Frequently Asked Questions

General FAQs

If you are wondering whether or not we can support you, book a "Meet and Greet" call with one of our doctors to learn more.

If you are ready to transform your health, improve your life, and resolve your symptoms, you can book an Initial Consultation to continue to learn more and dive deeper or join the Kickstart Program if you want the complete solution.

At Midlife Medicine, we specialize in supporting women who want to feel better, improve their hormone health and create lifelong strategies for better health overall. Our doctors will listen to you closely and will help you develop a proactive and integrative solution to your hormone and health goals.

Because every woman’s hormonal makeup is different, there is no "one-and-done" fix. We require a mandatory follow-up 8 weeks after your initial consultation to assess how your body is responding to treatment.

As a physician, Dr. Todd knows that you cannot separate the physical from the emotional. While hormones can fix a hot flash, coaching helps you navigate the impact those years of symptoms have had on your life. Our Kickstart Package integrates both so you can heal your body and your life simultaneously.

Yes. Our practice is a specialized consultative model focusing specifically on the perimenopause and menopause transition. You should maintain your relationship with your primary care provider and Ob/Gyn for routine screenings like general physicals, Pap smears, and mammograms.

Insurance FAQs

Dr. Todd is licensed to practice medicine in Virginia and Washington, D.C.  Based on state licensure requirements, her patients therefore need to reside in or be present in VA or Washington, D.C. at the time of the appointment.

To provide the level of time and personalized care you deserve, we do not contract with insurance companies. This allows us to spend an hour (or more) with you rather than the standard 15-minute "check-box" visit. Please note that we can provide you with a "superbill" that you may submit to your insurance for potential out-of-network reimbursement.  Please request this at the time of service.  You can use your insurance  for lab testing, prescriptions and imaging based on individual plans when applicable.

Yes! In most cases, our clinical consultations and lab tests are eligible expenses for Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). We recommend confirming with your specific plan administrator.

Hormone Therapy FAQs

If you are confused about the acronyms that you encounter in medicine, you are not alone!  Unfortunately, the acronyms surrounding menopause are no different.  To add to the confusion, it doesn’t help that you may read a blog post or article about MHT, and then read a different article that sounds like it’s talking about the same thing but the author uses the term HRT.  Confusing, right?  Spoiler alert: they are all (kind of) the same thing.

MHT, HRT, and HT refer to hormones used to treat estrogen, progesterone and sometimes testosterone deficiency.  The underlying cause of the low hormone levels or "deficiency" determines which acronym is used in medical jargon.

MHT (Menopause Hormone Therapy) is used to indicate hormone replacement associated with natural menopause. The average age of menopause in US women is age 52, but natural menopause can occur anytime between age 45 and 55 years old.

HRT (Hormone Replacement Therapy) is used to reference hormones prescribed due to early or premature menopause.  Early is menopause occurring between age 40-45 years old, and premature is menopause before age 40 years old.  Early and premature menopause may be the result of a medical condition such as “premature ovarian insufficiency” or it could be due to treatments like chemotherapy or radiation that may damage the ovaries and interfere with their ability to produce hormones.  Surgical removal of the ovaries before age 45 is yet another reason to prescribe HRT.

HT (Hormone Therapy) is used interchangeably with MHT and often HRT as well.

At Midlife Medicine, you will largely hear us using the term “MHT” but know that MHT, HRT and HT are not significantly different from each other in practice.  The reason for the prescribed hormone(s) is the main difference in the terminology.

For many healthy women near the menopause transition, hormone therapy can be an appropriate option after an individualized review of benefits, risks, symptoms, timing, and health history.  Like all medications, hormone therapies have risks and benefits.  Your doctor will review the risks and benefits based on your personal health history and you will have ample time to ask questions, get straightforward answers and reflect on what is best for you. Having a Menopause Society Certified Practitioner (MSCP) is important because it means your doctor understands the nuances of hormone therapy.  There is no “one-size-fits-all” hormone therapy treatment regimen. Your doctor should be able to validate and address your concerns, provide options and change dosages or formulations when needed. 

Midlife Medicine emphasizes Menopause Society-informed care and individualized medical decision-making.

Yes.  Midlife Medicine prescribes FDA approved therapies when available, including bioidentical hormone replacement.  Bioidentical means that the chemical structure of the hormone prescribed is identical to the hormones produced in your body.  There are several great FDA approved bioidentical estrogen and bioidentical progesterone hormones available for doctors to prescribe depending on your symptoms and needs.  Bioidenticals are the most common hormones prescribed by Midlife Medicine.

But ... we don’t prescribe pellets and typically avoid compounded medications unless there is a medical reason to compound.

Why?  Because the FDA ensures the quality and safety of each medication it approves.  Unfortunately, pellets can vary significantly in their quality and amount of drug in each formulation. Inconsistent dosing and increased side effects are more common with pellet formulations and overdosing is a problem.  Importantly, pellets cannot be removed if a side effect or problem occurs, and there can be permanent adverse effects from pellets.