Today, women are talking about their health issues—online, in person with friends, and with their doctors. But some of the information you may be hearing could be outdated, confusing, or contradictory. In this Q&A, Candice Fraser, MD, MBA, an obstetrician-gynecologist with Mount Sinai’s Carolyn Rowan Center for Women’s Health and Wellness, gives you the latest, science-backed information about what you can do about your symptoms.

What are the symptoms of menopause?

Symptoms vary widely from person to person. Most people associate menopause with hot flashes and night sweats. Because menopause affects multiple systems in the body, symptoms can be far-ranging, and many people might not associate them with menopause. Symptoms can include:

• Difficulty sleeping (very common)
• Brain fog, such as difficulty focusing or finding words
• Mood changes, irritability, and anxiety
• Vaginal dryness and painful intercourse
• Joint pain, weight gain, muscle aches, and itchy skin (less commonly recognized as menopause symptoms)

Brain fog is one symptom that can be very distressing—especially for women who are at the peak of their careers. Struggling to find the words, or losing your train of thought in the middle of a presentation can be very upsetting.

Candice Fraser, MD, MBA

What treatments are available for menopause?

Menopause symptoms are influenced by many changes happening in midlife, including hormonal changes, aging, and changes in the nervous system. The body is complex, and that’s why treatment must be individualized. At the Carolyn Rowan Center for Women’s Health and Wellness, we take our time understanding every patient and their needs. We gather their medical history, their family medical history, and most importantly, we get an understanding of what they are feeling and experiencing. Symptoms might not be entirely hormonal, or they may be due to a combination of factors. Every patient’s care plan might be different.

Also, it’s important to know that these symptoms can occur during the menopause transition or perimenopause—the 5-10-year period before menopause. The following treatments apply to women in these transitional years, as well.

• Currently, hormone therapy is recommended for vasomotor symptoms (such as hot flashes and night sweats), genitourinary symptoms of menopause (including vaginal dryness and bladder changes), and for reducing osteoporosis risk. The formulation of hormone therapies has changed over the years to be safer. Hormone therapy includes estrogen, and progesterone in women who have a uterus to lower the risk of cancer.
• Different delivery methods that make estrogen safer include topical forms of a patch, gel, or spray. Oral formulations may be appropriate, but those have a slightly higher risk of cardiovascular effects including stroke and blood clots in the legs and lungs. There are vaginal formulations for local delivery.

Non-hormonal medications are available, including:

• Fezolinetant and elinzanetant treat hot flashes by regulating signaling paths in the brain that control body temperature.
• A class of medicines known as SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIS (Serotonin and Norepinephrine Reuptake Inhibitors). These include paroxetine, fluoxetine, venlafaxine and duloxetone), which can help with mood and anxiety symptoms as well as reduce hot flashes.
• Oxybutynin is a prescription medication typically used for incontinence but has good study data for hot flashes and night sweats, as well.

For the management of vaginal dryness, and discomfort, non-prescription therapies are available, including:

• Vaginal lubricants, which are used during sex, may be an effective option for some women.
• Vaginal moisturizers, used two to three times per week, can also provide lasting hydration and improve comfort.

If lubricants and moisturizers aren’t enough, low‑dose vaginal estrogen is a safe and effective option for most women, with minimal risk of side effects. Other vaginal and oral medications may also be prescribed for management of vaginal and urinary symptoms.

In some cases, laser therapies or pelvic floor physical therapy may also be appropriate after a thorough evaluation.

What lifestyle changes can help manage menopause and perimenopause symptoms?

Lifestyle changes can be powerful in managing, reducing, and even preventing certain symptoms. Regular exercise, a balanced diet (such as the Mediterranean diet), adequate sleep, stress reduction, and cutting back on or eliminating alcohol can make a significant difference in how women feel during menopause.

The good news is that there are a broad range of options to manage the symptoms of menopause, and working with a knowledgeable clinician is essential to developing an individualized plan.

