The simple answer is – YES. As women get further post-menopausal, most will experience what is called the genitourinary syndrome of menopause. This is chronic and progressive, unless it is treated. Typical symptoms can include pain with sex, burning, itching, urinary symptoms without actual infection, and frequent urinary tract infections. These symptoms can significantly impact your quality of life, and they can also put you at risk for serious illness.

It’s helpful to have a consultation to learn more about the ways hormone loss affects your body. That way, you’ll be better prepared to discuss these changes with your primary care provider.

Unfortunately, our medical education system has very little focus (if any) on menopause. A very small percentage of physicians feel comfortable managing menopause. This not only applies to primary care providers, but also obstetricians/gynecologists, unless they have pursued further training.

Our practice focuses on the area of menopause. It is important for you to continue receiving annual gynecologic exams and breast exams through your PCP or gynecologist. You should also stay up to date with mammograms and other breast imaging, if indicated.

Our practice does not take insurance at this time, due to the administrative burdens and constraints placed by insurance companies on patient care. This allows Dr. Middleton to spend more time focused directly on your care. We’re happy to provide you with a superbill upon request, which you can submit to your insurance company for possible reimbursement.

We can meet anywhere you have internet access, since all visits are conducted using telehealth. You must be physically present in the state of Virginia during your telehealth visits. Plans are being made to offer in-person visits beginning summer 2026.

Initial paperwork, including medical history and consents, must be completed at least 48 hours prior to your first visit. You’ll receive this paperwork electronically. Contact us if you haven’t received your paperwork within three days of your visit.

Payment will be due no later than 48 hours before each visit and is non-refundable at that time. Appointments will be canceled and opened up to the waitlist if payment has not been received.