Stage 1: Perimenopause

(The Transistion)

Timeline: Can begin 8-10 years before menopause; typically starts in 40s; averages 4-5 years but varies significantly

Key characteristics: Irregular periods, hormonal fluctuations (estrogen rises and falls unevenly)

Common symptoms:

• Hot flashes and night sweats

• Sleep disturbances

• Mood changes, anxiety, irritability

• Brain fog, forgetfulness

• Vaginal dryness

• Changes in libido

• Urinary incontinence

• Weight changes

Management options: Lifestyle strategies, hormone therapy, non-hormonal medications, symptom tracking

Important note: "Contraception may still be needed during perimenopause"

"Why shouldn't women consider replacing the hormones their bodies are missing, especially if their quality of life is miserable and they are good candidates for a safe experience?"

— Sara Gottfried, MD, "What Happens to Our Hormones After 35"

"Every Woman's journey is different. There's no 'right' way to experience this transition."

• Definition: Confirmed after 12 consecutive months without a menstrual period

• Average age: 45-55 years globally

• What to expect: Period has stopped permanently; many perimenopause symptoms continue but may stabilize

• When to see a doctor: Bleeding after menopause (requires evaluation), severe symptoms impacting quality of life

Stage 2: Menopause

(The Milestone)

"Too often, women's voices are dismissed in healthcare. Gaslighting happens when your questions or instincts are met with condescension instead of compassion. But here's the truth: your lived experience, your intuition, and your informed research are powerful. Trust them." ~Aviva Romm, MD

"Menopause is a natural biological process marking the permanent end of mestruation. most women experience it between ages 45-55."

• Timeline: Begins after menopause confirmation; continues for the rest of life

• Symptom progression: Many symptoms ease over time, but some persist for several years

• Health considerations:

  • Increased risk of osteoporosis (bone density loss)

  • Increased cardiovascular risk (due to lower estrogen)

  • Genitourinary syndrome of menopause affects 1/3 to 1/2 of women (vaginal dryness, urinary symptoms)

• Focus: Prevention, long-term wellness, managing ongoing symptoms

Stage 3: Postmenopause

(The Rest of Life)

"Every Woman's journey is different. There's no 'right' way to experience this transition."

Next Level MD combines 15+ years of clinical experience with cutting-edge functional medicine approaches to menopause management. Led by board-certified physician Dr. William Buchner, our practice takes a partnership-based approach to menopause care—empowering you with evidence-based information and personalized treatment options that fit your lifestyle and goals.

Whether you're navigating perimenopause symptoms, exploring hormone optimization during menopause, or managing long-term health in postmenopause, we're here to support your journey with modern, patient-centered medicine.

• Dr. Buchner's Area's of Expertise relavent to Menopause Care

  • Hormone Optimization: Directly addresses hormonal changes during menopause transition

  • Anti-Aging Medicine: Focuses on healthy aging and longevity after menopause

  • Environmental Illnesses: Addresses toxin exposure that may worsen menopausal symptoms

  • Peptide & Supplement Interventions: Non-traditional management options for symptom relief

  • Custom Compounded Medications: Personalized hormone therapy formulations...

Dr. William Buchner, MD

Board-Certified Family Medicine Physician

• Medical Degree: Wayne State University School of Medicine, Detroit, MI

• Residency: University of California San Diego (UCSD)

• Clinical Experience: 15+ years in primary care and functional medicine

• Licensure: Licensed to practice in South Dakota & Michigan

• Professional Memberships:

  • American Academy of Anti-Aging Medicine (A4M)

  • American Academy of Family Physicians

• Dr. Buchner regularly attends conferences nationwide in:

  • Functional Medicine

  • Hormone Therapies

  • Anti-Aging Medicine

  • Environmental Diseases

• This ensures we bring the latest innovative treatments to our patients.

Free Consult

Schedule a complimentary 15 minute virtual visit to see how we might help you

• Next Level MD offers:

  • Comprehensive hormone evaluation and optimization

  • Custom compounded medication preparation

  • Advanced laboratory testing and interpretation

  • Lifestyle and nutritional counseling

  • Telemedicine consultations for SD & MI residents

  • In-person visits at our Sioux Falls, SD location
    

This educational content reflects current clinical understanding of menopause stages, symptoms, and management options based on guidelines from The Menopause Society, ACOG, and WHO. Content is reviewed by Dr. William Buchner, MD, board-certified in Family Medicine and member of the American Academy of Anti-Aging Medicine.

Last Updated:[10/2026]

The information provided on this page is for educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website.

Treatment recommendations should be personalized based on your individual health history, symptoms, risk factors, and preferences. Not all therapies discussed may be appropriate for every patient.

Sources for the educational Content found above.

• American College of Obstetricians and Gynecologists (ACOG) — https://www.acog.org

• The North American Menopause Society — https://menopause.org

• Office on Women's Health (US Govt) — https://womenshealth.gov

• World Health Organization — Menopause Fact Sheet — https://who.int

• A4M Provider Directory (if applicable) — https://a4m.com

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Sioux falls, SD 57105

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