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WOMEN’S HEALTH

A newsletter from El Camino Women’s Medical Group

In this issue:

Practice Updates

Online Prenatal Classes

Why One Nostril Always Feels Blocked 

Small Nutrition Hacks, Big Fat-Loss Support

Painful Periods? It Could Be Endometriosis 

Thousands Deal with Severe Trauma Completely Unbeknownst to Them

Why Willpower Keeps Failing You

A new Class of Drugs Helping Women Manage Menopausal Symptoms

Insomnia – A Message From Your OB-GYN Care Team

El Camino Hospital Visitor Policy Updates

Highlights from our Women’s Health Blog

Practice Updates

Practice Updates

New! Meet Jasmine — 24/7 AI Lactation Support

We know that breastfeeding questions don’t follow a schedule — and for many of our patients, the middle of the night is exactly when they need help most. We also know that a lot of our families are navigating new parenthood without much nearby family support. That’s why we’ve added Jasmine, a voice-first AI lactation assistant available to our patients around the clock.

Jasmine is simple to use — just call 1-866-646-6201, speak naturally, and get immediate guidance. No app to download, no typing, no waiting for a callback. Her knowledge base is built on IBCLC clinical standards and has been tested and validated by registered nurses who specialize in lactation. She’s HIPAA compliant, and your conversations are encrypted and private.

She can help with questions like:

• How can I tell if my baby is getting enough milk?
• What are some tips for a more comfortable latch?
• How do I maintain my supply when I return to work?
• How should I safely store and warm expressed milk?

Pro tip: Save 1-866-646-6201 in your phone as “Jasmine – Lactation Support” now, so it’s ready when you need it.

A few important things to keep in mind: Jasmine is designed to provide evidence-based guidance on common breastfeeding questions — she is not a substitute for a clinical evaluation or diagnosis. During business hours, you can usually reach Nadia, our lactation educator, through the office. For more complex concerns, El Camino Hospital has internationally board-certified lactation consultants (IBCLCs) available for one-on-one support — both in the hospital and via telehealth — through their Breastfeeding and Postpartum Support program (Mountain View: 650-988-8290).

Wrap-Around Services for Pregnancy and Postpartum

We think of support during pregnancy and the postpartum period as extending well beyond your office visits. Here are the resources we offer or connect our patients with:

Lovu Health — A digital maternal health platform that supports women from pre-conception through two years postpartum, combining real-time health monitoring, personalized care navigation, and a curated marketplace of services — lactation support, mental health resources, prenatal care tools, and more. It helps share actionable data directly with our office and is designed to make care more coordinated and accessible.

Jasmine, 24/7 AI Lactation Support — Call 1-866-646-6201 any time for evidence-based answers to common breastfeeding questions, with Nadia and El Camino’s IBCLCs available for more complex needs. (See above for full details.)

Mariam AlAgha, Nutritionist — Mariam supports patients through pregnancy, postpartum recovery, and breastfeeding nutrition, as well as conditions like gestational diabetes and PCOS. Televisit appointments on Tuesdays, Wednesdays, and Thursdays; in-network with most insurance. To schedule, call, email, or message us through healow.

Mental Health Support — Dr. Rania Awaad and therapist Daniya Ahmed, LMFT are available for patients experiencing perinatal mood and anxiety disorders, postpartum depression, or other mental health concerns. Screening questionnaires are required; there may be a waitlist. Call, email, or message through healow to get started.

Wrap-Around Services for Women’s Health

Mederva Health — A personal health coaching program, covered by most insurance plans, that pairs you with a dedicated coach to help you reach your health goals between visits — whether that’s weight management, stress, perimenopause, sleep, or building habits that actually stick. All virtual, no extra trips to the office. Register here.

Mental Health Support — Dr. Rania Awaad and Daniya Ahmed, LMFT see patients for a broad range of mental health conditions, including anxiety, depression, and life transitions. Call, email, or message through healow to get started.

Mariam AlAgha, Nutritionist — Mariam works with women managing prediabetes, high cholesterol, PCOS, perimenopause and menopause, and general weight and nutrition goals. She holds a master’s in Human Nutrition from the University of Aberdeen and has over eight years of clinical experience. Televisit appointments Tuesdays, Wednesdays, and Thursdays; in-network with most insurance.

