Frequently asked questions

Menopause

Menopause

1. What is menopause?

Menopause is the time in a woman's life when her ovaries stop producing estrogen and progesterone. Natural menopause is determined when a midlife woman has gone 12 months from their final menstrual period without any other associated medical conditions. This is called natural menopause. Surgical menopause occurs when both ovaries have been removed during a surgical procedure.

2. When does menopause occur?

The average age of natural menopause in the United States is around 51 years old but every woman’s journey is different. Natural menopause can occur anytime between ages of 40 and 58.

3. What is perimenopause

Perimenopause is the time period leading up to your natural menopause. It is during this time many women begin to experience symptoms of hormonal changes. Perimenopause can last for years in some women.

4. What is post menopause?

All the years beyond your menopause.

5. I had a hysterectomy. How will I know when I have gone through menopause?

If you had a hysterectomy, you will not be able to determine your final menstrual period based on vaginal bleeding. If your ovaries are in place, you will need to have blood testing of your hormone levels to determine when you have entered menopause. You may still experience symptoms of menopause, as your ovaries are your hormone powerhouse. If you had both of your ovaries removed at the time of your hysterectomy, you had a surgical menopause.

Symptoms

1. What are hot flashes?

Hot flashes are experienced by 75% of perimenopause women according to the North American Menopause Society. You may feel intense internal warmth along with profuse sweating, anxiety, skin reddening and palpitations that is followed by chills. Hormone therapy or a low dose antidepressant effectively treats menopause related hot flashes and is safe in most women.

2. What are night sweats?

Night sweats are hot flashes that occur during sleep. They may awaken you from sleep with your clothing drenched or they may just make you feel the need to kick the covers off. Treatment with hormone therapy or a low dose antidepressant can decrease your night sweats and allow you a restful night sleep.

3. Why am I gaining weight in my belly?

Unfortunately, women tend to gain weight as they age. Your metabolism naturally slows down. Hormonal changes cause your muscle mass to decrease. Since muscle burns more calories than fat, a woman may gain weight even if they have not changed their diet. The North American Menopause Society states there is no scientific evidence that menopause itself causes weight gain but the evidence is clear your hormonal changes do cause your extra weight to settle in your belly. Hormone therapy along with a healthy diet and exercise can help prevent unwanted weight gain in your midsection.

4. Why do I have trouble sleeping?

Many midlife women experience night sweats that awaken them from sleep. Others have difficulty falling or staying asleep. Midlife sleep disturbances can be related to your hormones but you may also be suffering from other conditions such as anxiety, depression, stress, sleep apnea or restless leg syndrome to name a few. Your menopause physician will help you sort this out.

5. Why am I moody, irritable and quick to fly off the handle?

The erratic change in your hormone levels during perimenopause may play a role in your mood changes but the science is not clear. We do know that women with a history of depression or premenstrual syndrome (PMS) often complain of mood changes as they go through menopause. Midlife can be a stressful time for many women for a whole host of personal reasons- marriage, job, children, and parents. Combine life stressors with the symptoms associated with hormonal changes and you have a perfect recipe for being moody and irritable. Thankfully, effective treatment is available.

6. Why does my vagina feel dry?

Your ovaries decrease the amount of estrogen in midlife and stop making estrogen in menopause. Estrogen loss causes your vagina to become dry and less stretchy. Some women notice dryness immediately at menopause, others complain years later and some lucky women have no symptoms at all. Luckily, a low dose of vaginal estrogen can safely restore your vaginal health.

7. Why is sex painful now?

Midlife and beyond, the most common cause of painful sex is dryness and thinning of the vagina caused by a lack of estrogen. You may experience less lubrication creating friction or a “sand paper feeling” during sex. Maybe you are experiencing vaginal tightness, burning, soreness, tearing or even bleeding with penetration of the vagina. Relief is available treating the vaginal tissues directly with low dose vaginal estrogen tablet or cream.

8. Why do I have no sex drive?

If you are not sleeping well, experiencing night sweats, vaginal dryness or are just moody from hormonal changes, I bet the last thing on your mind is an evening of intimacy. Maybe you are suffering from a low testosterone that has declined over time. Low hormone levels can definitely play a role in your sex drive and hormone therapy can help.

9. Why is my skin so dry?

Estrogen helps promote collagen and natural oil production in your skin. The decrease in estrogen associated with menopause causes a decrease in the production of collagen in your skin. The collagen loss causes your skin to thin, hold less moisture and feel dry. Topical moisturizers improve the feeling of dryness.

