Perimenopause & Menopause Psychiatrist Serving Washington State
Psychiatrist-led care for mood, sleep, anxiety, and concentration changes during midlife.
Longer visits. Careful evaluation. Direct physician care.
Dr. Shirin Vartak, DOBoard-certified in Psychiatry and Child & Adolescent Psychiatry
When midlife feels unfamiliar
For some women, perimenopause brings emotional or cognitive changes that feel unfamiliar. Anxiety appears when you were never especially anxious before. Sleep changes. You feel more irritable or emotionally reactive. Concentrating at work becomes harder. Depression that had been stable for years returns.
Sometimes the change is subtle. Sometimes you simply know: I don't feel like myself.
Navia Psychiatry provides virtual psychiatric care for women throughout Washington State who are navigating mental health changes during perimenopause and menopause. Care is provided directly by Dr. Shirin Vartak, DO, a psychiatrist board-certified in Psychiatry and Child & Adolescent Psychiatry.
What we help with
Women seek care at Navia for concerns including:
- New or worsening depression during perimenopause or menopause
- New or increased anxiety
- Irritability and mood changes
- Emotional reactivity
- Sleep disruption affecting mental health
- Difficulty concentrating or feeling mentally sharp
- Questions about whether symptoms reflect ADHD, hormonal changes, anxiety, depression, sleep problems, or a combination
- The return of psychiatric symptoms that had previously been well controlled
- Reviewing psychiatric medications as symptoms and health needs change
- Second opinions when treatment does not seem to be addressing the full picture
For broader women's psychiatric care, visit our women's psychiatry page.
If pregnancy, postpartum, or planning for pregnancy is your primary concern, learn more about our perinatal and postpartum psychiatry services.
Why can mental health change during perimenopause?
Perimenopause can begin several years before the final menstrual period, and symptoms may start before someone recognizes that they are entering the menopausal transition.
Mental health symptoms during this period rarely have only one possible explanation. Hormonal changes may be part of the picture, but so can disrupted sleep, thyroid conditions, medication effects, physical health changes, work stress, caregiving responsibilities, relationship changes, previous psychiatric conditions, and other factors.
That is why Navia takes a broader approach. Rather than assuming every symptom is hormonal, or assuming hormones have nothing to do with it, Dr. Vartak takes a careful history and considers the different factors that may be contributing.
Brain fog, concentration, and ADHD questions
Difficulty concentrating is one of the more confusing concerns women may experience during midlife. You may find yourself forgetting words, losing track of tasks, struggling to organize your day, or wondering whether you have ADHD.
There can be several explanations for these symptoms, including sleep disruption, anxiety, depression, hormonal transition, medication effects, ADHD that was never previously recognized, or more than one factor at the same time.
A thoughtful psychiatric evaluation can help clarify what may be contributing before deciding how to treat it.
Treatment that fits the whole picture
Treatment is individualized. Depending on your symptoms and medical history, recommendations may include:
- Starting or adjusting psychiatric medication
- Reviewing whether a current medication is still serving you well
- Psychotherapy
- Sleep-focused strategies
- Lifestyle approaches that support mental health
- Coordination with your primary care physician or OB-GYN
- Suggested medical evaluation or laboratory testing to discuss with another physician
Navia's focus is psychiatric care. When hormone therapy is being considered, Dr. Vartak can collaborate with your OB-GYN or primary care physician so that your psychiatric and medical treatment plans complement one another.
Perimenopause and menopause psychiatric care across Washington
Navia provides secure virtual appointments to women throughout Washington State, including Seattle, Bellevue, Tacoma, Olympia, Spokane, Vancouver, and surrounding communities. You must be physically located in Washington at the time of your appointment.
Virtual care can make it easier to access thoughtful psychiatric treatment without adding another commute or waiting room to an already full schedule.
How care works
- 01
Start with a free fit consultation
Schedule a complimentary 15-minute consultation to discuss what you're experiencing and determine whether Navia may be the right fit. This is a brief conversation about fit, not a clinical evaluation or treatment.
- 02
Meet with Dr. Vartak
Your initial appointment is designed to understand not just what you are experiencing now, but what changed, when it changed, what you have already tried, and what else may be contributing. Most perimenopause and menopause concerns are best served by the 90-minute extended evaluation, though Dr. Vartak can advise during your fit consultation.
- 03
Develop a clear plan
Dr. Vartak will discuss her assessment and recommendations with you. Treatment may include medication, psychotherapy recommendations, coordination with another clinician, or suggestions for additional medical evaluation.
- 04
Continue care as needed
Follow-up visits are scheduled based on your symptoms, treatment plan, and progress.
Frequently asked questions
How do I know whether my symptoms are related to perimenopause?
There is not always a single test or symptom that answers that question. Perimenopause can begin years before menstrual periods stop completely, and changes in cycle patterns may occur alongside changes in sleep, mood, or anxiety. A psychiatric evaluation can help identify possible contributors and determine whether additional medical evaluation would be useful.
Can perimenopause cause anxiety even if I have never had anxiety before?
Some women report new or worsening anxiety during the menopausal transition. That does not automatically mean hormones are the only cause. Sleep, medical issues, medications, life circumstances, and underlying psychiatric conditions may also contribute. A careful evaluation can help put the symptoms in context.
Do you prescribe hormone replacement therapy?
Navia's focus is psychiatric care. Hormone therapy is typically managed by your OB-GYN, primary care physician, or another clinician experienced in menopausal care. When appropriate and with your permission, Dr. Vartak can coordinate with that clinician so your psychiatric and medical treatment plans work together.
Do you take insurance?
Navia is a private-pay practice. We provide a superbill after each visit that you may submit to your insurance company for possible out-of-network reimbursement. Reimbursement depends on your individual plan.
Dr. Shirin Vartak, DO
Dr. Vartak is board-certified in Psychiatry and Child & Adolescent Psychiatry.
She founded Navia Psychiatry to provide women and families with thoughtful, evidence-based psychiatric care, built around careful evaluation, longer visits, and a direct relationship with their psychiatrist.
Every Navia patient is seen directly by Dr. Vartak.
Meet Dr. VartakFees and logistics
| Service | Duration | Fee |
|---|---|---|
| Free fit consultation | 15 minutes | Complimentary |
| Initial psychiatric evaluation | 60 minutes | $700 |
| Extended initial evaluationReproductive or hormonal concerns | 90 minutes | $900 |
| Medication management follow-up | 25–30 minutes | $350 |
| Extended follow-up | 45–60 minutes | $575 |
Logistics
- InsurancePrivate pay; superbills provided
- AppointmentsSecure virtual visits
- LocationPatients must be located in Washington State during appointments
- PaymentDue at the time of service
- HSA/FSAAccepted
Start with a conversation
If changes in mood, anxiety, sleep, or concentration during midlife are affecting your quality of life, a psychiatric evaluation can help clarify what may be contributing and what treatment options are available. Begin with a complimentary fit consultation.
Thoughtful psychiatry for women and families.
Or call 425-598-0917