If you've booked a menopause consultation — or you're thinking about it — here's a clear picture of what the visit involves. The short version: we talk, you decide, we follow up.
The longer version is below.
Before Your Visit
A few practical things:
You can choose in-office or telehealth. A menopause consultation works well as a video visit because most of it is conversation. We use telehealth across 12+ states for menopause care, follow-ups, and prescriptions. If you'd prefer in-office, we're in Kensington, MD with free parking.
Schedule extra time. We schedule menopause consultations longer than a typical follow-up because the conversation matters. You won't feel rushed.
You don't need to come in with a plan. Some patients arrive knowing they want hormone therapy. Others arrive saying "something is off and I want to understand what." Both are completely fine starting points.
Bring (or upload) any relevant records. Recent labs, prior hormone-related prescriptions, family history of cancer or clotting issues, mammogram results, and a list of current medications. None of this is mandatory — we can work without it — but it helps.
Step 1: We Hear What's Going On
The visit starts with you talking and us listening. We'll ask about:
- Your cycle — pattern, changes, how recently
- Sleep — when it started getting weird, what it looks like
- Mood, anxiety, brain fog — what's new, what's worse
- Hot flashes and night sweats — frequency, severity, triggers
- Sex and intimacy — pain, dryness, desire changes
- Urinary symptoms — frequency, urgency, recurrent UTIs
- Joint and body changes — aches, weight, hair, skin
- What's bothering you most — because this guides everything else
We ask in detail because perimenopause and menopause symptoms are often dismissed elsewhere. We'd rather know about all of it.
Step 2: We Look at the Bigger Picture
Once we have a symptom picture, we look at:
Health history. Past pregnancies, gynecologic history, surgical history, current medications. Cancers (yours and family). Cardiovascular history. Clotting history. Migraine pattern.
What might be mimicking menopause. Thyroid issues, iron deficiency, sleep apnea, depression, and a few other conditions can produce overlapping symptoms. We rule them out when needed — sometimes that means labs, sometimes it just means careful history.
Risk factors. Honestly, not as gatekeeping. If hormone therapy is on the table, we want to make sure we're choosing the right type, dose, and delivery method for your specific picture.
Step 3: We Talk Through the Options
Based on what we've heard, we walk through what's available. This usually includes:
Hormone therapy options — what type (estradiol patch vs. gel vs. oral), what progestin component if needed, what the actual risks and benefits look like for someone with your history.
Non-hormonal options — SSRIs/SNRIs, gabapentin, fezolinetant, CBT, vaginal moisturizers. We have [a whole post on non-hormonal options](/blog/non-hormonal-options-for-menopause-symptoms).
Vaginal estrogen — separately from systemic hormones, because the safety profile is very different. Often appropriate for patients who can't use systemic hormones.
Combination approaches — e.g., vaginal estrogen for GSM plus an SSRI for hot flashes plus CBT-I for sleep. Most plans aren't all-or-nothing.
We explain what each option does, what side effects to watch for, and what realistic expectations look like.
Step 4: You Decide
This is the actual point of the visit. We don't push hormone therapy and we don't refuse it without a real reason. You leave with a plan that fits your situation and your preferences.
If you want to think about it before deciding, that's fine — we can wrap up the visit, send you anything you'd like to read, and you can message us through the patient portal when you're ready.
If you're ready to start, we send prescriptions to your pharmacy. We discuss what to expect over the first few weeks and when to check in.
Step 5: Exam (If Needed)
A pelvic exam isn't always part of a menopause consultation. We do one when:
- You're due for a Pap smear and want to combine the visit
- You have specific symptoms that warrant evaluation (bleeding, GSM, pain)
- We're considering vaginal estrogen and want to assess tissue changes
- You request one
If we do an exam, we use comfort measures — heating pad, TENS, nitrous oxide if you'd like. You set the pace. We explain what we're doing before we do it. There's no surprise touching, ever.
If you're a telehealth patient and an exam is needed, we schedule a follow-up in person.
Step 6: Follow-Up
Menopause care is iterative. After you start a treatment, we typically:
- Check in at 4-8 weeks to see how things are going
- Adjust dose, formulation, or delivery method if needed
- Recheck symptoms periodically
- Follow up for ongoing prescriptions, lab monitoring, and screening updates
Most of this happens via the patient portal between visits. Your provider stays involved long-term.
Common Questions
Do I need a referral? No. You can book directly through our online scheduler.
Can my partner or support person be there? Yes. Bring whoever helps you process information.
What if I just want labs? We can do labs as part of a workup, but we don't recommend ordering FSH/estradiol "to confirm menopause" — they fluctuate too much in perimenopause to be diagnostic, and a clinical conversation is more useful. We talk about whether labs would actually help.
What does this cost? With insurance, your visit goes through standard benefits — copay, deductible, etc. depending on your plan. We accept BCBS, Anthem, CareFirst, Aetna, Cigna, and UHC. Self-pay rates available — [contact us](/contact) for current pricing.
Booking
Schedule a menopause consultation — in office or telehealth. Or send us a message if you have questions first.
You may also want to read perimenopause symptoms, hormone therapy after the WHI study, or non-hormonal options.