10. Why am I getting wrinkles?

Your decreasing estrogen at midlife and beyond contributes to your skin’s loss of collagen and elasticity. Your skin becomes thinner and you begin to see wrinkles. Topical retinoid, can help slow the visible signs of aging. If you are taking hormone therapy for other symptoms, it will certainly help slow the skin’s aging process.

Hormone Therapy

Hormone Therapy

1. Does hormone therapy really work?

Yes! In fact, The North American Menopause Society states that hormone therapy is the most effective treatment for hot flashes and vaginal dryness due to menopause.

2. Is hormone therapy safe?

Yes! The most recent medical studies determined hormone therapy is safest if begun within 5 years of a woman’s final period. Topical estrogen therapy for vaginal symptoms can be begun safely at any age.

3. How long can I continue hormone therapy?

Both the North American Menopause Society and the American College of Obstetrics and Gynecology agree that use of menopausal hormone therapy should be individualized. Their recommendation is to use hormone therapy for the shortest duration possible and at the lowest dose to control your symptoms. The most recent medical studies indicate it is safe to continue your hormone therapy up to age 59. Beyond that, you may continue hormone therapy if both you and your menopause specialist agree that the benefits of symptom relief outweigh the risks. Non-hormonal treatments and estrogen creams / tablets for treatment of vaginal symptoms can safely be continued throughout a woman’s lifetime.

4. What is bioidentical hormone therapy?

Bioidentical hormones have the same molecular structure as the hormones produced naturally in your body. We prescribe bioidentical hormone therapy that has been approved by the FDA. FDA approved bioidentical hormones have gone through rigorous testing and quality control for safety.

5. What is compounded bioidentical hormone therapy?

Compounded bioidentical hormone therapy or widely known as bHRT, are hormones mixed in a specialty compounding pharmacy at doses chosen by the prescriber. These bioidentical hormones are still produced in a laboratory from many of the same sources as FDA approved hormones and carry the same risks as FDA approved bioidentical hormone therapy. When you think about it in simple terms- your yam based estradiol didn’t go from the ground to a topi-click cream without a visit to the lab first! Compounded prescriptions do not need to undergo quality control, nor are they required to supply a standard patient package insert explaining potential risks or adverse events. Patients are led to believe custom compounded hormones are safer that FDA approved hormones when in fact the opposite can be true. In short- we feel compounded medications certainly have a place in treating menopause symptoms but only if an FDA approved product is not available.

6. Does Hormone Therapy cause weight gain?

According to The North American Menopause Society, there is no scientific evidence that hormone therapy causes weight gain.

7. Can hormone therapy help my low sex drive/libido?

Yes, in women who suffer from low sex drive/libido related to hormonal changes associated with menopause symptoms such as hot flashes, night sweats, mood changes, vaginal dryness and painful sex.

The content is meant for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please seek the advice of your physician with any questions you may have regarding a medical condition.


MMRX Telehealth

Visits

1. Is my visit conducted with video or email?

All of our visits are conducted with video. We are human just like you and enjoy meeting the women we are treating. It is our opinion that menopause visits conducted via email are too impersonal for such personal decisions.

2. What is a video visit?

Imagine sitting across from your menopause specialist in their office. You focus on their face and the discussion regarding your symptoms and treatment. A video visit is exactly the same experience except on the screen of your personal device. If you have ever “face timed” or been on a zoom call, you have experienced a video visit. Our patients absolutely love them.

3. Is the video private?

Yes. Each video visit is conducted through our HIPAA compliant video platform.

4. Can I schedule with the same provider each visit?

No, but do not worry. Prior to your appointment, your menopause specialist will review your current history and any details from your previous visit(s). Our providers are all menopause specialists and follow the same guidelines for treatment aligned with The North American Menopause Society.

5. Why don't you offer on demand visits?

We value your time. Maintaining an appointment schedule allows you to choose a dedicated time frame that is convenient for you. This eliminates waiting for what seems like an eternity in a virtual waiting room for the next available menopause specialist.

6. How long does each visit take?

The average new patient visit lasts about 20 minutes. Prior to the video portion of your visit, your provider will review your medical history and personal treatment goals.

7. Why do I need to complete such a detailed medical history?

We believe quality care begins with your medical history and symptom tracking. Other common diseases such as anemia, hypothyroidism (underactive thyroid) and depression could cause similar menopause symptoms.

