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 foundational 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.

Doctors need to have a medical license in each state they wish to prescribe medication and practice medicine.  State laws define the practice of medicine as “occurring where the patient is located” so patients must either reside in one of the states where our physicians are licensed or must travel to one of the states where our physicians are licensed.  

Dr. Shah is currently licensed in the following states:

• Virginia
• Washington, DC
• Maryland
• West Virginia

Dr. Todd is currently licensed in the following states:

• Virginia
• Washington, DC

We have made the conscious decision to operate outside of the insurance network for two fundamental reasons: to put your health and time first.  

At Midlife Medicine, our primary focus is you—not the paperwork, bureaucracy, and restrictions of the insurance industry.  We are committed to quality care, delivered directly to you with full pricing transparency.  

When doctors work with insurance companies, their time, decisions, and attention are often dictated by external administrative requirements. This frequently leads to: rushed appointments, delays (hours of time are spent on authorizations, coding and claims), and potentially compromised decision-making because treatment choices can be guided by what an insurance company will cover, not what might be best for you.

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 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 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 is used interchangeably with MHT and often HRT as well.    

At Midlife Medicine, you will largely hear us using the term “hormone therapy” 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.

Yes! 

For most women, hormone therapy is perfectly safe.  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 Provider (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 only employs physicians who are certified by The Menopause Society (MSCP) so you are in good hands with us.   

Yes. 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 and compounded hormones can vary significantly in their quality and amount of drug in each formulation. Inconsistent dosing and increased side effects are more common with compounded and 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. One example is “cliteromegaly” which is a permanently enlarged clitorus associated with testosterone pellets which does not happen when FDA approved testosterone is prescribed “off label” for women with appropriate dosing which can be monitored and changed before there is a permanent problem (this is not so with pellets).