Twelve months without a cycle
The usual clinical marker is plain: twelve months without a menstrual cycle. If you are still bleeding, even irregularly, you are generally still in the transition, and the perimenopause page is the better fit. FRI uses that distinction so the lab question matches the stage you are actually in.
After the marker, estrogen and progesterone are no longer cycling the way they did. Symptoms do not look identical from person to person. Dr. Sani Kohen, D.C. and Dr. Tara Kohen, D.C. ask what changed in sleep, temperature, strength, and mood, rather than assuming one script.
Bone, muscle, sleep, and hot flashes
Hot flashes and night sweats are the complaints people name first. Sleep can stay broken even on nights without a flush. Muscle can feel harder to keep, and stairs or a lifting session can expose it. Bone health is a physician's conversation, including whatever imaging or medication that clinician already manages.
FRI does not claim to treat osteoporosis, and it does not replace the clinician following your bone density. The office can talk about protein, strength, and the joints that make training miserable. DUTCH hormone testing can still describe metabolites and cortisol if night symptoms and stress are tangled together.
Training and protein when joints hurt
If shoulders, hips, or knees are why you stopped loading muscle, the answer is not only a hormone discussion. Corrective exercise therapy looks at how you squat, hinge, and reach, then rebuilds what you can tolerate. Chiropractic Sports Medicine can address the joint that blocks the program.
Protein intake is reviewed as part of keeping muscle, alongside what you can digest and what your labs show. There is no gram target printed here as a universal rule, because body size, kidney history, and appetite differ. Your physician should weigh in if kidney disease or another condition limits protein.
Hormone therapy decisions stay with your prescriber
FRI does not sell hormone replacement doses, bioidentical or otherwise. If you are considering therapy, or already using it, the prescription and the monitoring stay with your physician. Functional Medicine can organize symptoms, optional hormone mapping, nutrition, and training around that medical plan.
Functional medicine at FRI does not replace a primary physician, endocrinologist, gastroenterologist, or mental health clinician. Bleeding that returns after the twelve-month mark needs medical evaluation. Nutrition and supplementation is matched to you, without a brand protocol.
What to expect when you are seen for Menopause
You can book a complimentary 20-minute consultation to see if the visit matches your questions. Care is out of network. A superbill is available, and HSA or FSA payment is accepted. The office is open Monday–Thursday, 9–6.
Bring the date of your last cycle and any hormone therapy you use, including creams. Testing is optional and chosen from symptoms. Expect talk about sleep, protein, and joints. You will not be promised a flash-free month.
What Costa Mesa visits focus on
Shoulder pain, neck pain, and knee pain cover a lot of the training and work injuries. Whiplash after a freeway crash needs a careful exam and, often, coordination with other clinicians. Functional movement screening is useful for people who train hard and still cannot explain a recurring tweak.
Gut and hormone questions are welcome in the same practice. Food sensitivities and hormonal imbalance each have their own explanation so we are not pretending a adjustment will answer them. The Costa Mesa chiropractor page is the overview.
Payment and first-visit logistics
Out of network, superbill, HSA/FSA. No referral. Bring imaging if a physician already ordered it after a crash. Do not wait on a lawyer to be examined if you are hurting, and do not expect us to manage the legal side of a claim.
The doctors are Drs. Sani and Tara Kohen. Biographies are on the about page. The clinic itself is on the office page. The complimentary consultation is 20 minutes if you want to compare this model with a high-volume office closer to Harbor Boulevard.
Westside shops, Eastside neighborhoods, and the 55
Costa Mesa is physically split. The Westside and the streets around the LAB and the action-sports shops mean standing, lifting, and a younger training culture. The Eastside and Mesa Verde are more residential. South Coast Plaza adds retail shifts on hard floors. The 55 freeway is the spine of the commute for people heading inland. Neck and low back complaints often belong to that freeway. Shoulder and knee complaints often belong to training or to a job on your feet. We ask which Costa Mesa, because the city is not one ergonomic story.
Action sports and gym culture also mean people arrive having already tried a lot of soft tissue. If you have had months of massage without a change in the movement that hurts, say what was actually done. ART and IASTM are specific tools. They are not a more expensive version of a general rub, and they are not always the right next step.
Reaching La Alameda from the 55
The usual drive is the 55 south to the 73, then toward Mission Viejo and La Alameda. From the Westside, some people prefer the 405 south to the 73. About 16 miles and 25 to 40 minutes. The address is 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. Parking on site. Open Monday through Thursday, 9 to 6.
Afternoon returns to Costa Mesa on the 55 are slow. A morning visit is kinder to a fresh neck exam and to your schedule. Call (949) 312-1754. If you work a retail shift at South Coast Plaza, bring that standing schedule to the history. It changes how we dose a plantar fascia or low back plan.
Questions patients ask
Is twelve months without a period the definition you use?
Yes. Twelve months without a menstrual cycle is the usual clinical marker, and FRI says that plainly. Bleeding before that point is generally the transition, covered on the perimenopause page. Your physician confirms how that marker applies if surgery, a hormonal IUD, or another treatment has changed bleeding. This office does not override that medical judgment.
Can you prescribe hormone replacement?
No. FRI does not set hormone replacement doses, including bioidentical prescriptions. Those decisions stay with the prescribing physician, who also handles monitoring. What this visit can do is lay out symptoms, consider DUTCH hormone testing when the pattern is unclear, and talk about food, sleep, and strength. You keep your prescriber.
What if joint pain is keeping me from lifting?
Then the plan includes the joint, not only a hormone conversation. Corrective exercise therapy and Chiropractic Sports Medicine look at how you load a sore knee, hip, or shoulder. Neuromuscular Rehabilitation can rebuild control when a movement keeps failing. Pain is not dismissed as an inevitable part of this stage.
Does a DUTCH test still help after cycles stop?
It can, when the question is metabolite pattern or the cortisol curve rather than whether you are still ovulating. Night sweats plus a high evening cortisol pattern is a different conversation from hot flashes alone. FRI does not use the test to set a hormone dose. Your physician interprets anything that would change a prescription.
Related care for Costa Mesa
Menopause is handled at the Mission Viejo clinic, not in a satellite office in Costa Mesa. The related pages below stay on that same visit and add the methods or neighboring problems that usually come up in the history.
- Costa Mesa chiropractor
How people from Costa Mesa reach 26400 La Alameda and what the three pillars cover.
- Menopause clinical overview
The non-geographic condition page, if you want the clinic-wide explanation without the drive.
- Functional Medicine
The pillar this problem sits in at Functional Restoration Institute.
- Perimenopause in this city
Perimenopause is the transition while cycles are still happening, often unevenly. Sleep can break, mood can swing, and joints can ache even.
- Sleep & Insomnia in this city
Sleep problems have a clock, a chemistry, and often a body part that hurts. Caffeine, a late bedtime, a cortisol curve, thyroid.
- Hormonal Imbalance in this city
Hormone symptoms rarely live in one gland. Cycle changes, thin sleep, temperature swings, and uneven energy often reflect how sex hormones, cortisol,.
- Thyroid Dysfunction in this city
Thyroid trouble is not one feeling. A slow pace can leave you cold, heavy, and constipated. A fast pace can leave you.
- DUTCH Hormone Testing
The DUTCH test uses dried urine collected across a day to look at sex hormones, their metabolites, and the shape of cortisol.
