Menopause & Hormone Therapy in Salt Lake City
Hot flashes, disrupted sleep, mood changes, and new bladder symptoms are among the most common concerns of perimenopause and menopause. They are also treatable. Dr. Ferlic evaluates each symptom individually and builds a treatment plan around your history and your goals.
Elisabeth Ferlic, MD
Board-certified urologist · Fellowship-trained in voiding dysfunction and female pelvic medicine
Common symptoms of perimenopause and menopause
Perimenopause and menopause look different from one woman to the next. Some women have years of hot flashes. Others have none, and instead struggle with sleep, low libido, or new urinary symptoms. These problems trace back to the same hormonal change, and they are treatable.
You do not need to wait until symptoms become severe to make an appointment. If they are affecting your daily life, they are worth treating.
Whole-body symptoms
- Hot flashes & night sweats
the most recognized symptoms, and for many women the most disruptive. Hormone therapy remains the most effective treatment available for them.
- Sleep problems
trouble falling asleep, frequent waking during the night, or sleep that no longer feels restful.
- Mood changes
irritability, anxiety, or a low mood that is new for you. Hormonal changes are a recognized cause and can be treated directly.
Intimacy and bladder symptoms
- Low libido
a decline in sexual desire that concerns you or affects your relationship.
- Painful intimacy
dryness or discomfort with sex caused by thinning vaginal tissue (vaginal atrophy). This is among the most treatable symptoms on this list.
- Urinary symptoms of menopause
new leaking, urgency, waking at night to urinate, or recurrent urinary tract infections after estrogen declines. These symptoms are the particular focus of a urologist-led practice.
Menopause changes your bladder, too
Estrogen does more than regulate the menstrual cycle. It keeps the tissues of the bladder, urethra, and pelvic floor thick, elastic, and well-supplied with blood. When estrogen falls at menopause, those tissues thin. Many women then develop symptoms they were never warned about: leaking that was not there before, sudden urgency, waking at night to urinate, urinary tract infections that keep returning, and dryness or pain with intimacy. This cluster of symptoms has a medical name, genitourinary syndrome of menopause, and it is frequently underdiagnosed. Many women are never told that their urinary symptoms and their menopause are related.
A urologist may not be the first physician who comes to mind when you look for a menopause specialist, but the connection is direct. Dr. Ferlic is a board-certified urologist, fellowship-trained in voiding dysfunction and female pelvic medicine, one of only two in Utah with that training. She has spent her career treating the organs menopause affects most. Her hormone practice grew out of that work: again and again, she saw women whose bladder symptoms and menopause symptoms were the same condition, divided between two offices or treated by no one.
That training changes what treatment looks like. Low-dose vaginal estrogen, for example, is one of the most effective treatments for the urinary and vaginal symptoms of menopause, yet it is often missing from plans written by clinics focused only on hot flashes. In this practice, your hormones and the organs they affect are evaluated together. If your bladder symptoms need more than hormones, the same physician provides that care as well.
About Elisabeth Ferlic, MD
Elisabeth Ferlic, MD, is a board-certified urologist, fellowship-trained in voiding dysfunction and female pelvic medicine. She treats women and men across the Salt Lake Valley.
What are my options?
A starting point for the conversation, not a prescription. Your evaluation decides what fits.
Hot flashes, night sweats, or poor sleep
Whole-body symptoms of perimenopause and menopause
Systemic hormone therapy
Pills, patches, or gels that treat whole-body symptoms
Dryness, painful sex, or bladder symptoms
Tissue changes after estrogen declines
Low-dose vaginal estrogen
Works locally, with very little absorption into the rest of the body
Hormones aren't right for you
Because of your health history or your own preference
Non-hormonal options
Non-hormonal medications and treatments, worth discussing
Bladder symptoms that need more
When hormones alone don't resolve them
Bladder care from the same physician
Dr. Ferlic treats the bladder as well as the hormones
What hormone therapy involves
Hormone replacement therapy for women means replacing some of the estrogen, and usually progesterone, that the body stops producing at menopause. Prescribed carefully, it is the most effective treatment available for hot flashes and night sweats, and it also addresses the sleep, vaginal, and urinary changes that accompany them.
You may have heard of bioidentical hormone therapy, which uses hormones chemically identical to the ones your body produces. It is among the options Dr. Ferlic prescribes. More important than the label is the fit between the hormone, the dose, the delivery method, and your health history.
The delivery method matters. Systemic options (pills, patches, gels) treat whole-body symptoms such as hot flashes and poor sleep. Low-dose vaginal estrogen works locally, treating dryness, painful sex, and urinary symptoms with very little absorption into the rest of the body. Many women do well with one; some need both. If hormone therapy is not appropriate for you, because of your history or your own preference, non-hormonal medications and treatments are available and worth discussing.