Candice Fraser, MD, MBA

It used to be that previous generations of women had little support and few remedies to deal with menopause.

In this Q&A, Candice Fraser, MD, MBA, an obstetrician-gynecologist with Mount Sinai’s Carolyn Rowan Center for Women’s Health and Wellness, explains how menopause care has changed dramatically over recent years.

What has changed in menopause care and treatment?

When I was training as a resident, the school of thought was to avoid hormone therapy because of widespread concerns about increased risks of cancer, stroke, and even death. Until recently, menopausal hormone therapy came with “black box” warnings about the risks. But as more data has emerged, we understand that these risks apply only for certain subsets of women. At the end of 2025, the Food and Drug Administration (FDA) removed these broad black box warnings from hormonal treatments. Today, we evaluate each woman for her risk factors, and for most women, these treatments are safe.

Another factor is that women have become more vocal about the need for better menopause care. The interest among the medical community has grown in supporting women through midlife. Clinicians, eager to better meet the needs of their patients, are enrolling in specialized training programs and earning certification through professional organizations to provide high‑quality menopause care. Residency programs are also developing dedicated menopause curricula to ensure future clinicians are well-prepared.

In addition, more research is being conducted to clarify, challenge, or strengthen the data we currently have, and this will help physicians better counsel patients on treatment options and their associated risks. We also have a new class of FDA-approved non-hormonal medications to treat hot flashes. Today, we have better information, better training, and better care.

Hospital systems—including the Mount Sinai Health System—are creating centers specifically focused on caring for women in midlife. This shift reflects a broader move toward more holistic and comprehensive care. Rather than addressing only bothersome symptoms, we’re looking at the full picture: preventive care, risk reduction, and the management of medical conditions that often emerge or change during this stage of life.

What is new about the Rowan Women’s Health Center’s approach to treating menopause?

At the Carolyn Rowan Center for Women’s Health and Wellness, menopause care is an integrative approach designed to address the full spectrum of midlife health. We incorporate cardiometabolic health, bone health, nutrition, digestive health, and mental and psychological well-being, as well as gynecologic and hormonal health into our care plans. We are establishing what we call “pathways” for women in various stages of life, and MyPath Balance 40+ is the first of these. This pathway brings together multidisciplinary expertise under one roof, creating a structured six-month program. And all the visits are coordinated by the Rowan Center’s care navigators, so it takes the burden off the patient.

The first visit is scheduled for 60 minutes, allowing space for patients to discuss symptoms, review their medical history, and ask questions. It allows us to understand what patient are experiencing and what their needs are. We introduce them to our care model and why we’ve developed it this way. While the program is structured, it has the flexibility to be personalized to each individual patient. And we hope this model of care becomes the standard for women’s health care everywhere.

Growing up in Pakistan, Sameer Ahmed, MPH, learned early on about the direct relationship between air quality and respiratory health. He could see the smog, and he understood its connection to asthma. And, he wanted to know about the many other factors that also shape health outcomes. In the following Q&A, he explains why he became passionate about public health, and how the MPH program has given him the added tools to make a difference in the field.

What is your background?
My academic and professional interests have centered around community health, health equity, asthma prevention, environmental health, and addressing the social determinants of health. As part of the Applied Practice Experience (APE) requirement of the MPH program, I had the honor of serving for more than a year as the Project Manager for the New York City Asthma Network (NYCAN), a citywide coalition housed within the NYC Department of Health and Mental Hygiene’s Bureau of Harlem Neighborhood Health.

What first attracted you to this field?
My interest in public health and asthma work is deeply personal. I was born in and spent the first 18 years of my life in Pakistan, where air pollution and poor air quality are major public health concerns. In many cities, air quality index levels can become dangerously high, especially during the season when farmers burn wheat crop stubble, which significantly worsens smog and air pollution. During those periods, hospitals often experience extreme spikes in respiratory illness-related emergency department visits and hospitalizations.

