Jonathan Bratter DO FACOG Women’s Health of the High Country

09/19/2025

Many experience mood changes during the menopause transition. Far too often, doctors make a quick diagnosis of anxiety or depression and start patients on medications like SSRI's unnecessarily. Shifting hormone levels, especially the decline in estrogen, can affect brain chemicals that regulate emotions, making anxiety and depression more likely during this stage of life. Hot flashes, night sweats, and poor sleep can all affect mood. Diet and exercise changes, counseling, and sometimes medication can help. For many women, hormone replacement therapy (HRT) not only eases hot flashes and night sweats, but also improves sleep, stabilizes mood, and reduces feelings of anxiety or low energy.

09/03/2025

Menopause often brings changes in body shape and weight, especially with more fat stored around the abdomen. This type of fat, called visceral fat, is more active than fat under the skin and releases inflammatory chemicals that can affect overall health. These changes can increase low-grade inflammation in the body, which not only raises the risk of conditions like high blood pressure and diabetes but also makes menopause symptoms such as hot flashes, night sweats, and sleep problems feel worse. Studies have shown that women with a higher body mass index or larger waistline tend to experience more frequent and severe (peri)menopausal symptoms. The good news is that lifestyle habits play a powerful role in improving how you feel. Regular exercise can lower inflammation and reduce abdominal fat, while balanced nutrition, good sleep, and stress management all support your body during the menopause transition. In addition, medications known as GLP-1 receptor agonists (such as semaglutide or tirzepatide) may provide extra support by helping with weight management, reducing visceral fat, and lowering inflammation. For some women, this can mean improved metabolic health and relief from the intensity of menopause symptoms.

08/13/2025

A normal menstrual cycle typically occurs every 21–35 days and can last 2–7 days. It should not cause extreme pain or significantly interfere with daily activities. Menstrual flow is considered abnormal when bleeding is very heavy (such as soaking pads or tampons every hour for several hours), lasts longer than seven days, skips months without pregnancy, varies widely in timing, or includes large blood clots or severe cramps. Weight and nutrition play an important role in menstrual health. Low body weight or inadequate nutrition can disrupt the hormones that regulate ovulation, leading to missed or irregular periods. Excess body weight can cause increased estrogen production, sometimes resulting in heavier or more irregular bleeding. Eating a balanced diet with adequate iron, healthy fats, lean protein, and complex carbohydrates supports hormonal balance and helps replenish blood loss each month.

Don't ignore the changes. We are here to help you.

08/11/2025

Spotting, heavy flow, or bleeding between periods could be more than just an “off” cycle. Abnormal uterine bleeding can be linked to hormone changes, fibroids or polyps, bleeding disorders, certain medications, and sometimes more serious conditions like pre-cancer or cancer. If your bleeding pattern changes suddenly or feels “not normal” for you, it’s important to get checked. Your body is talking, listen to it.

06/18/2025

Thank you to Sarah for inviting me to help teach the Wake Forest PA students about labor and delivery. This was so much fun!

06/06/2025

Within 10 years of menopause, a woman’s risk of cardiovascular disease rises sharply, often reaching the same level as men of the same age. Postmenopausal women are 2–3 times more likely to develop coronary artery disease than premenopausal women.
Heart disease becomes the leading cause of death in women over age 50, accounting for about 1 in 3 female deaths in the U.S. Know your risks and let's work to reduce them!

06/02/2025

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Why Strength Training Matters in Menopause

05/29/2025

05/20/2025

When our very own Sarah is not protecting your health, she is protecting your home! Makes WHHC and all of us proud!

05/19/2025

Sound familiar:
Hot flashes, Decreased energy, Weight gain, Decreased muscle mass, Decreased s*x drive and/or performance, Lack of sleep, Joint pain, Brain fog
Symptoms associated with perimenopause can begin several years before your last period and can persist on average 7 years afterwards.

The protective effect that your hormones have on your heart, bones and brain begin to diminish at this time.

There are treatments available to help maintain your protection and improve your symptoms.

Know your options!

05/07/2025

Your hormones are helping to protect your heart, bones and brain. This protection is lost after menopause. The timing of the initiation of hormone replacement therapy may be crucial to reducing the risk of long term chronic disease.