These days, we’re all steering clear of doctor’s offices. But well before any of us had ever heard of a novel coronavirus or Covid-19, virtual technology was helping people receive care from their doctors remotely.
Telemedicine first popped up back in 1959. That’s when doctors at the Nebraska Psychiatric Institute hooked up a video conference line to a state hospital several towns away and lead group therapy sessions and other mental health services.
Fast forward to modern times, and a number of women’s health doctors are grabbing hold of the technology and using it to help women navigate some of the choppiest physical and emotional waters of their lifetimes: the years where they’re moving from perimenopause to menopause and beyond.
“These kinds of health care conversations lend themselves so well to telemedicine, because you don’t always need a hands-on exam in order to address women’s concerns and symptoms,” says Tamara Neuhaus, MD, a North American Menopause Society (NAMS) certified menopause practitioner and chief medical officer of The Cusp, a telemedicine service dedicated to menopause care.
If the idea of skipping the waiting room and avoiding the time suck of a traditional doctor’s visit appeals to you, here’s a look at the landscape of telemedicine services aimed at women in their 40s, 50s, and 60s.
Your Regular Doctor, a New Doc, or an Online Menopause Clinic? You Have Options
“The challenge for women struggling with hot flashes, and mood swings, and insomnia, and all of the other symptoms of perimenopause and menopause is finding a doctor who really knows what they’re talking about,” says Suzanne Gilberg-Lenz, MD, an integrative women’s health expert who speaks around the country and whose practice is based in Southern California, but who treats women across the country through telemedicine.
“If you have a great relationship with your doctor, and you’re satisfied that they’re addressing your concerns, fantastic! Stick with them, and don’t put off seeking care because of Covid-19,” says Dr. Gilberg-Lenz, who runs Menopause Bootcamps for women. “Schedule a tele visit. There’s no reason to delay your health care.”
On the other hand, if you’ve tried getting help through your regular doctor and haven’t been happy with the advice, well, know that you have some options thanks to telemedicine.
We’ve said it here before, but medical schools tend to spend very little time training doctors about the ins and outs of perimenopause and menopause. “That means the women under their care are often unprepared for what’s coming,” says Jill Angelo, CEO and co-founder of Gennev, an online menopause clinic that offers both telemedicine appointments and access to menopause coaches.
If you’ve ever been on the receiving end of medical advice along the lines of “drink Metamucil”—when you’ve sought relief for hot flashes—you know this first hand.
“Women, much like the one who was told to drink a constipation solution, tend to find me after they’ve tried things like dressing in layers, cooling pillows, or trying antidepressants,” says Leslie Meserve, MD, a NAMS-certified practitioner who offers telemedicine appointments through her Newport Beach, California, practice Framework Health.
“They haven’t received a complete explanation of what they’re going through, or what the true benefits and risks of hormone replacement therapy (HRT) are, or even what their non-hormonal options are,” Dr. Meserve continues. “They’re confused.”
Another upside to telemedicine-only services, says Angelo, is that they’re a great option for women who don’t have easy access to good Ob/Gyn care, either because of where they live or because of their work or family commitments.
“The current healthcare system can be opaque, confusing, and expensive—leaving many women behind entirely. Cost and location should not prohibit women from seeking the care they need,” says Hilary Cole, co-founder of Hers, a growing telemedicine service that stretches beyond the Ob/Gyn field to include more than 30 urgent primary-care concerns (such as help for UTIs or allergies), as well as online therapy and skincare.
When women reach out to Hers, they’ll be paired with an appropriate health care provider based on their main concerns at that moment. That means if it’s hot flash relief you’re looking for, they’ll connect you to a physician or nurse practitioner who’s a women’s health specialist.
What to Expect with a Menopause-Focused Telemedicine Appointment
Video visits are surprisingly similar to an in-office appointment. You can expect to fill out a health questionnaire ahead of time, and the conversation begins with you describing your chief concerns. All of the experts interviewed for this story use secure, private platforms to conduct tele-appointments (that means they conform to HIPAA-privacy rules).
Something that might surprise you, is that online appointments are frequently longer than the usual 10- to 15-minutes you’re used to. Dr. Gilberg-Lenz says she thinks that’s because the doctors are no longer rushing from exam room to exam room, stopping to answer questions in between.