Seeing the direct relationship between environmental conditions and respiratory health sparked my earliest interest in asthma and environmental health. Over time, that evolved into a broader passion for public health as I realized that many health outcomes are shaped not only by medicine, but also by housing, environment, policy, infrastructure, and systemic inequities. Public health appealed to me because it combines science, advocacy, systems-thinking, and community engagement to create meaningful change.

Who were your mentors?  
I’ve learned from incredible mentors throughout my time at Mount Sinai and the NYC Department of Health. Sire Sow, MD, a former Mount Sinai physician and now Clinical Director of Asthma Initiatives within the Bureau of Harlem Neighborhood Health, has been my preceptor and supervisor during my time as NYCAN’s project manager, and he played a major role in helping me grow professionally within asthma and community health work. I am also deeply influenced by Geoffrey (Cappy) Collins, MD, my professor and advisor across multiple MPH courses. They included Intro to Public Health, where I first learned foundational intervention models; Public Health Lab: How to Solve Problems in Public Health, where I learned how to design public health interventions and develop grant proposals, and Communitology, where we explored community-centered public health approaches. Dr. Collins fundamentally shaped the way I think about public health and continues to inspire me. His approach to addressing public health crises reinforced my belief that sustainable health improvement requires systems-level and community-centered solutions.

What are some of your research highlights?

One was my APE, leading and coordinating projects through NYCAN that were focused on asthma disparities, housing conditions, environmental health, and implementation of New York State’s Medicaid 1115 Health Equity Reform Waiver. My capstone project explored how NYCAN’s coalition infrastructure could help address housing-related asthma conditions in East Harlem by leveraging opportunities created through Social Care Networks and health-related social needs initiatives. I also helped coordinate citywide asthma education and outreach efforts, including NYCAN’s Annual World Asthma Day Resource Fairs, coalition-wide policy and advocacy initiatives, and collaborations with health care providers, community-based organizations, and government partners across New York City.

Why Mount Sinai—what, specifically, are the strong points of the MPH program?

One of the strongest is its deep connection to New York City communities and real-world public health practice. The program emphasizes applied learning and interdisciplinary collaboration, which gave me opportunities to directly engage with government agencies, health systems, and community-based organizations throughout my studies. What especially stood out was the accessibility and support of the faculty and program leadership. Faculty and program managers were always available to guide students, provide mentorship, and support both academic and professional growth. The relatively small class sizes also created opportunities for more personalized learning and meaningful one-on-one interactions with professors and classmates. Another unique strength is Mount Sinai’s New York City location at the intersection of the Upper East Side and East Harlem, a geographic proximity that allows students to directly observe and better understand the stark health and socioeconomic disparities that exist between these two communities. Studying public health while immersed in neighborhoods shaped by such complex histories of inequity, structural injustice, and resilience made the learning experience far more tangible and meaningful.

How else did you excel at Mount Sinai?

I focused heavily on applied leadership, coalition-building, and community engagement. Through my work with NYCAN and the NYC Department of Health, I coordinated meetings, projects, and events involving partners across health care, housing, advocacy, academia, government, and community sectors. I contributed to coalition infrastructure development, policy and advocacy initiatives, public health communications, and large-scale community outreach efforts focused on asthma education and health equity. These experiences helped strengthen my leadership, systems-thinking, and collaborative problem-solving skills while contributing to work that directly impacts New Yorkers. I also appreciated the opportunity to bridge classroom learning with practical public health implementation in real community settings.

What’s Next?
I am joining the Bronx Asthma Program within the Bureau of Bronx Neighborhood Health at the NYC Department of Health and Mental Hygiene as the Asthma Community Engagement Coordinator. I’m excited to continue working in asthma prevention, environmental health, and health equity. Long-term, I’d like to continue bridging public health practice, health care systems, policy, and community-based approaches to address chronic disease disparities and improve health outcomes in underserved communities and continue to grow as a public health professional and future health care provider.

Maggie So, MHA, has been steeped in the administrative side of health care for a long while, excelling at a variety of positions along the way. But, she was eager to learn more about the field and, importantly, improve her skills.