Online Prenatal and Women’s Health Classes

Prenatal Classes

We offer four virtual prenatal classes each month. These classes cover preparing for childbirth, breastfeeding, and newborn care.   These classes have been very popular, and we plan to have them every month.  They are also available to women who are interested in signing up, though we prioritize our patients.

Virtual Breastfeeding Class

This is a 2-hour class presented by Nadia, RN, our lactation educator.  The class is a virtual, in-depth review of breastfeeding.  Learn how to get the best start, avoid pain, make sure your baby is getting enough, and when to ask for help!

 Virtual Newborn Care & Safety Class

2.5-hour class presented by Nadia, RN

Practical tips for caring for a newborn

• Appearance of newborn
• Normal skin conditions
• bathing & diaper changing
• safe sleeping
• Newborn safety:
  • Car seat safety
  • Choking hazards
  • Poison control
  • Childproofing your home

Childbirth Preparation Part One

2.5-hour class presented by Nadia, RN:

• The last month of pregnancy
• Preparing for the hospital
• Laboring at home, when to call and when to come in
• Admission to the hospital
• Active labor
• Pain management

Childbirth Preparation Part Two

2.5-hour class presented by Nadia, RN:

• The last stage of labor: pushing
• Vaginal delivery
• Cesarean delivery
• Initial recovery in the hospital
• The postpartum period

You can learn more about these classes or register here.

Why One Nostril Always Feels Blocked (and Why That’s Actually Normal) 

By Katrina Chaung, M.D.
Board-certified Otolaryngology-Head and Neck Surgery
Camino Ear, Nose & Throat
(408) 227-6300

Ever feel like you can only breathe clearly through one side of your nose? Maybe your left nostril feels open while the right seems clogged, and then later, they switch. It might seem like the start of a cold or allergies, but in most cases, it is something completely normal: the nasal cycle.

The Nasal Cycle is a natural physiologic process where there is more airflow through one of your nostrils.  This then alternates sides every few hours. At any given time, one nostril does most of the work while the other takes a bit of a break. This happens because of subtle swelling and shrinking of tissue inside your nose, specifically the structures called turbinates, which help filter, warm, and humidify the air you breathe.

During the cycle, blood flow increases in one side of the nose, causing that nostril to feel more “blocked.” Meanwhile, the other side opens up and allows more airflow. After a few hours, the roles reverse. Most people don’t notice this shift unless they’re paying close attention—or if they already have some nasal irritation or blockage.  Structural issues such as a deviated nasal septum can accentuate this difference.  Conditions like allergies, colds, or sinus infections can exaggerate the feeling of blockage. Instead of a subtle shift, it may feel like one side is completely stuffed. 

There are also other factors that can temporarily affect which nostril feels open. For example, lying on your side often makes the lower nostril feel more congested due to gravity increasing blood flow to that side. Even stress and hormonal changes can influence nasal airflow.

So why does your body do this? Scientists believe the nasal cycle helps keep your nose healthy. By alternating airflow, each side gets time to recover from exposure to dust, allergens, and dry air. The “resting” nostril can focus more on clearing out mucus and trapping particles, while the open side handles most of the breathing.

In most cases, a shifting blocked nostril isn’t something to worry about but actually a sign that your body is functioning as it should. Staying hydrated, using a humidifier in dry environments, and avoiding irritants like smoke can help keep your nasal passages comfortable.

If, however, one nostril feels persistently blocked for days at a time, or you experience other symptoms like facial pain, thick nasal discharge, or frequent nosebleeds, an evaluation may be a good idea.

So the next time one side of your nose feels mysteriously clogged, don’t panic. Your body is just doing its job!

By Katrina Chaung, M.D.

Board-certified Otolaryngology-Head and Neck Surgery
Camino Ear, Nose & Throat
(408) 227-6300
https://www.caminoent.com

Small Nutrition Hacks, Big Fat-Loss Support 

By Mariam AlAgha
Master’s in Human Nutrition 
ElCamino Women’s Medical Group

Beyond the Calorie Deficit: Smart Nutrition Hacks for Sustainable Fat Loss

After working with women’s nutrition for more than a decade, one thing is clear: fat loss is not one-size-fits-all. Each woman has different metabolic needs, health history, body composition, and lifestyle factors. However, when a calorie deficit is already in place, certain evidence-informed strategies may help support the process, improve consistency, and protect overall health.

