Your body isn't failing you. It's changing.
Sleep disruption. Brain fog. Weight changes. Cholesterol rising despite doing everything right. These aren't separate problems. They're one connected pattern — and conventional medicine rarely has time to read them together.
You've been told your labs are normal.
But you don't feel normal.
Most women in perimenopause have already had appointments, bloodwork, and recommendations. What they haven't had is someone who sees how sleep, hormones, metabolism, and mood are affecting each other at the same time.
"Normal results don't mean nothing's happening. Perimenopause isn't one symptom at a time — it's a pattern."
Integrative perimenopause care reads the full picture — and builds a plan around what's actually happening in your body.
Common Presentations
The standard workup treats symptoms separately.
Perimenopause isn't separate.
Sleep treated without addressing the hormonal driver. Mood flagged as anxiety rather than perimenopause. The pattern stays incomplete when the pieces aren't read together.
"Most of the women I work with have already seen other physicians. What they needed was someone who could see the full picture."
I'm a board-certified integrative physician.
I'm also postmenopausal.
When my own LDL hit 160 despite disciplined diet and strength training, I understood exactly what was happening — estrogen depletion reducing LDL receptor activity. Not dietary failure. Physiology.
That personal and clinical experience shapes how I listen. I know how to read the full pattern and explain it in language that finally makes sense.
Fellowship-trained at the Andrew Weil Center for Integrative Medicine. 25+ years in clinical practice.
Western diagnostic precision alongside Ayurvedic constitutional medicine. Both frameworks read together produce a picture standard medicine rarely constructs.
Unhurried appointments. Labs read as a system. A care plan built for your constitution, history, and life — not a protocol handed over before I understand your picture.
Membership-based. Out-of-network. HSA/FSA eligible. Telehealth available. In-person in the Bay Area.
Metabolic-First
Fasting insulin, lipids, and cardiovascular risk reviewed routinely. Hormone levels checked when clinically indicated.
Hormonal + Non-Hormonal
FDA-approved hormone therapy — bioidentical or synthetic, based on your clinical picture. Ayurvedic protocols, supplements, and nervous system support alongside.
Integrative
Evidence-based medicine, ancient wisdom, mind-body modalities, and botanicals — selected based on what your pattern actually needs.
Longitudinal Care
Perimenopause unfolds over years. Membership care tracks labs over time and adjusts your protocol as the transition evolves.
Three steps to a clearer map.
A thorough initial consultation
Not a 15-minute intake. We cover your full timeline, symptoms, labs, and history before I make any recommendations.
A plan built through conversation, not a single visit
Your workup, testing, and care plan unfold over as many visits as it takes — not compressed into one appointment.
A relationship that lasts through the transition
Perimenopause unfolds over years, not months. Care adjusts as your body changes, with the same physician tracking your progress the whole way.
Hormone therapy prescriptions available to members starting Oct 2026. Acupuncture requires in-person. All other care available via telehealth.
When the picture is addressed whole,
the body starts cooperating again.
Patients who come in with years of scattered, unexplained symptoms often describe the same shift — not that one fix solved everything, but that the picture finally made sense. Sleep stabilizes. Cognitive clarity returns. Weight responds to what's actually happening hormonally. Mood lifts in a way that feels physiological — because it is.
"What used to feel like verdicts — labs, follow-up appointments, difficult conversations — started feeling like data. Information to work with, not threats to brace for."
— Ayur patient, 2 years of careFrequently asked about
perimenopause care at Ayur
What is integrative perimenopause care?
It combines rigorous clinical diagnosis and metabolic testing with Ayurvedic and mind-body approaches — reading your full hormonal transition as one connected pattern, not a set of isolated symptoms.
Do you rely on labs to diagnose perimenopause?
No — perimenopause is a clinical diagnosis based on your history and symptoms. Testing is used to assess metabolic and cardiovascular risk, or in cases where further clarification is needed — not to obtain the diagnosis.
Is hormone therapy the only option?
No. Ayur offers hormonal and non-hormonal care. FDA-approved hormone therapy — bioidentical or synthetic, based on your clinical picture — is available where appropriate, alongside Ayurvedic protocols, evidence-based supplements, and nervous system regulation. Hormone therapy prescriptions are available to members starting October 2026.
Can I see Dr. Malathi via telehealth?
Yes. All consultations and ongoing perimenopause care are available via telehealth. In-person care is available in the Bay Area. Acupuncture requires in-person.
Who is a good candidate for this care?
Women in their 40s or 50s experiencing unexplained fatigue, sleep disruption, brain fog, weight changes, mood shifts, or metabolic changes — especially those who have been told their labs are "normal" but don't feel normal.
If this is where you are, a discovery call is the right next step.
A real conversation about what's happening in your body, what you've tried, and what a more complete approach could look like. No obligation.