WHAT WE TREAT

The hormonal piece, understood inside your full immune picture.

Corneva treats the perimenopause and hormonal transition happening inside a body already managing immune complexity - not the underlying conditions themselves.

You didn't arive here needing someone to explain your immune system to you. You arrived needing a physician who already understands it well enough to know what perimenopause does to a body managing immune complexity - and to focus on this piece with precision.

LET’S BE PRECISE ABOUT THIS

This is exactly what we do. And exactly what we don't.

Two fears bring women to this page. One: another provider who needs her whole history explained again. The other, quieter fear: a provider who blurs into territory her specialists already own. Corneva removes both. We manage the perimenopause and hormonal transition — practiced with fluency in your immune complexity. We do not diagnose or treat immune dysregulation, autoimmune disease, immunodeficiency, or any other underlying condition. Your specialists keep that work. We simply take the piece that has never had an owner.

WHAT CORNEVA MANAGES

Perimenopause and hormonal transition symptoms and staging

Hormone-related strategy, informed by your full immune picture

The interaction between hormonal fluctuation and mast cell activity

Ongoing hormonal monitoring and adjustment as your transition progresses

WHAT YOUR SPECIALISTS MANAGE

Diagnosis and treatment of mast cell disorders, autoimmunity, immunodeficiency

Immunodeficiency management and infusion or biologic therapy

Neuropathy workup and treatment, interstitial cystitis and pelvic pain management

Any condition-specific medication titration your specialists already own

CONDITIONS WE BUILD CARE AROUND

Your specific complexity changes how perimenopause should be managed. We start there.

Generic perimenopause guidance was never built with your immune profile in mind. The following are the conditions we most often see alongside the hormonal transition - and, for each, what changes during perimenopause that a physician fluent in both systems needs to be watching.

MAST CELL

Mast Cell Activation Syndrome (MCAS)

Mast cells express estrogen receptors, and estradiol can directly trigger mast cell degranulation and mediator release. As hormone levels fluctuate during perimenopause, mast cell activation thresholds may shift — potentially increasing flare frequency and severity. While the underlying biology is well-established in laboratory research, clinical studies specific to MCAS during perimenopause are still needed. This is an area where clinical observation is ahead of formal research.

We watch: hormonal timing of flares, and how a hormonal strategy can reduce the amplitude of those swings - in coordination with your MCAS treatment plan.

CONNECTIVE TISSUE

Hypermobile EDS & Connective Tissue Disorders

Estrogen influences collagen synthesis, cross-linking, and ligament stiffness. Research in women with hEDS has documented hormonal sensitivity across reproductive milestones — including puberty, the premenstrual phase, and postpartum. The unpredictable estrogen fluctuations of perimenopause may similarly affect joint stability, pain, and fatigue, though prospective studies during this specific transition are limited.

We watch: the hormonal contribution to joint and connective tissue symptoms, coordinating with your rheumatologist or physiatrist on timing and strategy.

AUTONOMIC

POTS & Dysautonomia

Autonomic regulation is sensitive to hormonal shifts, and women with POTS often report symptom fluctuations tied to their menstrual cycle — particularly during low-estrogen phases. The hormonal instability of perimenopause may transiently worsen orthostatic intolerance, heart rate variability, and fatigue. Notably, POTS is rare after menopause, suggesting that while the perimenopausal transition can be destabilizing, the longer-term trajectory for many patients may be one of improvement.

We watch: how hormonal instability is compounding autonomic symptoms, and where hormonal management can ease that burden alongside your cardiology or autonomic specialist.

AUTOIMMUNE

Autoimmune Conditions

Estrogen has significant immunomodulatory effects, but these effects are not uniformly anti-inflammatory — they are disease-specific and dose-dependent. For example, high estrogen states tend to improve Th1-mediated conditions like rheumatoid arthritis and multiple sclerosis, while potentially worsening B cell-mediated conditions like lupus. As estrogen levels become erratic and eventually decline during perimenopause, shifts in autoimmune disease activity are expected based on established immunology — though the direction of change depends on the specific condition.

We watch: the hormonal-immune interaction over time, communicating relevant changes to your rheumatologist or immunologist

IMMUNE

Immunodeficiency

The menopausal transition is associated with measurable changes in immune function, including increased inflammatory cytokines and reduced immune responsiveness. For women already managing primary or secondary immunodeficiency, these age- and hormone-related immune changes may compound existing vulnerabilities — though direct research in immunodeficient populations during perimenopause is lacking. Fatigue, infection susceptibility, and recovery time are areas that warrant clinical attention.

We watch: the hormonal contribution to fatigue and recovery, in coordination with your immunology team and any infusion or biologic schedule.

NEUROLOGICAL

Peripheral Neuropathy

Estrogen modulates pain signaling, nerve regeneration, and central pain processing. Postmenopausal women experience neuropathic pain significantly more frequently than men, and laboratory research shows that estrogen withdrawal worsens neuropathic pain while estrogen supplementation reduces it. Some women may notice neuropathic symptoms intensify or become less predictable as hormone levels fluctuate during perimenopause, consistent with these biological findings.

We watch: the hormonal correlation with symptom flares, coordinating with your neurologist on the broader picture.

PELVIC HEALTH

Interstitial Cystitis & Pelvic Pain Conditions

The lower urinary tract and pelvic tissues express estrogen receptors, and the symptoms of interstitial cystitis/bladder pain syndrome are known to fluctuate with the menstrual cycle — worsening during low-estrogen phases. The average age of symptom onset is approximately 45, coinciding with perimenopause. Both the fluctuation and the eventual decline of estrogen during this transition can intensify bladder and pelvic pain.

We watch: the genitourinary hormonal component specifically, coordinating with your urogynecologist or pelvic health specialist on overall strategy.

WHY THIS REQUIRES SOMEONE WHO UNDERSTANDS BOTH

The hormonal-immune connection is not a theory. It is physiology, and it is measurable.

This is the clinical reasoning behind why Corneva exists as a distinct specialty. Estrogen is not a reproductive hormone that happens to have side effects elsewhere — it acts directly on mast cells, collagen synthesis, autonomic regulation, immune modulation, neurotransmitter signaling, and genitourinary tissue. As estrogen fluctuates and declines through perimenopause, every one of those systems moves with it, because it is the same hormone acting on the same receptors already involved in your diagnosis. That is the mechanism a physician fluent in both immunology and hormonal medicine is trained to track — the thread connecting every condition on this page.

Treating the hormonal piece in isolation, without this picture, is treating half the problem.

YOU DON’T HAVE TO CHOOSE

You keep every specialist you already have.
We simply join the conversation.

You are never asked to choose between Corneva and your care team. You are adding the one piece your team was never structured to hold. If a symptom pattern looks like it belongs to your underlying condition rather than the hormonal transition, we say so directly and route you back to the specialist who owns that piece. That boundary is not a limitation of the practice. It is the practice functioning exactly as it should.

READY WHEN YOU ARE

You've read what we treat. Now find out exactly how care begins.

The next page walks through the full process, step by step - from your first consultation to your ongoing precision care plan, so there are no surprises before you book.