Kara Wilfong
Doctorate Prepared Advanced Registered Nurse Practitioner
Fleming IslandA doctorally-prepared nurse practitioner who spent a decade as an emergency room nurse before moving into aesthetics and wellness.
Menopause Treatment · Fleming Island, FL
Perimenopause and menopause, treated as one journey
Hot flashes, brain fog, disrupted sleep, weight shifts, and a fading libido are hormone symptoms, not something to push through. We map your stage, test past the reference range, and build a plan around how you feel.
Written by the Well Labs+ editorial team · Last updated July 2026
Treatment Overview
A symptom-first path through the transition
Perimenopause can begin years before a period actually stops, and the symptoms rarely arrive one at a time. Rather than reading a single lab value in isolation, we start with a comprehensive consultation that maps your hot flashes, sleep, mood, weight, and libido changes to where you are in the transition, and we treat you to an optimal level, not just a level that happens to fall inside a normal range.
For most patients, relief runs through bioidentical hormone therapy. We explain the mechanism and delivery choices on our BHRT page, part of our complete Hormone Replacement (HRT) program, and we will tell you honestly when a different plan will serve you better.
Common Symptoms
What perimenopause and menopause bring
Every patient’s symptoms show up differently. These are the ones we hear about most, and the ones a well-built plan can meaningfully change.
Hot flashes & sleep
The heat, the night sweats, the sleep that never quite lands. These are among the first perimenopause symptoms patients bring to us, and among the most responsive to a well-built plan.
Brain fog & mood
The forgetfulness, the shorter fuse, the sense of not feeling like yourself. Hormone shifts drive real cognitive and mood symptoms, not "just stress," and we take them seriously.
Weight & libido changes
Metabolism and drive both shift as estrogen and testosterone decline. We look at the whole picture, not one symptom in isolation, and connect you with our weight and hormone teams as needed.
Menopause symptoms often overlap with weight and intimate-wellness concerns; your provider connects you with our weight loss and women’s health teams where it fits your plan.
Fleming Island · Northeast Florida
Why Fleming Island trusts us with menopause care
Fleming Island’s mature, research-first community brings real, specific questions about the menopause transition, not vague complaints. We take hot flashes, brain fog, and sleep disruption seriously as hormone-driven symptoms, map your stage honestly, and build a plan around how you feel rather than pushing you toward a single hormone product.
Northeast Florida’s UV index climbs to extreme from spring through late summer, and sun exposure drives much of the collagen loss and visible aging we treat, so care here is as much about prevention as it is about correction.
The practice Fleming Island trusts for medical wellness, voted the area’s best medspa six years running. We serve from our Medical Spa on Island Lane.
Serving
- Fleming Island
- Orange Park
- Middleburg
- Green Cove Springs
- Jacksonville
- Clay County
The Pura Vida Approach
Your stage, your symptoms, your plan
Every menopause consultation runs roughly an hour to an hour and a half. We discuss your specific symptoms, set an honest expectation for the timeline ahead, and book every follow-up appointment before you leave, so you always know what comes next.
That is the difference between a generic prescription and care built around your stage, part of our full Hormone Replacement (HRT) program.
Is This For You?
Am I a Candidate?
A Good Fit If…
- you are noticing hot flashes, night sweats, or sleep disruption tied to a hormone shift
- you have brain fog, mood changes, or a fading drive you suspect are hormone-related, not "just stress"
- you want your symptoms mapped to your stage of perimenopause or menopause, not treated generically
- you are ready for a comprehensive consultation and ongoing follow-up, not a single visit
Let’s Talk First If…
- you have a personal or family history that needs review first, so we screen thoroughly before recommending BHRT
- you are hoping for a guaranteed timeline for symptom relief, which honest hormone care cannot promise
- you are looking for an anti-aging treatment rather than symptom management, which is not how we frame menopause care
- your primary concern is weight or intimate wellness specifically, where our dedicated programs may be the better starting point
If a different plan will serve your symptoms better, we will tell you honestly and point you toward it. Declining a treatment that will not serve you is part of how we work.
Ready to Start?
Sounds like your stage? Let’s map your plan.
Request an appointment and start with a comprehensive consultation that maps your symptoms to your stage, here in Fleming Island.
Our Process
What to expect at your visit
Mapping your symptoms to your stage
Perimenopause and menopause look different for every patient. Your first consultation, roughly an hour to an hour and a half, maps your specific symptoms, including hot flashes, sleep, mood, weight, and libido, to where you are in that transition.
Hormone testing, read against how you feel
We run a hormone panel, but we do not stop at the reference range. We treat you to an optimal level, not just a lab level, and every hormone we prescribe is bioidentical, never synthetic.
A plan built through BHRT
For most patients, symptom relief runs through bioidentical hormone therapy: pellet, cream, or injection, matched to your goals. We walk through the mechanism and delivery choices together.