In the following Q&A, she explains how the Mount Sinai Master of Health Administration (MHA) program has helped her gain fresh perspectives about health care—knowledge that she is applying in her current job.

What is your background?
I graduated from Carnegie Mellon University in 2006 with a BA in humanities as a first- generation, American-born Chinese. Early on, I taught conversational English to Japan Self-Defense Force members, businessmen, airline stewards, housewives, and children. My journey in health care did not start until I came back to New York City and worked in administration for a Chinese health care facility in Brooklyn. I wore many hats. Eventually, a  provider there opened his own practice and I became a business liaison and later worked at the front desk as a medical assistant, then office manager. I left for a position at The Mount Sinai Hospital, where I worked as an administrative assistant for nearly two years for a pediatric orthopedic surgeon. I now work at Hospital for Special Surgery (HSS) as an office manager.

What first attracted you to this field?
I have always wanted to help people and felt at home whenever I was in a hospital setting. I want to advocate for those who cannot advocate for themselves. I believe in always treating people the way I would like me, my daughter, and my family to be treated, no matter one’s race, ethnicity, or gender.

Who were your mentors and what are some of your accomplishments in the program?
Through the Graduate School I was introduced to my mentor Zachary Almer, MPA, who, as a consultant, helped develop and launch the MHA Mentorship Program for first-year MHA students. His guidance helped me tremendously, starting with resume writing, but more significantly, with picturing what, exactly, I wanted from a career, and how I could apply my new skills. Matt Baney, MS, Senior Director of the Institute for Advanced Medicine  and faculty in the Icahn School of Medicine at Mount Sinai’s Department of Public Health, had a class in Organizational Behavior and Human Resources that helped me to see management in a different perspective and to understand there are different work cultures. I learned my management style through the DiSC: Finding Your Teamwork Style class. It was eye-opening. I saw how true it is that no one has just one style, and I was taught how to be mindful of the style of others.

Why Mount Sinai—what, specifically, are the strong points of this program?
From the beginning, my tour of the school with program leadership made me feel so comfortable. First—and significantly—they understood the constraints I had and the flexibility I needed as a full-time employee, full-time single mom, and now as a student. However, what really drew me was the quality of the faculty and the program courses, such as Introduction to Health Care Policy with Ashley Fox, PhD, and Population Health and Managed Care (Arthur Gianelli MA, MBA, MPH), which  taught me to create an innovation that can actually make a difference. I also liked the class on Quality Management for Health Care with Michael Pugh, MPH.  And, through this course, I have already applied one lesson I learned after earning my Certificate of Quality and Safety from the Institute for Health Care. I no longer ask patients “What is the matter with you?” I now ask “What is it that matters to you?”

What else have you learned along the way?
As a trained and working administrative assistant, I believe I am able to introduce efficiency and optimize workflow while delivering accurate executions of daily duties. I think what I excel at most is the amount of care and positive attitude I have toward patients. Working in pediatric orthopedics, we manage nervous and scared parents who come to us for not only medical care for their child, but also to have us relieve a lot of their own anxiety and stress they may be feeling. I have firsthand experience with how scary things can be when something happens to your child. The program helped me to become more patient and be a better listener.

What’s Next?
I currently work at HSS and I plan to explore moving to the patience experience and service excellence department. I want every patient and family to have the best experience while receiving care.

After earning a Data Science and Mathematics degree at New York University in 2024, Zirui (Frank) Feng, MDSAI, enrolled in Mount Sinai’s Master of Science in Biomedical Data Science and AI program. In the following Q&A, Mr. Feng discusses the experiences that shaped him and how he excelled.

What is your background?

I grew up in Hunan province, China. The COVID-19 pandemic shaped my early college years in a very personal way: I completed my freshman year remotely from home while watching how scientists fight with the rapidly evolving virus. I gained strong training in quantitative modeling, programming, machine learning, and large-scale data analysis. I later joined the laboratory of Yi Shi, PhD, at Mount Sinai as a part-time research assistant and began the Master of Science in Biomedical Data Science and AI program, where I found a way to connect my computational background with real biomedical discovery.

