pause & pivot

Capacity, not chaos.
Tools for the transition through perimenopause and beyond.

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You’re not unraveling. You’re realigning.

In your early to mid‑40s, you’ve mastered the art of achievement. You’ve built teams, led strategy, broken barriers. Focus, ambition, and resilience aren’t just strengths — they’re second nature. Then, without warning, your body rewrites the rules.

Sleepless nights. Mental fog. A shorter fuse. A quiet but relentless shift — with no roadmap. Culture calls it decline. We see it differently: you’re not fading. You’re evolving.

Pause & Pivot is built for high‑achieving women navigating the seismic transition of perimenopause and menopause — without losing momentum, identity, or edge.

What Makes This Different

We are doctoral‑level clinical psychologists with 15+ years of expertise supporting high performers through our parent practice, Azimuth Psychological.

Pause & Pivot is evidence‑driven therapy built for women who think in strategy and act with intention.

Two women in conversation at an art gallery

Here's what you'll find:

One-to-One Therapy

Private-pay, confidential sessions under the Azimuth Psychological umbrella, tailored to professional women in midlife transitions.

Science-backed Practices

Curated, research-driven practices that reveal how menopause reshapes identity, ambition, and connection.

Concierge Physician Access

Priority access to physicians specializing in women's health and the full spectrum of menopause-related care.

Vetted Products & Tools

A handpicked list of research-backed products, tools, and supplements to support every stage of this transition.

Private Newsletter

A thoughtful, strategic guide to navigating career, relationships, and identity in midlife — rooted in results, not trends.

This isn’t the end of your story.
It’s an inflection point.

Menopause and perimenopause don't erase your ambition, intelligence, or worth. It's a moment to reassess, recalibrate, and decide — deliberately — what comes next.

We'll help you:

  • Quiet the anxiety that undermines your focus
  • See past the cultural noise about "aging"
  • Return to clarity, strength, and a sense of self you trust
  • Approach this phase with evidence‑based clarity

"Still You. Sharpened."

Specialized support for women who lead remarkable lives

Headshot of Madhabi Mistry

Dr. Madhabi Mistry

Clinical Psychologist

I'm deeply engaged in understanding the emotional, cognitive, and physical shifts women experience throughout perimenopause and postmenopause. These natural hormonal transitions need not threaten the lives women have so intentionally built.

Increasingly, research is giving us the tools to better understand these changes — to mitigate some, adapt to others, and move through this phase with clarity and strength.

It's a privilege to work alongside clients during this pivotal time, sharing evidence‑based insight and helping them define what they want from this next chapter — one that holds the potential to be just as purposeful, and perhaps even more fulfilling, than the last.


Headshot of Dr. Jacqueline Alfonso Barry

Dr. Jacqueline Alfonso Barry

Clinical Psychologist

I'm a bicultural and bilingual (English/Spanish) psychologist specializing in high-stress populations—including professionals, entrepreneurs, and those navigating life transitions to address issues such as anxiety, identity, relationship challenges, and stress-related concerns, with a focus on helping clients live in alignment with their values.

My experience working with highly successful women has also ignited a passion for helping them navigate the uniquely demanding, often overlooked, and inevitable phase of perimenopause and menopause to provide support through the shifts in identity, mood, and relationships with clarity and compassion.

Grounded in evidence-based practices, I draw on Motivational Interviewing (MI) and Emotionally Focused Therapy (EFCT, EFIT) to support meaningful, lasting change, and clients describe me as warm, open, and easy to connect with. I aim to create a space where you can be fully yourself—and where real progress feels, and is possible.


Headshot of Janna Koretz

Dr. Janna Koretz

Clinical Psychologist

Menopause doesn't have to derail the life you've built. Smart, accomplished women often find themselves struggling with changes that feel overwhelming — but the solutions are usually more straightforward than they seem. The challenge isn't the symptoms themselves; it's navigating how menopause intersects with your relationships, your work, and your sense of self.

I help high‑achieving women map out what's really happening during this transition and create clear strategies that work. Whether it's managing brain fog in important meetings, communicating your needs to partners who don't understand, or maintaining your professional reputation while your body feels unpredictable — these aren't unsolvable puzzles.

As someone who thinks differently and works relentlessly, I understand women who refuse to let menopause dim their ambition. Together, we find practical paths forward that honor both who you've always been and who you're becoming.


Headshot of Dr. Nicholas Kolasinski

Dr. Nicholas Kolasinski

Clinical Psychologist

I deeply enjoy working with individuals during times of transition, when life feels like it's shifting and new parts of identity are unfolding. For women navigating menopause, this can mean facing both the expected, and sometimes unexpected, changes that come with this season of life. Many women find themselves surprised by how deeply this season can affect their energy, relationships, and sense of identity.

You don't have to navigate those changes alone. Together, we can explore how this transition intersects with the areas of your life that matter most—whether that's your career, your relationships, or your own sense of self—and develop practical tools that help you to continue creating a life that you find personally meaningful and fulfilling.


Headshot of Dr. Alicia Aldrich

Dr. Alicia Aldrich

Clinical Psychologist

I've had the great fortune to know many wonderful, fascinating, and creative women who have confided in me about their experiences with their health, particularly during perimenopause and menopause. These relationships inspired me to specialize in this area as part of my clinical practice.

This stage of life can bring unexpected changes physically, emotionally, and in relationships. I see it not only as a time of challenge but also as an opportunity for growth, renewal, and self‑discovery. My role is to provide a supportive space where women can feel understood, explore what they're experiencing, advocate for themselves, and discover new ways to thrive.

My approach is integrative, drawing from psychodynamic, cognitive behavioral (CBT), and mindfulness‑based practices. With additional experience as a yoga teacher, I bring a deep appreciation for the mind–body connection and incorporate these traditional awareness‑based practices into therapy in an evidence‑based manner when requested.


Headshot of Dr. Carmela Mancini

Dr. Carmela Mancini

Physician & Medical Advisor

I am the founder of a concierge primary care practice and the Women's Wellness & Menopause Center. Recognizing the need for dedicated, evidence‑based women's healthcare, I specialize in guiding clients through postpartum, perimenopause, menopause, and midlife metabolic changes.

My approach centers on hyper‑personalized care that evolves alongside my clients' changing needs. I believe that women deserve healthcare that understands the complexity of their transitions — not just treating symptoms, but supporting the whole person through each phase of life.

Through Pause & Pivot, I provide medical expertise and guidance to help women navigate hormonal transitions with confidence, ensuring they have access to the latest evidence‑based treatments and personalized medical support that acknowledges both their professional demands and personal wellness goals.

Where are you feeling the impact?

Take our research‑informed self‑assessment to understand how perimenopause may be reshaping your identity, emotions, and work confidence.

Azimuth Perimenopause Impact Index

A 21-question self‑assessment that helps you understand psychological impacts across three key domains:

  • Identity & Values: How this transition affects your sense of self
  • Emotional Well‑being: Stress, anxiety, and mood patterns
  • Work Confidence: Self‑efficacy and cognitive function at work

Takes 5–7 minutes • Research‑informed • Personalized results

A quieter power is taking shape.

Strategic problem‑solving for when your body changes the game mid‑career.

Receive our private newsletter — a curated guide to navigating career, relationships, and identity during midlife transitions. Rooted in results, not trends.

Plus: our vetted list of research‑backed products, tools, and supplements for every stage of perimenopause and menopause.

Ready for personalized support?