Start With Better Data

A DEXA scan can be a helpful tool because it measures body fat percentage, fat distribution, and lean muscle mass. This is important because the goal is not just weight loss, the goal is to reduce body fat while preserving muscle.

Calorie Deficit Matters, but Nourishment Comes First

Fat loss requires a calorie deficit, but the body still needs adequate nourishment. A strong plan should include enough protein, fiber-rich vegetables, balanced carbohydrates and healthy fats, hydration, movement, sleep support, and consistency.

Reducing added sugars and hidden sugars can also help improve blood sugar stability, reduce cravings, lower inflammatory burden, and make the calorie deficit easier to maintain. Check labels for ingredients such as high-fructose corn syrup, maltodextrin, dextrose, syrups, and other added sweeteners.

Build a Structured Plate

A balanced plate should include colorful anti-inflammatory vegetables, protein, controlled portions of carbohydrates, and healthy fats based on individual needs. Since needs vary, portion sizes should be personalized rather than copied from someone else’s plan.

One practical satiety strategy is starting meals with zucchini soup. It is high-volume, vegetable-based, and may help increase fullness before the meal. You can find the recipe here: Zucchini Soup Recipe.

Science-Informed Supports

These tools may support the process, but they are not magic fat burners. The foundation remains calorie deficit, protein intake, resistance training, sleep, and consistency.

1. Ceylon Cinnamon Tea

Ceylon cinnamon may support blood sugar control and insulin sensitivity, especially in individuals with insulin resistance, PCOS, or type 2 diabetes. It may also help with inflammation, cholesterol, and blood pressure, although evidence varies by outcome.

Ceylon cinnamon is preferred over cassia cinnamon because cassia contains more coumarin. It is important to note that Ceylon cinnamon is not a proven weight-loss aid; it is best viewed as a metabolic support tool if tolerated and not contraindicated.

2. CoQ10: Ubiquinol Form

CoQ10, especially the ubiquinol form, supports mitochondrial energy production and antioxidant protection. During fat loss, it may indirectly support energy, exercise tolerance, and metabolic health.

Human evidence does not show strong or consistent weight-loss effects, so CoQ10 should be viewed as a supportive supplement, not a fat-loss driver.

3. Dihydroberberine

Dihydroberberine may support glucose handling, insulin sensitivity, and fat-oxidation pathways. It is more bioavailable than regular berberine, meaning the body may absorb and circulate more active compound at lower doses.

For fat loss, it should be considered a support tool, not a guaranteed solution. It may be more useful for individuals with insulin resistance, fatty liver, or metabolic syndrome. Because it affects glucose metabolism, it may interact with diabetes medications or other glucose-lowering supplements, so medical guidance is important.

4. Protein Powder

Protein is important during fat loss because it supports fullness, muscle preservation, recovery, and metabolism. If you start your day with coffee, adding a scoop of protein powder can be a simple way to help meet your protein needs and improve satiety, which may indirectly help with appetite control.

Pea protein with monk fruit may work well for those who are vegan, lactose-sensitive, or looking for a lower-sugar option. Whey protein may be better for those who tolerate dairy and want a fast-digesting protein that supports muscle protein synthesis.

Choose based on your tolerance, goals, ingredient quality, and overall nutrition needs.

5. Vitamin D

Vitamin D should be checked through blood work first. If levels are low, the dose should be individualized based on lab results and clinical guidance. Adequate vitamin D supports overall health, bone health, immune function, and metabolic wellness.

6. Psyllium Husk Fiber

Psyllium husk may support fat loss indirectly by increasing fullness, slowing digestion, improving blood sugar response, supporting bowel regularity, and helping reduce overall calorie intake.

It forms a gel in the stomach and small intestine, which can improve satiety before meals. Evidence suggests psyllium may modestly reduce body weight, BMI, and waist circumference in people with overweight or obesity, especially when taken before meals in divided doses.

Best use: start with 1 teaspoon in 1 cup of water, followed by another cup of plain water. Use the whole husk form when possible, not capsules. Separate psyllium from medications and supplements because it may interfere with absorption, never exceed 2 tablespoons per day.

Optional satiety tip: add 1 teaspoon of psyllium husk to your cup of zucchini soup if tolerated.

Bottom Line

Fat loss is not about restriction or perfection. It is about creating a calorie deficit while protecting nourishment, muscle, blood sugar balance, and long-term health.