Follow-up, not a one-time fix
Every follow-up appointment is booked before you leave your first visit. We track your progress by how you feel and by your labs, and adjust the plan as your symptoms change.
What Our Patients Are Saying
What Fleming Island patients say
4.9★ From 1,400+ verified Google reviews across both Fleming Island locations.
"I visited Pura Vida for hormone health support. Kara is so caring and informational to help you understand how your body works and what you are feeling… a holistic approach of treating from the inside out, down to the cellular and nutrient level, which I appreciate."
"I had my first appointment with Kara today and I have all the faith in the world that she will sort out my perimenopause issues. Look forward to the road ahead."
"We see Kara for BHRT and our overall better health. She is kind, knowledgeable, and relatable. The care we have received is life changing. She is a true professional."
Prefer to Talk First?
Questions about your stage? Call us.
Talk through your symptoms with our Fleming Island team before you schedule a consultation.
Proven Excellence
The most-reviewed medspa in Clay County
Menopause care is available at our Island Lane Medical Spa, serving Orange Park, Middleburg, and greater Jacksonville.
1,400+
Five-Star Reviews
More Google reviews than any other medspa in the region.
4.9★
Average Rating
Verified on Google across both Fleming Island locations.
2
Fleming Island Locations
Serving Clay County, Orange Park & greater Jacksonville.
Meet Your Care Team
A clinician-led hormone team
Nurse practitioners and physician assistants led by Kara Wilfong, DNP, APRN, FNP-C form your experienced care team, visit after visit.
Brittany Smith
MSN, APRN, FNP-C
Fleming IslandA certified Family Nurse Practitioner specializing in advanced aesthetic medicine, with six years in trauma and progressive care before aesthetics.
Emily Arnold
Physician Assistant-Certified
Fleming IslandA board-certified physician assistant specializing in aesthetic medicine, with a Master of Physician Assistant Studies from Augusta University.
Portrait coming soon
Brooke Taylor
Medical Assistant
Fleming IslandSupports the clinical team through every appointment so your provider can deliver attentive, unhurried care.
Patient Care Team
Scroll to meet the full team
Frequently Asked Questions
Menopause Treatment Questions, Answered
What are the signs I need hormone therapy for perimenopause or menopause?
The most common signs are hot flashes, night sweats, disrupted sleep, brain fog, mood swings, weight changes, and a lower sex drive, all tied to declining estrogen and progesterone as you move through perimenopause and menopause. These symptoms do not start at one universal age: some women notice changes in their early forties, others later. It is one of the most common transitions we treat in Fleming Island, where many patients are navigating this same stage in their late forties and fifties, and we map your specific symptoms to your stage at a comprehensive consultation rather than relying on one lab value.
What is the difference between perimenopause and menopause?
Perimenopause is the transition leading up to menopause, often lasting several years and marked by fluctuating hormones and symptoms like irregular cycles, hot flashes, and sleep disruption. Menopause is reached once a full year has passed without a period. Both stages can benefit from a supervised hormone plan, and we map your specific symptoms to where you are in that transition at your consultation.
Why am I gaining weight during menopause when nothing else has changed?
Declining estrogen shifts how your body stores fat and slows metabolism, so weight can change even without any change in habits. Hormone optimization addresses part of that picture; for patients who want a dedicated plan, we also offer a medical weight loss program alongside hormone care.
What is the downside to hormone therapy, and why do some doctors still hesitate to prescribe it?
Hormone therapy is not risk-free: common downsides include breast tenderness, spotting, and the need for ongoing lab monitoring, and it is not the right fit for every health history. Some doctors remain cautious because of an older study, the Women’s Health Initiative, that overstated risk for the general population in the early 2000s. Current research supports bioidentical hormone therapy as a safe, effective option for most healthy women when properly screened and monitored, which is why we review your health history thoroughly before recommending it.
Will hormone therapy make me look or feel younger than I am?
No, and we will not promise that. Hormone therapy for menopause supports how you feel through hot flashes, sleep, mood, and drive. It does not reverse aging. We describe what a well-built plan can honestly do, and nothing more.
Where can I get menopause and perimenopause hormone therapy near Fleming Island?
Pura Vida treats perimenopause and menopause at both of our Fleming Island locations, and we see patients from Orange Park, Middleburg, Green Cove Springs, and greater Jacksonville throughout Clay County. We have been voted the area’s best medspa six years running, so your hormone plan comes from a team Fleming Island already trusts for this exact transition.
What does menopause treatment cost?
Pricing and the exact hormones, dosing, and delivery method recommended for you are determined during your consultation, since every menopause plan is individualized to your symptoms and your labs.
Ready When You Are
Let’s map your stage and build your plan
Request an appointment and we’ll start with a comprehensive consultation, map your symptoms to your stage, and build a plan treated to an optimal level, not just a lab level.
Not ready to book? Send us a question instead.