Questions we get asked

No. You can request an appointment directly through this site or by phone. Some HMO plans require a referral for specialist visits; if yours does, our scheduling team will tell you when we call.

The date of your last menstrual period, a list of your current medications and supplements, the date of your last mammogram, any prior DEXA results, and a short note about which symptoms bother you most. If you have used hormone therapy before, bring the names and doses if you have them.

Plan on about 40 minutes. We go through your symptom history, your personal and family medical history, a safety screen, and an exam when it is relevant to your symptoms.

Yes. Perimenopause — the years of changing cycles before your final period — is one of the most common reasons women come to us, and treatment is often different from treatment after menopause.

Yes. Whether you still have a uterus changes what hormone therapy looks like, but it does not change whether you can be treated.

Safety depends on your age, how long it has been since menopause, your personal history, and which product is used. In late 2025 the FDA updated labeling on systemic and vaginal estrogen products and removed the class-wide boxed warning. That changed the label; it did not remove the need for individual assessment. We go through your history — breast cancer, blood clots, stroke, migraine with aura, liver disease — before prescribing.

Systemic estrogen circulates through your body and treats whole-body symptoms like hot flashes and night sweats, and protects bone. Vaginal estrogen is a low dose placed in the vagina to treat local tissue symptoms — dryness, pain with sex, urgency, and repeat urinary tract infections. Very little is absorbed into the bloodstream.

Yes. Non-hormonal medications treat hot flashes, including the newer neurokinin receptor antagonists fezolinetant and elinzanetant, plus SSRIs and SNRIs, gabapentin, and oxybutynin. Cognitive behavioral therapy has evidence for hot flash bother and sleep. Bladder and pelvic floor problems have their own non-hormonal treatments.

No. We prescribe FDA-approved products only. FDA-approved estradiol and micronized progesterone are already structurally identical to the hormones your body makes, so compounding adds cost and dosing uncertainty without adding benefit. We do not implant hormone pellets either.

There is no fixed stopping date. We review your symptoms, your risks, and the evidence at least once a year and decide together. Some women taper after a few years; some continue longer, particularly when bone protection is part of the reason.

They can. Hot flashes often return for a period of time after stopping, and genitourinary symptoms usually return within a few months because the tissue change resumes. That is worth planning for rather than being surprised by.

It contributes to them. After menopause the vaginal and urethral tissue thins and the vaginal microbiome shifts, which makes repeat infections more likely. The AUA/CUA/SUFU recurrent UTI guideline supports vaginal estrogen to reduce recurrence in peri- and postmenopausal women.

At age 65 for all women, and earlier if you have risk factors: a fracture after age 50, early menopause, long-term steroids, rheumatoid arthritis, low body weight, a parent who fractured a hip, heavy alcohol use, or smoking.

It is common, but common is not the same as untreatable. Most women improve with pelvic floor physical therapy, and there are effective medication and procedural options when therapy alone is not enough.

No. Visits, labs, and DEXA scans are billed to insurance like any specialist visit. We're in-network with most major plans.

We do. If your plan requires prior authorization for a medication or a scan, our team submits it and follows up.

Some follow-up visits can be done by video. First visits are usually in person, because an exam, labs, or a scan often changes the plan.

See our locations page for current sites and what each one offers. Not every location has DEXA on site; our team will book you where the services you need are available.