The most effective foundation includes structured meals, adequate protein, colorful anti-inflammatory vegetables, portion control, reduced added sugars, hydration, movement, sleep, and consistency. Supportive tools such as zucchini soup, Ceylon cinnamon tea, psyllium husk, protein powder, vitamin D correction, CoQ10, and dihydroberberine may help, but they work best when built on a strong nutrition foundation.

Wishing you a smooth and sustainable nutritional journey.

Yours in health,
Mariam AlAgha
Master’s in Human Nutrition 
ElCamino Women’s Medical Group

Painful Periods? It Could Be Endometriosis 

By Lee Christianson MD FACOG DipABLM
Minimally Invasive Gynecologic Surgeon
Lamorinda Gynecology & Surgery
Instagram/Facebook/TikTok: @thelifestylegyn

What Is Endometriosis? 

Endometriosis is a common condition that affects about 1 in 10 biologic females of reproductive age. It occurs when tissue similar to the lining of the uterus grows in other areas of the body, most often in abdominal cavity, specifically the pelvis. This tissue responds to hormonal changes during the menstrual cycles, causing inflammation and pain. 

Symptoms to Watch For

The hallmark symptom of endometriosis is pelvic pain, especially during your period. However, endometriosis can cause more than menstrual cramps.  Symptoms that warrant further evaluation for endometriosis include: 

• Period pain that worsens over time – mild craps that gradually become severe
• Pain during or after sexual intercourse 
• Pain with bowel movements or urination 
• Difficulty getting pregnant 
• Chronic pelvic pain that occurs even outside of your period 
• Fatigue, bloating or nausea timed with your menstrual cycle 

Many people assume that severe period pain is “normal.” While some discomfort during periods is common, pain that interferes with your daily life, keeps you home from work or school, or gets progressively worse is not something to ignore. 

Why Early Evaluation Matters

Symptoms often start in teenage years. On average, it takes 5 to 12 years from the onset of symptoms for endometriosis to be diagnosed. This delay can lead to worsening pain, reduced quality of life, and potential effects on fertility.  The good news is that doctors can now often make a diagnosis based on your symptoms, a physical exam, and an ultrasound.  Surgery is not always needed to start treatment.  

How Is It Treated? 

There are effective treatments available, and your doctor will work with you to find the best approach based on your symptoms and goals.  

Lifestyle changes include dietary changes to reduce inflammation, exercise, yoga, and stress reduction techniques. 

Hormonal medications such as birth control pills, hormonal IUDs, or other hormone-based therapies can reduce pain by suppressing the growth of endometriosis tissue. 

Surgery  may be recommended for ongoing symptoms not adequately managed with conservative measures, infertility, or if diagnosis remains unclear. Surgery is typically performed with a minimally invasive approach via laparoscopy.  Gynecologists specifically trained in endometriosis surgery can excise endometriosis to improve symptoms.    

Unfortunately, there is no cure for endometriosis. Endometriosis is a chronic condition, meaning it often requires ongoing management.  However, most people experience significant improvement in symptoms with the right treatment plan. 

When to See A Doctor

If you have painful periods that are getting worse, pelvic pain that affects your daily activities, or difficulty becoming pregnant, schedule a consultation with us for evaluation. Early evaluation and treatment of endometriosis can significant improve symptoms and quality of life. 

At Lamorinda Gynecology and Surgery, we have same week availability for in person and telemedicine consultations.  

Lee Christianson MD FACOG DipABLM
Minimally Invasive Gynecologic Surgeon
Lamorinda Gynecology & Surgery
Instagram/Facebook/TikTok: @thelifestylegyn

 At this very moment, there are thousands of people dealing with severe trauma, completely unbeknownst to them

As a psychotherapist, I feel compelled to alert families, and young immigrant couples in particular, to the peril of separating the child from the parents at a very young age. I refer to the practice of young immigrant parents sending their child, often under age 1, thousands and thousands of miles away to be raised by grandparents in another country for an extended length of time.
Working in the culturally diverse Bay Area, I have had opportunities to hear about, witness and deal with the long-term effects of this phenomenon. Sadly, it is not a decreasing trend. And my experience is that the parents often minimize and deny the inherent trauma of the separation.
I have observed this practice more often in communities and cultures that have traditional values associated with extended families and multiple mothering. Young immigrant families sometimes find themselves
overwhelmed by caring for their baby in a culture far from their own. By “far,” I mean distance both in terms of geography and of emotional and cultural difference.
The child is temporarily raised by grandparents or extended family while the young parents work and study toward a better quality of life — more time and money and the long-term interests of the family. In my experience, this separation happens more often in Asian, South Asian and Middle Eastern cultures.