“One of the best things we offer to women is time,” adds Dr. Neuhaus of The Cusp. “We’re not bound to the traditional doctor’s office scheduling, so we’re able to take all the time that’s necessary to educate women about their symptoms and their options.”
If you’re meeting with your regular doctor, they’ll already have access to your most recent lab work and mammogram results. But if you’ve decided to go with a new doctor or one of the online-only services, you’ll need to get some blood tests done locally if you and the doctor decide that HRT is right for you.
Speaking of prescriptions, federal and state telemedicine rules allow for seamless ordering of prescriptions and refills. Most doctors will send the prescription to the pharmacy of your choice, while some of the online clinics use a prescription delivery service.
As for payment options, during the Covid-19 pandemic most private health plans, as well as Medicare, are treating telemedicine visits the same as they would an in-person office visit. (This rule relaxation may not be extended once the public health emergency is declared over.) That said, it’s always best to check with your health plan to understand exactly what they’re covering and your payment responsibilities.
If the provider you’ve chosen doesn’t accept insurance, you may be able to use funds from a flexible spending account (FSA) or health spending account (HSA) to cover the cost of your visits. Your insurance plan may also allow you to submit a receipt and other appointment documentation for out-of-network services.
One thing that sets the menopause-only telemedicine clinics and online services apart from private doctors is the number of add-ons that they offer. As noted earlier, for example, Gennev gives women the option of signing up for unlimited access to registered dietitians and menopause coaches who create personalized plans. They also have a line of wellness products and supplements. The Cusp has its own mobile app that lets women check in with their care team in between visits.
Drawbacks to Menopause-Only Telemedicine
There are obviously limits to technology. Most notably, you’ll be missing out on a hands-on exam. The experts from the online menopause clinics stress that the care they offer does not replace the need to keep up with your annual exams and recommended screenings.
Also, if you’re having abnormally heavy bleeding, notice a new or changing lump, or suspect a sexually-transmitted disease, you’ll need to get those concerns checked out in person.
One other big drawback is that some aren’t yet able to provide care in all 50 states. Gennev is up and running in 48 states plus Washington, D.C. (Rhode Island and Arkansas are the outliers). The Cusp operates only in California and New York.
There are, of course, other telemedicine platforms, such Medici and FollowMyHealth, but these are general health and primary care providers, not necessarily menopause specialists.
How to Find a Telemedicine Provider
Curious to learn more about the telemedicine options for this time of your life? Start your search here:
Dr. Suzanne Gilberg-Lenz (thedrsuzanne.com/telehealt-medical)
How she works: Schedule a video visit with Dr. Gilberg-Lenz or other providers with the Women’s Care of Beverly Hills Medical Group by calling 310-657-1600; Anthem Blue Cross Blue Shield insurance accepted. (Your insurance plan may allow you to submit a claim for an out-of-network visit.) Prescriptions are called in to the pharmacy of your choice. Currently available to women in all 50 states.
How it works: Book a 3-month plan for $210, which includes multiple video visits and unlimited chats via the mobile app. As a special offer for the Get in the Groove community, use the code GITG51 at checkout for $51 off, making the total $159 for the 3-month plan (offer good through July 15). Prescriptions are sent through the app and can be filled at the pharmacy of your choice. Currently only available to women living in California or New York.
How it works: Schedule either a 15- or 30-minute appointment ($45 and $85, respectively) with menopause practitioners who are available in 48 states and Washington, D.C.; not available to women in Rhode Island or Arkansas. Prescriptions are called in to your pharmacy of choice.
You can also sign up for Gennev’s HealthFix membership ($25/month) to receive unlimited phone and text support with a menopause coach who is a registered dietitian, plus complimentary Gennev supplements, lubricants and hygiene products. For $75 per month, you can also receive unlimited telemedicine appointments with a doctor.
Get in the Groove readers can try out Gennev’s HealthFix membership free for one month to work with a menopause coach who is trained in menopause and certified in nutrition, movement, sleep and stress management. Use code GROOVE when checking out.
How it works: This site addresses more than 30 primary care concerns (such as colds, allergies, tension headaches), in addition to having health care providers who specialize in women’s health concerns. Hers also offers online therapy and skincare. Take an online medical assessment to get matched with a physician. Consultations are $39. Prescriptions are called in to your pharmacy of choice. Certain medications are also available for purchase on the site. Primary care is currently available in 29 states.