What first attracted you to this field?

My field is AI-guided antibody and protein design, which combines immunology, structural biology, machine learning, and computational modeling to design better therapeutic molecules. I was first attracted to this field because antibodies are one of the most powerful modalities in medicine, and AI creates new opportunities to understand and engineer them at a larger and faster scale. The COVID-19 pandemic made this interest feel urgent to me. I saw how quickly new viral variants could emerge, and I became interested in how AI could help rapidly design therapeutics against future pandemics. By modeling antibody–antigen interactions, exploring large sequence and structure spaces, and prioritizing promising candidates for experimental testing, AI can make therapeutic discovery more scalable and responsive. This is what drew me toward computational structural biology, nanobody discovery, and AI-guided therapeutic design.

Who were your mentors in the master program, and what are some of your research highlights?

Under Dr. Shi’s guidance, one of my major research highlights was leading the first-author study “One Thousand SARS-CoV-2 Antibody Structures Reveal Convergent Binding and Near-Universal Immune Escape,” published in Cell Systems in 2026. In this work, I analyzed more than 1,000 SARS-CoV-2 antibody structures and identified broad antigenicity across the receptor-binding domain, distinct binding strategies between IgGs and nanobodies, and near-universal immune escape by advanced Omicron variants.

I also contributed to “Repertoire-scale antibody structural prediction informs therapeutic design,” published in 2026 in Science Advances, which presents AF3-TurboAb, a high-throughput AlphaFold 3-based framework for repertoire-scale antibody–antigen structural prediction and therapeutic antibody design. Together, these accomplishments reflect my growth as a computational biomedical scientist and were recognized with the 2026 Commencement Award for Scientific Excellence in Biomedical Data Science at Mount Sinai.

Why Mount Sinai—what, specifically, are the strong points of this master program?

Mount Sinai was the right place for me because it combines biomedical research, quantitative training, translational science, and strong mentorship. The master’s program allowed me to learn computational and AI methods while applying them directly to real biological problems through highly accessible research resources. What I value most about the program is its supportive environment and flexibility. The curriculum gives students room to personalize their study track, choose courses that fit their goals, and shape their training around their own scientific direction. At the same time, the program offers abundant opportunities to rotate in different laboratories and gain research experience across multiple areas of biomedicine. This flexibility allowed me to build a path that connected data science, structural biology, immunology, and therapeutic design, while also helping me explore the broader biomedical research environment.

How else did you excel at Mount Sinai?

I grew as a scientific communicator. I presented my antibody research three times in the Department of Pharmacological Sciences: first as a poster at the 2024 Annual Research Retreat, then as an oral presentation in the Work in Progress Discussion Series, and later as an oral presentation at the 2025 Annual Research Retreat. These experiences trained me to explain complex computational and structural biology projects clearly and to receive feedback from an interdisciplinary audience. Beyond Mount Sinai, I also explored how biomedical AI is applied in industry through internships at New York Stem Cell Foundation (NYSCF) and Regeneron Pharmaceuticals. At NYSCF, I worked on machine-learning-based contamination detection for cell-culture plates, and at Regeneron, I developed an AI system for scientific document search. These experiences helped me understand how industry teams organize research, build practical solutions, and translate computational methods into real biomedical workflows.

What’s Next?

I will continue my training in the PhD in Biomedical Sciences program at Mount Sinai, focusing on computational structural biology, antibody engineering, and AI-guided protein design. My goal is to understand the key principles behind effective therapeutic molecules and use them to design better treatments. Long term, I hope to become a biotech entrepreneur and help translate computational protein design into real therapeutic platforms. The master’s program at Mount Sinai helped me move from data science into biomedical discovery, and the next step for me is to become an independent scientist who can build technologies that turn molecular insight into medicines.