In these cultures, almost everyone knows someone who has sent their child “back home” for a few
months to a year or two. As cozy as the phrase “back home” may be, the reality is that the child is very
far away, and the parents and child cannot be together for months at a time.
The parents do consider the physical safety of the child, the trustworthiness of the grandparents, the probability of the child being surrounded by a network of loving family members, the difficulty of trusting childcare here, and the parents’ own heartache. What they do not often account for is the break in the
attachment of the child — first from the parents, and then again from the grandparents.
The difficulty in making this decision may not leave room for the parents to carefully consider the emotional cost. Parents may be overwhelmed by immigration procedures, the separation from their own families, the task of raising children without the family network they depended on, and by financial pressure. They may be unable at the time to consider the emotional life of the child.
There is often contact during the separation by phone, by video conference or by brief visits. These visits further traumatize both parents and child.
Sometimes the mother realizes that the child does not remember her and leaves before the child reattaches to her. Sometimes the parents report that the child will refuse to talk to them on the phone. There have even been
instances in which the mother and child no longer have a language in common — the child forgets the mother tongue and adopts the language of the grandparents.
I consider these children twice disrupted in the attachment process and would expect them to have much in common with adopted children. A conscious awareness of all the factors involved may not change every individual decision, but more conscious awareness of the trauma for the child may lead to a more balanced decision.

Here is an article on a related topic in my Substack – I am at Chai&Clarity.

Why Willpower Keeps Failing You

Guest article from our partners at Mederva Health 
Ifrah Ali, MD
Emergency Medicine physician in Redwood City, California

A patient told me recently she had tried three diets in six months, joined a gym twice, and still could not get her blood pressure under control.
“I just don’t have the willpower,” she said.
I told her willpower was not the problem. The strategy was.

Why motivation runs out

Motivation is a spark — the rush of energy you feel after a doctor’s visit or a stressful moment. But it rises and falls with your sleep, your stress, your schedule.
When we try to overhaul everything at once, we are asking motivation to carry a weight it cannot hold. A birthday, a deadline, or a sick child is all it takes for the plan to collapse.
That is not a willpower failure. That is biology.

Habits do the work motivation can’t
Habit lives in a different part of the brain than decision-making. Once a behavior is repeated enough, it stops costing you energy.
You do not motivate yourself to brush your teeth — you just do it.
That is the goal: move the behavior from something you decide to do to something you just do.

One thing to try this week
Pick a habit so small it feels almost silly. Then attach it to something you already do.
• After you brush your teeth, stretch for 30 seconds.
• After you pour your morning coffee, drink one full glass of water.
• After lunch, walk for two minutes.
Don’t aim for intensity. Aim for consistency.
After two weeks, it stops feeling like effort.
After two months, it is just who you are.

Ifrah Ali, MD

El Camino Women’s Medical Group partners with Mederva Health to offer insurance-covered virtual health coaching for patients working on health goals such as blood pressure, blood sugar, weight, sleep, stress, anxiety or depression.

Learn more and sign up here or ask our team at your next visit.

 A New Class of Drugs Helping Women Manage Menopausal Symptoms—without Hormones

For decades, women experiencing debilitating hot flashes and night sweats had two choices: hormone therapy or suffering through it. That is no longer the case. Two newly FDA-approved, non-hormonal medications — Veozah and Lynkuet — are changing the way we care for women during one of life’s most significant transitions.

Insomnia – A Message from your OB-GYN Care Team

If you’ve been waking at 3 a.m. staring at the ceiling, lying awake with a racing mind, or dragging through your days on broken sleep — you are not alone, and you are not imagining it. Sleep disruption is one of the most common and underestimated symptoms of the menopausal transition, and it deserves real attention and real solutions.

Why Midlife Sleep Is Different

Sleep problems affect women across all ages, but they spike sharply during perimenopause and menopause. Research shows that up to 60% of postmenopausal women experience significant sleep disturbances — and perimenopausal women are actually the most affected of all, with more than half reporting less than 7 hours of sleep per night. That’s a striking number for a group that is often still in the thick of careers, parenting, and caregiving.