8. Do I have to enter my medical history again before each visit?

No. After your first visit, you will be asked to verify and update your previously entered medical history. This includes updates to your menopause questionnaire, sexual desire and depression screener at each visit.

9. Do you check my hormone levels?

The North American Menopause Society recommends tailoring hormone therapy to a woman’s symptoms not a lab number. True to our affordability mission, we do not order hormone testing that is not necessary for treatment. There are some occasions we may recommend hormone testing. We recognize many women are curious regarding the status of their hormone levels. If at any time you would like to check your hormone levels, we are happy to provide an order for testing. You may also self order lab testing at any time on your patient dashboard.

10. Will I need to have any testing prior to beginning hormone therapy?

No. We will provide you an order for lab testing that includes a comprehensive metabolic panel (CMP), complete blood count (CBC), lipid panel cholesterol) and thyroid stimulating hormone (TSH) at your first visit. Depending on your specific symptoms, we may recommend additional lab testing and will provide the corresponding order. All lab testing must be completed prior to your follow up visit. We also request you upload a recent mammogram report (dated within one year of initiating hormone therapy) prior to your follow-up visit.

11. How many visits will I need to begin feeling better?

You should begin to see an improvement in your symptoms about 2 weeks after beginning treatment but most treatments take 8-12 weeks to see optimal benefit.

12. How often do I need to have a visit?

Most patients who are beginning their menopause treatment need an average of 3 visits the first year: initial, at 8-10 weeks, and at 6 months. Once stable, we recommend a yearly visit. Your menopause journey is unique; your visit schedule will reflect what you need to feel like yourself again.

13. Why do I need to have a yearly visit if I feel great?

A year is a long time! Your personal health history may have changed during that time. Updated medical recommendations may have been published and we may offer you an alternative treatment option.

14. Will I receive a summary of my visit?

We are proud of the care provided at MyMenopauseRX. You will have full access to your visit note on your patient dashboard.

15. Can I share my visit summary/lab results with my primary care provider or Ob/Gyn?

Absolutely! We are proud of the quality menopause care we provide.

16. Will MyMenopauseRx replace my Ob/Gyn?

No. MyMenopauseRX was created to educate you on midlife wellness and menopause, and offer you evidence-based treatments for perimenopause/menopause symptoms. We also are available for and those urgent health issues like UTI symptoms and STD screening/treatment. Your general Ob/Gyn is your local go to for all your basic gynecologic care.

17. Can my primary care provider refill my menopause prescriptions?

Yes, they can but we do not recommend it. Our menopause specialists stay up to date on the latest menopause medical literature. Each time you need a refill, we review your medical history to ensure you are receiving the best and safest treatment option available.

18. What do I do if I have a medical emergency?

MyMenopauseRx is an online doctor’s office devoted to menopause care and midlife wellness. We do not provide emergency care and advise all patients to call 911 or proceed to the closest emergency room.

19. Who do I contact if I have a question after my visit?

We encourage all patients to message our clinical team through your secure patient dashboard.

Billing and Insurance

1. Do you take insurance?

Yes. We accept most major PPO insurance plans. We recommend you contact your insurance plan for your individual coverage.

2. How do I know if MyMenopause is in-network?

Insurance is complicated. Each plan has different rules and coverage varies. Your insurance plan is a contract between you and your insurance carrier. We recommend you check with your individual plan to verify your coverage.

3. How much is my visit if I choose to use my health insurance?

The costs of your visit utilizing your health insurance will range from 0-$249. We can tell you, menopause visits are not considered wellness and their cost will get applied towards your deductible. You will also be responsible for any co-pay amounts and co-insurance.

4. If I chose to use my health insurance, what is the process?

After you select your appointment time, just choose the option to pay with your health insurance on the payment screen. You will be prompted to enter a valid credit card for our payment processor, Square, to securely keep on file. You will then enter your health insurance information along with uploading a copy of the front and back of your insurance card. If your insurance policy is determined by our system to be up to date, you will be allowed to complete the booking of your appointment. After your visit is complete, we will send a bill to your insurance company for payment.

5. I entered my insurance information and it says my account is not active. What should I do?

We recommend you double check all the information you entered. If everything seems correct, we advise you to check with your insurance carrier. You can always book a self-pay visit for $99 and submit to your insurance on your own. All insurance companies have a form you can fill out on their websites.

