Perimenopause & menopause care
Perimenopause can begin a decade before your last period — and most doctors miss it entirely. Vela connects you with clinicians who specialize in the full hormonal transition, from first symptoms to beyond.
Which of these sounds familiar?
Whether you're in perimenopause, menopause, or not sure yet — Vela's clinicians will figure it out with you.
It's not in your head
Whether you're in perimenopause or menopause, declining estrogen affects your entire body — not just your reproductive system. Here's what that actually looks like across both phases.
Anxiety, brain fog, memory lapses, depression, irritability — all linked to estrogen's effect on neurotransmitters. Often appears years before periods change, which is why it gets misdiagnosed as burnout or depression.
Waking at 3am, night sweats, insomnia. One of the earliest signs of perimenopause. Disrupted sleep is a hormonal issue — not an anxiety issue — and it responds well to the right treatment.
Caused by the hypothalamus misfiring as estrogen drops — not stress, not anxiety. More common in menopause but can begin in perimenopause. Highly treatable with HRT and other options.
Unexplained joint pain, muscle aches, and weight changes especially around the abdomen. Estrogen regulates inflammation. When it drops, your whole body feels it — even if your periods are still regular.
Estrogen protects cardiovascular and bone health. Its decline increases risk for heart disease and osteoporosis — conditions that are largely preventable with the right care started at the right time.
Shorter cycles, heavier periods, spotting, or cycles that become unpredictable — these are often the first measurable sign of perimenopause, even when everything else feels "normal."
Experiencing symptoms but not sure which phase you're in? That's exactly what the quiz is for.
Simple from the start
No waiting rooms, no referral loops, no "come back in six months." Vela gets you to a clinician who understands the full hormonal transition — fast.
Tell us what you're experiencing — whether you're still having regular periods or years past your last one. Our quiz is designed to identify symptoms across the full perimenopause-to-menopause spectrum.
5 minutesA licensed clinician who specializes in perimenopause and menopause reviews your intake and connects with you asynchronously — no scheduling, no waitlists.
Within 24 hoursYour clinician tailors treatment to where you are in the transition. Perimenopausal? Your plan looks different than postmenopausal. Both are valid. Both are treated.
Personalized to youMedication ships from a licensed pharmacy to your door. Your clinician stays available for follow-ups as your symptoms change — because the hormonal transition is a journey, not a single event.
Free shippingClinical credibility
Most healthcare providers know menopause. Very few know perimenopause. Vela's clinicians are trained in both — and they know the difference matters enormously for how you're treated.
Perimenopause-trained clinicians
Our providers specialize in the full hormonal transition — not just postmenopause. They know that fluctuating hormones in perimenopause are harder to test for and require a different clinical approach.
Licensed in all 50 states
Vela's clinical network is fully licensed and credentialed across the US — so wherever you are in the country, and wherever you are in the transition, a specialist is available.
HIPAA-compliant & secure
Your health data is protected by HIPAA-compliant infrastructure. Your privacy is non-negotiable at Vela — full stop.
Licensed compounding pharmacies
All medications are compounded and dispensed by nationally licensed pharmacies. Your treatment is prescription-grade, not supplement-grade.
Perimenopause is easy to miss and hard to test for. A woman's hormones might look completely normal on Tuesday and show significant imbalances on Wednesday.
— Dr. Mary Jane Minkin, Yale School of Medicine, 40+ years in menopause care
Questions answered
Honest answers. No jargon. No runaround.
This is the most common question we hear — and the most important one. Perimenopause doesn't wait for your periods to become irregular. It can begin years earlier, with symptoms like disrupted sleep, brain fog, mood changes, anxiety, and joint pain that appear while your cycle still looks completely normal. Hormone levels fluctuate so unpredictably during perimenopause that blood tests often come back "normal" even when you're clearly experiencing something. Our clinicians are trained to evaluate the full symptom picture, not just your labs.
The 2002 Women's Health Initiative study created widespread fear about HRT — and it set women's hormonal healthcare back by decades. But follow-up research revealed critical flaws: the study only included women who were already 10+ years post-menopause, using a single delivery method that's largely been replaced. Today, the evidence shows that for most women within 10 years of menopause and under 60, the benefits of HRT significantly outweigh the risks. For perimenopausal women especially, starting treatment early can protect cardiovascular and bone health long-term. Your Vela clinician will review your individual risk profile.
Absolutely — and this is actually the most common situation our patients are in. The symptom quiz is specifically designed to help figure that out. You don't need to arrive with a diagnosis. You just need to tell us what you're experiencing. Our clinicians will assess your symptoms, your cycle history, and your health background to identify where you are in the transition and what the right approach looks like for you.
Perimenopause requires a different approach than menopause — because hormones are still fluctuating rather than declining to a stable lower level. Treatment options include low-dose hormonal therapy to smooth out fluctuations, progesterone for sleep and mood, low-dose testosterone for energy and libido, and non-hormonal options for women who prefer them. The right treatment depends on your specific symptoms and health history, which is why the clinical assessment comes first.
Once your clinician prescribes, your medication is compounded and dispensed by a licensed pharmacy and shipped directly to you. By law, the medication label carries the compounding pharmacy's name — Vela is not the licensed compounder. Your packaging and patient experience are fully Vela-branded, but the medication itself will reference the pharmacy. Refills are automatic and your clinician stays available as your symptoms evolve.
Vela starts at $179 for your first month, which includes your clinical consultation and medication. Ongoing subscriptions vary depending on your treatment plan. We don't accept insurance currently, but HSA and FSA funds are accepted. Many patients find Vela significantly more accessible than trying to get specialist menopause care through traditional healthcare — which often involves long waits, multiple referrals, and providers who aren't trained in this area.
Wherever you are in the transition
Five minutes. Tell us what you're experiencing. A Vela clinician trained in the full hormonal transition will reach out within 24 hours.
Take the symptom quiz