The causes are interconnected and layered. Vasomotor symptoms — hot flashes and night sweats — are the most obvious culprits, pulling women out of sleep with waves of heat and soaking sweats. But hormonal changes also directly affect the brain’s sleep architecture, reducing deep sleep and increasing nighttime arousals even in women who don’t experience prominent hot flashes. Mood changes, anxiety, and a busy, overactive mind at bedtime compound the problem further. For some women, this becomes a full cycle of insomnia — poor sleep worsens anxiety, anxiety worsens sleep, and the pattern entrenches itself over months and years.

The good news is that sleep disruption in midlife is treatable — and you have more options than ever before. Beyond hormone therapy and sleeping pills, three newer and lesser-known approaches deserve your attention.

1. Cognitive Behavioral Therapy for Insomnia (CBT-I): The Gold Standard You May Never Have Heard Of

If you haven’t heard of CBT-I, you’re not alone — but you should know that major health institutions including Johns Hopkins and the Cleveland Clinic recommend it as a first-line, evidence-based treatment for insomnia — including menopause-related insomnia.

CBT-I is a structured, short-term program — typically 4 to 6 sessions — that works by addressing the thoughts, behaviors, and habits that perpetuate insomnia. Unlike sleep medications, which manage symptoms while you take them, CBT-I teaches your brain and body to sleep differently. It works when hot flashes aren’t fully the cause of your insomnia, and it continues working long after the program ends.

Multiple randomized controlled trials have confirmed its effectiveness in menopausal women specifically. Studies show CBT-I reduces the time it takes to fall asleep, cuts the amount of time spent awake during the night, improves overall sleep efficiency, and importantly, also reduces daytime fatigue, mood disturbance, and work impairment. One landmark study found it outperformed both sleep hygiene education and medication-based approaches in achieving lasting remission.

CBT-I typically includes a combination of sleep restriction therapy (temporarily limiting time in bed to build sleep drive), stimulus control (retraining the brain to associate the bed with sleep only), cognitive restructuring (challenging anxious beliefs about sleep), relaxation techniques, and sleep hygiene education. It is available through therapists trained in behavioral sleep medicine, some OB-GYN and primary care offices, and increasingly through telehealth and digital platforms — making it more accessible than ever.

If you are lying awake at night and have never been offered CBT-I, ask your OB-GYN about a referral. It may be the single most impactful non-hormonal tool available for midlife sleep.

2. Noctera by Hello Bonafide: A Supplement Designed Specifically for Menopausal Sleep

Most sleep supplements on the market — think melatonin, valerian, or generic sleep gummies — were not designed with menopausal women in mind. Noctera, from the women’s health brand Hello Bonafide, is different. It is the first hormone-free sleep supplement formulated specifically to address the neurochemical disruptions that drive sleep problems during perimenopause and menopause.

Here is the science behind it: as estrogen declines, it disrupts the balance between GABA (a calming, inhibitory brain chemical) and glutamate (an excitatory one). This imbalance is a key driver of the frequent nocturnal awakenings and inability to fall back asleep that midlife women describe so commonly. Noctera’s formula is built around four ingredients chosen to address this specific mechanism:

• Magnesium glycinate — a highly bioavailable form of magnesium that helps block the excitatory signals keeping you awake and supports longer, more continuous sleep
• GABA — a calming neurotransmitter that activates natural sleep signals to quiet the mind and promote deeper rest
• L-theanine — an amino acid that blocks excitatory glutamate pathways, helping rebalance the sleep-wake cycle
• SAMe (S-adenosyl-L-methionine) — a naturally occurring compound that supports neurotransmitter balance; Noctera is the only sleep supplement specifically formulated for menopausal women to include it

Importantly, Noctera is not a sedative and contains no melatonin. It uses a continuous-release delivery system to provide support throughout the night rather than knocking you out at bedtime. It is intended for women who are waking during the night and struggling to fall back asleep — not primarily for those who have difficulty initiating sleep.