6. How is my out of pocket expense (how much I own MyMenopauseRx) determined?

If your insurance company covers the cost of your visit in full, your cost is zero. Woo Hoo! If your insurance company responds with a partial payment, MyMenopauseRx will charge your card on file for the remaining balance you owe and send you the receipt electronically. Please realize, MyMenopauseRx does not determine the amount of your visit. Your out of pocket costs are determined by your insurance plan.

7. Why does my visit cost more using my health insurance than your transparent self-pay $99 fee?

Insurance is complicated. Each plan has different rules and coverage varies. MyMenopauseRx has to pay additional fees to accept and process insurance. Billing to health insurance plans requires specially trained staff and a billing department. The process drives up the cost for everyone.

8. How do I obtain a receipt to submit to my FSA/HSA for reimbursement?

A copy of your receipt will automatically be emailed to you after you purchase a lab or telehealth visit if you chose to use our transparent self-pay option. If you are having difficulty and need further assistance, just send us a message from your HIPAA compliant patient dashboard.

9. Will my insurance cover the cost of labs at MyMenopauseRx?

Yes, but we recommend you check directly with your plan. Each health insurance plan has different rules. Lab testing that is checked for problems (i.e. menopause symptoms) usually goes toward a patient's deductible. If your deductible is not met, the entire cost is considered your out of pocket responsibility - meaning you will have to pay the bill for your labs. The cost of those labs are determined by your health insurance carrier.

10. Can I use my health insurance to order my own labs?

No. Your health insurance company requires any testing to be medically necessary. Your curiosity doesn’t count to them!

11. Can I use my FSA/HSA to order my own labs?

Yes! Just send your receipt along with any required paperwork to your benefit administrator.

Orders

1. Will MyMenopauseRx order and interpret labs recommended?

Yes. MyMenopauseRx will order your labs to be completed at Quest Diagnostics. Your order will be available for you to print from your patient dashboard. Quest Diagnostics has locations nationwide. Once we receive your results, our menopause experts will review them and message you on your patient dashboard.

2. Why do you only order labs through Quest Diagnostics?

We believe in offering transparent pricing. Partnering with Quest Diagnostics has enabled MyMenopauseRx to offer upfront competitive pricing for routine menopause lab testing. No more surprise bills after your visit.

3. Can I use a local lab close to my home?

Yes. Quest Diagnostics is nationwide.

4. How do I pay for my labs?

Upon completion of your visit, your lab orders will appear in the lab section of your patient dashboard. Simply click purchase on the assigned labs or any labs that you chose to order and complete your purchase. After purchasing, you can print your lab order and visit any Quest Diagnostic location you choose.

5. Are lab fees covered by my insurance?

Lab fees are reimbursable thru your FSA/HSA account. We recommend you check with your insurance carrier or benefit department for more specific information regarding your policy.

6. Where can I view my lab results?

Lab results ordered by MyMenopauseRx and completed at Quest will be available on your patient dashboard.

7. What if I already had recommended labs completed by my local primary care provider or Ob/Gyn?

Great! You can upload your labs on your patient dashboard for our review. We require a recent lab panel within 3 months of beginning treatment. Your visit summary will detail what labs your menopause specialist recommended. If you discover your labs are outdated or not exactly what we suggested, you can self order lab testing on your patient dashboard. We care about providing you with quality menopause care.

8.Will MyMenopauseRx provide a mammogram order for me?

No. We recommend you maintain a relationship with a local primary care provider or Ob/Gyn for your female preventive care. MyMenopauseRx prides itself on quality care. Breast cancer prevention and detection is more than just a mammogram order. Your local provider will be better at managing your mammogram breast health depending on your personal/family history and breast density. You may require additional testing such as whole breast ultrasound or even a breast MRI. We do want to review any breast cancer testing that was completed as it may change what menopause treatments we recommend to you. Please upload your recent mammogram and any additional testing thru your secure patient dashboard.

9. Why do I need to get a mammogram?

Mammograms detect breast cancer. Breast cancer risk from taking hormone therapy is very low in most women as documented by many large medical studies. However, hormone therapy can stimulate the breast and the clinical team at MyMenopauseRx takes your health very seriously. It is recommended by The American College of Obstetrics and Gynecology a woman has a mammogram yearly beginning at age 40.

10. I don't have a printer to print my lab order. What should I do?

Send us a message from your patient dashboard after you have completed your lab payment. Our clinical team will send your order to Quest Diagnostics electronically. You can then visit any of their locations to complete your lab testing.

