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.
Desk symptoms and training symptoms, handled separately
Corrective exercise and DNS are how we retrain sitting and breathing patterns after the exam shows they matter. Chiropractic adjustments are used when a joint is not moving, not as a subscription. Carpal tunnel symptoms get a neck screen and a nerve exam, because a keyboard is not automatically the wrist.
The same city asks functional medicine questions: thyroid, burnout-style fatigue people want explained, and gut symptoms after years of desk lunches. Those are history-first visits. The hub page is the Irvine chiropractor page.
Insurance and coordination
Many Irvine employers offer HSA or FSA accounts. Those cards work here. We are still out of network and we still give a superbill rather than billing your plan directly. Lab work is quoted before it is ordered. We will not tell you to stop a medication from your Irvine physician.
Drs. Sani and Tara Kohen lead the clinic. Training details are on the about page. If you want to see the rehab gym before you drive the 5, use the office page.
Business parks, village trails, and a city built for sitting
Irvine's villages do not share a body. Woodbridge and University Park are older loops and pools. Turtle Rock and Quail Hill have more grade. The Spectrum and the Great Park are newer and more spread out. The job, for a lot of patients, is a campus along Jamboree, Barranca, or the Irvine Business Complex: long meetings, a badge, and a walk that is only from the garage. Neck, upper back, and headache complaints often start there. Knee and hip complaints often start on the village trails people use to undo the job.
We do not treat Irvine as a single activity level. A cyclist on the San Diego Creek trail and a software lead who has not exercised since a move from Woodbridge need different exams. Neck pain and headaches are common desk presentations. Hip and SI pain shows up when someone adds mileage fast. Say which village and which campus.
South on the 5 or the 73 from Irvine
From central and north Irvine, I-5 south toward Mission Viejo is the simple drive. From the south villages and from many business parks, the 133 to the 73 toll road is often cleaner. About 12 miles. Twenty minutes is realistic off peak. Thirty-five is realistic when the 5 is slow through Lake Forest. The office is 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. Building parking. Monday through Thursday, 9 to 6.
Irvine patients are used to efficient clinics. This one is deliberately less efficient. An exam takes time. If you need to be back on Jamboree for a meeting, book a morning visit and leave a buffer. Phone (949) 312-1754. The 20-minute consultation is the right first step if you are shopping for a style of care rather than ready for testing.
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 Irvine
Menopause is handled at the Mission Viejo clinic, not in a satellite office in Irvine. The related pages below stay on that same visit and add the methods or neighboring problems that usually come up in the history.
- Irvine chiropractor
How people from Irvine 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.