The product is backed by a randomized, double-blind, placebo-controlled clinical trial in perimenopausal and postmenopausal women. Trial data showed that 88% of participants with moderate-to-severe sleep disturbances moved to within-normal-limits sleep scores within three weeks, sleep duration increased by an average of 40 minutes, and 89% of women found it easier to fall back asleep after waking. The formula is hormone-free, non-GMO, and gluten-free, and is available directly through Bonafide’s website and on Amazon. It is worth noting that as a supplement, it is not FDA-approved in the same way a prescription drug is, and individual results will vary. As always, speak with your provider before adding any new supplement to your routine — especially if you are taking other medications.

3. Mederva Health Coaching: Personalized, Insurance-Covered Behavioral Support

Sometimes the missing ingredient in sleep improvement isn’t a supplement or a therapy — it’s accountability and personalized guidance between medical appointments. Mederva Health is an innovative platform that pairs patients with a dedicated health coach, combines their full medical history and wearable data, and builds a personalized protocol around the 2–3 highest-impact lifestyle changes for their specific health goals — including sleeping through the night.

What makes Mederva stand out is its integration with your existing healthcare. Rather than replacing your OB-GYN or primary care provider, Mederva works alongside them — pulling your health records, lab results, and behavioral data to identify the root causes of your sleep struggles, then building a structured daily plan with a human coach who checks in weekly. The methodology is grounded in Stanford’s Tiny Habits® behavioral science model, emphasizing small, sustainable changes rather than overwhelming overhauls.

For midlife women, this kind of between-visit support can be transformative. Your 15-minute annual appointment is simply not enough time to build the sleep hygiene habits, stress management routines, and nutrition adjustments that compound over weeks and months into meaningfully better rest. A dedicated coach who knows your history, tracks your progress, and adapts your plan as you improve fills a gap that the standard healthcare system often leaves open.

One of Mederva’s most notable features: it is covered by most commercial insurance plans, Medicare, and Medicaid — meaning there is often no out-of-pocket cost. If you are interested in exploring health coaching as part of your sleep support plan, ask your OB-GYN or primary care provider whether Mederva is available to you through your current insurance.

A Note on the Bigger Picture

Poor sleep in midlife is not just a quality-of-life issue. Cleveland Clinic and leading sleep researchers have linked chronic sleep disruption in women to increased risks of cardiovascular disease, cognitive decline, metabolic changes, depression, and reduced immune function. Sleep is not a luxury — it is a pillar of health that deserves the same urgency and clinical attention as blood pressure or bone density.

The approaches above are not mutually exclusive. CBT-I addresses the behavioral and cognitive patterns driving insomnia. Noctera addresses the neurochemical imbalance specific to hormonal sleep disruption. Mederva provides the accountability structure to turn intention into lasting change. Many women may benefit from a combination of these tools alongside — or as an alternative to — hormone therapy, depending on their individual history and preferences.

Bring It to Your Next Visit

If sleep is affecting your daily life, your mood, your work, or your relationships — please bring it up. Sleep disturbance is one of the most underreported symptoms we hear about, often because women normalize it as “just part of getting older.” It is not something you have to accept. At your next visit, we can discuss which of these options may be right for your situation, refer you for CBT-I, discuss whether Noctera is appropriate alongside your current regimen, and explore whether Mederva health coaching could support your goals.

You deserve good sleep. Let’s work together to get you there.

Sources & Further Reading

• Cleveland Clinic — Menopause Overview
• Cleveland Clinic — Vasomotor Symptoms: Hot Flashes and Night Sweats
• Cleveland Clinic — Nonhormone Therapies for Vasomotor Symptom Management
• Cleveland Clinic — Night Sweats and Hot Flashes at Night
• Johns Hopkins Medicine — Menopause Clinic
• Hello Bonafide — Noctera Sleep Supplement
• Mederva Health — Personalized Health Coaching Platform
• Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition. Nature and Science of Sleep. 2018.
• Kalmbach DA, et al. Treating chronic insomnia in postmenopausal women: CBT-I vs. SRT. Journal of Clinical Sleep Medicine. 2019.

El Camino Hospital Visitor Policy Updates

General information on visitors’ policy

Effective April 1, 2026

Please note: In accordance with Santa Clara County guidelines, healthcare workers are no longer required to wear a mask unless necessary for safe patient care. However, staff will have the option to wear a mask, and we will continue to make masks available to both staff and visitors.

Additionally, visitors must be in good health, free of any symptoms listed here, and must follow our Hospital Visitor Guidelines.

Highlights from our Women’s Health Blog

General Office Information