11. Do I have to use Quest if I plan to use my health insurance for lab testing?

You may choose to use any lab you like but unfortunately, we can not guarantee we will receive the results. If you choose not to use Quest, you will be solely responsible for obtaining and uploading your results to your patient dashboard at MyMenopauseRx.

12. If I self-order labs without using my health insurance, do I have to use Quest Diagnostics?

Yes. We are contracted with Quest Diagnostics for lab testing and have direct access to results.

Prescriptions

1. Can I use my insurance coverage for prescriptions?

Absolutely! Just provide your insurance information to your pharmacy.

2. I don’t have health insurance, are prescriptions for menopause symptoms expensive?

No. Natural, plant based, bioidentical pills, capsules, patches and creams are available in generic form and are cost effective.

3. Can I choose which pharmacy I would like my prescriptions to be sent?

Absolutely! Just update your preferred pharmacy information in your patient dashboard.

4. How do I change pharmacies?

If you would like to change pharmacies after your prescription has already been sent, please contact your preferred pharmacy and ask them to arrange a pharmacy-to-pharmacy transfer. Prior to each appointment we recommend you update your pharmacy information in your patient dashboard.

5. Can I use my mail order pharmacy?

Yes. Just enter your mail order pharmacy information as your preferred pharmacy in your patient dashboard.

6. My pharmacy changed my generic medication brand. Is that ok?

In most cases, a change in generic brand is just fine. If you are feeling unwanted side effects from the generic change, please contact your pharmacy and request they order the generic brand that worked for you.

7. How many months of medication will my prescription be valid for?

In general, new patients that are just beginning treatment will receive a 3-month supply of their medication. A follow up visit is required for additional refills. Follow up visits are determined based on each patient’s unique treatment plan. Patients who are stable on their treatment and have completed any recommended health prevention testing will be seen every 6 months to yearly.

8. How do I request a refill?

Your physician will prescribe enough medication with refills to get you to your next recommended appointment. If you are in need of a refill, you must be due for a visit. Please schedule one thru your patient dashboard. If you are not sure, please message us.

9. What do I do if my current dose does not seem to be working as well?

It is not unusual to need to tweak your treatment at times. We recommend you schedule a visit.

10. What do I do if my prescription is too expensive?

If you are using your health insurance, we recommend you check with them regarding medication coverage. Unfortunately, all insurance companies and plans have individual unique price structures for prescription coverage. We strive to prescribe cost effective generic medications. If you have checked with your insurance carrier and are not satisfied with the cost of your medication, message us thru your patient dashboard. We are happy to assist you obtain the most cost effective pricing.

Privacy

1. How is your site secure?

MyMenopauseRx uses the latest standards to protect your personal information, encrypting your data both in transit and at rest. Communication between your browser and MyMenopauseRx systems is 256 bit SSL/TLS encrypted, while data stored within our system is encrypted using the AES-256 standard. While medicine is our passion, security is a priority. We routinely conduct security audits and personnel training to ensure that our systems and staff are able to guard your data like it was our own.

2. Is your site HIPAA compliant?

Yes.

3. Do you sell my personal information?

No. We respect your privacy and will never sell your personal information.

Refunds

1. I scheduled a visit but missed my appointment. How do I obtain a refund?

If you canceled your appointment on your patient dashboard prior to 72 hours of your scheduled appointment time, you are entitled to a full refund and it will be automatically applied to your method of payment. If you miss or cancel an appointment within 72 hours of your scheduled appointment time, no refunds will be issued.

2. Why do you have a 72 hour rule for refunds or changes of appointments?

We are an online doctor’s office providing menopause care from menopause specialists. We value your time. Our providers focus their undivided attention to our mission at MyMenopauseRx: Empower women with education, community and affordable convenient menopause care at midlife and beyond. Limiting last minute schedule changes affords our providers the ability to meet your appointment time as scheduled.

3. There was a technical issue during my appointment and it was not completed fully. How do I receive a refund?

We understand technology fails at times. If you experienced an interruption in your scheduled appointment after it was initiated, please message us on your patient dashboard. We will reschedule your appointment free of charge.

4. I ordered lab testing and have changed my mind. How do I get a refund?

We are so sorry you have changed your mind. There are no refunds issued on lab testing. This policy is highlighted for you on the top of your order page just prior to completing your payment. We are sorry you missed it.