Get Off One Stop Before Menopause. Not After You've Missed It.
Dr Anagha Karkhanis · Gynaecologist and Fertility Specialist · Cocoon × Dr Tvacha, Thane
Care for the years before your periods stop, when symptoms usually begin. A long consultation with a woman doctor, only the tests you need, and treatment adjusted to how you feel.
Told It's Just Your Age?
Let's Talk About What's Actually Happening
symptoms are symptoms. they deserve a doctor, not a shrug.
Sound Familiar?
These can start in your late 30s or 40s, often while periods are still regular. Many women never connect them to hormones.
Two Ideas. One Programme.
Dr Anagha's Perimenopause-First Method rests on two things most women are never told.
What The Health Check Includes.
- A long consultation, going through every symptom on your list.
- Only the tests you need: general bloods and, where indicated, bone density, ultrasound and a Pap smear, each explained.
- A written care plan: hormone therapy where suitable, non-hormonal options where not, plus sleep, nutrition and strength guidance.
- An honest conversation about hormone therapy and breast cancer, with your own risk reviewed.
- Options before surgery for heavy bleeding and fibroids, every medical option explained first.
- Bladder and comfort care, including pelvic floor guidance.
- Weight, hair and skin under one roof, with Dr Amit's team at the same centre.
- Reviews at three months, then yearly, with teleconsults for follow-ups.
The Fees, Written Down.
Made For You If…
- You are about 38 to 60 and something has changed.
- You were told "every woman goes through this".
- You were advised surgery and want every option first.
- You are booking for your mother.
Our Commitments.
- Every symptom on your list is discussed at the first visit.
- Every option is explained before any surgery is advised.
- A woman doctor and a female coordinator throughout.
- Review dates fixed from day one.
She Had The Hot Flushes Too.
Dr Anagha Karkhanis spent years managing hormones for women in fertility care. Then many of those same women came back in their 40s describing the same symptoms, and were being told to wait it out.
When she went through hot flushes herself, she understood what women deal with every day. So she built Cocoon × Dr Tvacha for it, under the same roof as Dr Tvacha Thane. It's not their fault, she says, and it's not something to just put up with.
Gynaecologist and Fertility Specialist · Reg. No. 2006/02/1187
Questions We Answer Every Day.
All women's health answers →Eating well in perimenopause: an Indian diet guide
In perimenopause, eat to protect muscle, bone and heart. In an Indian kitchen that means protein at every meal (dal, paneer, curd, eggs, soya, chana), calcium from milk,…
Women's HealthBone health after 40: osteoporosis risk and the DEXA scan
Estrogen protects bone, so when it falls around menopause, bone density can drop quickly. Osteoporosis gives no symptoms until a bone breaks, so I assess risk early. A…
Women's HealthWho should not take menopausal hormone therapy?
Hormone therapy is usually not advised if you have had breast cancer or another hormone-sensitive cancer, have unexplained vaginal bleeding, active liver disease, or are…
Women's HealthDo you need a hormone blood test to diagnose perimenopause?
Usually not, if you are over 45. NICE and the British Menopause Society say perimenopause and menopause are diagnosed from your symptoms and period pattern. Hormones…
Women's HealthWhat is perimenopause? Signs to look for in your 40s
Perimenopause is the transition before menopause, when the ovaries start working unevenly and estrogen and progesterone swing up and down. It usually begins in the 40s…
Women's HealthWhy women gain weight around the middle after 40
After 40, falling estrogen shifts where women store fat, from hips and thighs to the waist, while muscle slowly declines and burns fewer calories. Poor sleep and a busy…
Frequently Asked Questions
My periods are still regular. Can this be perimenopause?
Yes. Perimenopause can begin years before periods stop, and many women have regular cycles while symptoms like poor sleep, brain fog or irritability start.
My blood tests were normal. Why do I feel like this?
Hormone levels swing through the day in perimenopause, so one test can look normal. That is why care here is led by your symptoms, not a single number.
Does hormone therapy cause breast cancer?
The fear came from an older study that was widely misread. In November 2025 the US FDA began removing the boxed warnings from menopausal hormone therapy labels. It is still not right for everyone, so your personal risk is reviewed before anything is prescribed.
What if I can’t or don’t want to take hormones?
There are non-hormonal options for many symptoms, along with sleep, nutrition and strength guidance. Your plan is built around what suits you.
I was told I need a hysterectomy. Can you give a second opinion?
Yes. Every medical option for heavy bleeding and fibroids is explained first, before surgery is considered.
Which tests will I need?
Only the ones your history points to: general bloods and, where indicated, bone density, ultrasound and a Pap smear. Each test is explained, and charged at actual cost.
Can my husband or daughter come with me?
Yes. Family are welcome in the counselling, and many daughters book the Health Check for their mothers.
What are Dr Anagha’s consultation timings?
Monday to Saturday, 9:30 am to 12 pm and 1:30 to 3:40 pm. Saturday slots work well for working women and daughters booking for a parent.
Do I have to keep coming to Thane?
The first Health Check is in person. Follow-ups can be teleconsults, with a review at three months and then yearly.
Is everything kept private?
Yes. You see a woman doctor, bookings are handled by a female coordinator, and your records stay between you and your doctor.
(book the Midlife Women's Health Check, for yourself or for your mother. every item on the list gets discussed.)
Cocoon × Dr Tvacha · 2nd Floor, Suraj Arcade, Opp. Cosmos Bank, Gokhale Road, Thane (W) 400602 · 97685 56666
Mon to Sat, 9:30 am to 12 pm and 1:30 to 3:40 pm · Saturday slots available