A thorough conversation first: your symptoms, your health history, and what you want to change Options explained in plain language: pills, patches, creams, vaginal estrogen, and non-hormonal alternatives A plan built for your body: including the bladder and pelvic symptoms many hormone clinics overlook Follow-up visits: the dose and delivery method are adjusted over time until the plan is working
| Systemic hormone therapy | Low-dose vaginal estrogen | Non-hormonal options | |
|---|---|---|---|
| How it's given | Pills, patches, or gels | Low-dose estrogen that works locally | Medications and treatments that don't use hormones |
| Often chosen for | Whole-body symptoms such as hot flashes and poor sleep | Dryness, painful sex, and urinary symptoms | When hormone therapy isn't appropriate, because of your history or your preference |
| Good to know | The most effective treatment available for hot flashes and night sweats | One of the most effective treatments for the urinary and vaginal symptoms of menopause | Available and worth discussing if hormones aren't the right fit |
Systemic hormone therapy
- How it's given
- Pills, patches, or gels
- Often chosen for
- Whole-body symptoms such as hot flashes and poor sleep
- Good to know
- The most effective treatment available for hot flashes and night sweats
Low-dose vaginal estrogen
- How it's given
- Low-dose estrogen that works locally
- Often chosen for
- Dryness, painful sex, and urinary symptoms
- Good to know
- One of the most effective treatments for the urinary and vaginal symptoms of menopause
Non-hormonal options
- How it's given
- Medications and treatments that don't use hormones
- Often chosen for
- When hormone therapy isn't appropriate, because of your history or your preference
- Good to know
- Available and worth discussing if hormones aren't the right fit
Ask about visit costs
Contact the practice to ask about visit costs, billing, and scheduling.
No referral required — come directly; no gatekeeping between you and care
Benefits and risks, side by side
Every treatment has trade-offs. Your history and your goals decide which ones matter most.
What treatment can address
- Hot flashes and night sweats
- Trouble sleeping and mood changes
- Dryness or discomfort with sex
- New leaking, urgency, or repeat UTIs after estrogen declines
What to weigh first
- Your personal and family health history
- The type, dose, and timing of the hormones
- Your own preference about using hormones
- Follow-up visits adjust the dose and delivery method over time
What happens at the first visit?
The visit starts with what has changed and what you want help with. Any treatment and follow-up plan is specific to you.
Talk through your symptoms
Bring your concerns, medication list, and relevant medical history.
Decide what needs checking
Testing depends on your symptoms and history, and some concerns need a separate workup.
Discuss a plan and follow-up
Review benefits, risks, alternatives, and what to watch for.
Before you schedule
Ask which appointments are available and whether your concern suits a video visit or needs an in-person evaluation.
Here’s what our great patients say
Is HRT safe?
For many women, yes, although the answer depends on your individual health history. Current evidence shows that for most healthy women who start hormone therapy within about ten years of menopause, the benefits for symptoms and quality of life generally outweigh the risks. Your personal and family history (breast cancer, blood clots, stroke, heart disease) affects that balance, as do the type, dose, and timing of the hormones used. Dr. Ferlic reviews your history with you and helps you decide whether hormone therapy, or a non-hormonal alternative, is appropriate in your case.
Is this bioidentical hormone therapy?
Bioidentical hormones, which are chemically identical to the ones your body produces, are among the options Dr. Ferlic prescribes when they are the right fit. She will explain the differences between formulations in plain language and match the hormone, dose, and delivery method to your symptoms and history.
Can hormone therapy help with bladder leaks or repeat UTIs?
Often, yes. Estrogen loss thins the tissues of the bladder and urethra, which contributes to leaking, urgency, more frequent urination, and recurrent urinary tract infections after menopause. Low-dose vaginal estrogen treats those tissues directly and is one of the most effective treatments for these symptoms. If your bladder symptoms need more than hormone therapy, Dr. Ferlic provides that care as well; it is the focus of her fellowship training.
Do I need labs before starting?
Sometimes, but not always. Menopause is usually diagnosed from symptoms and history rather than a blood test. Labs help in specific situations: symptoms that start unusually early, an unclear clinical picture, or ruling out conditions with similar symptoms, such as thyroid disease. If labs would add useful information in your case, Dr. Ferlic will tell you which ones and why.
Is this a virtual visit?
Contact the practice to ask which visit types are available and when in-person appointments and procedures can be scheduled. Ask whether your concern suits a video visit or needs an in-person evaluation.
How do I know if I'm a candidate?
If you are in perimenopause or menopause and your symptoms are affecting your sleep, mood, intimacy, bladder function, or daily comfort, an evaluation is reasonable. At the first visit, Dr. Ferlic reviews your history, discusses your goals, and tells you plainly whether hormone therapy makes sense or whether another approach fits better. There is no obligation to start treatment, and no referral is needed to be seen.
Our team is ready to help you
Serving the Salt Lake Valley.