Menopause Care Near San Francisco
If you would rather be seen in person, Dr. Malathi’s office is on the San Francisco Peninsula, in Portola Valley.
Ayur Integrative Medicine
130 Portola Rd, Suite F
Portola Valley, CA
On the Peninsula, south of San Francisco
Common Questions
Frequently Asked Questions
Straight answers about menopause care, telehealth and what to expect. Still unsure? A free discovery call is the easiest way to find out.
Do you prescribe hormone therapy?+
When hormone therapy is clinically appropriate, Dr. Malathi can discuss FDA-approved options, including potential benefits, risks, and your personal and family history. Hormone therapy is not automatically right for every patient, and the decision is individualized. Hormone therapy prescribing for Ayur members begins October 2026.
What is the difference between perimenopause and menopause?+
Perimenopause is the transition, when hormone levels fluctuate and periods become irregular. Menopause is reached after 12 months without a period. Symptoms can start years before menopause and continue after it. Dr. Malathi sees patients at either stage.
Is telehealth available for San Francisco patients?+
Yes. Dr. Malathi offers video visits to patients located anywhere in California, including San Francisco. Some services need an in-person visit at the Portola Valley office.
How much does care cost, and do you take insurance?+
Ayur is an out-of-network practice, and payment is made directly to the practice. Whether HSA, FSA, or HRA funds can be used depends on your plan, so check with your plan administrator or tax professional. You can talk through current options on a free discovery call.
Do you replace my gynecologist or primary care doctor?+
No. Dr. Malathi works alongside your gynecologist, primary care physician, and any other specialists. Routine screenings and exams continue with them.
What should I bring to my first visit?+
A list of your medications and supplements, recent lab results if you have them, a rough timeline of your symptoms and cycle changes, and your main questions. If you cannot gather everything, that is fine.
How long is the first visit?+
It is a thorough consultation, not a 15-minute intake. Dr. Malathi reviews your full health timeline and priorities before deciding what happens next, and not everything has to happen in one visit.
Start With a Conversation
Find Menopause Care That Sees the Whole You in San Francisco
Book a free discovery call to talk about your symptoms, your history, and whether telehealth or an in-person visit is the right place to start. There is no obligation and no guaranteed outcome.
Book a Discovery CallPrefer to call? +1.650.671.2023
Telehealth across California • Office in Portola Valley