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May 28, 2020

Behind the Curtain: What It’s Like to Have a CurieMD Appointment

Behind the Curtain: What It’s Like to Have a CurieMD Appointment

From her office in Newport Beach, California, Dr. Leslie Meserve joins me on a video call. She’s dressed in a pink blouse; her white lab coat hangs on the door behind her. An exam table covered in white paper stands against a wall filled with diplomas and certifications.

I will not be sitting mostly naked on that exam table today. I am relieved that I am not wearing a thin cotton gown in an ice-cold exam room. This is my first telemedicine visit ever—but it’s not the first time I’ve tried to engage a physician about my menopause symptoms.

Why I Scheduled a CurieMD Appointment

I’m 49. After years of irregular periods, it’s been about 8 months since my last period. I wonder if that was my last one ever. I often wake up during the night and cannot get back to sleep no matter what I try. I am exhausted in a way I didn’t know was possible, and I ache everywhere all the time. But I’m not sick—I know this. I believe I’m perimenopausal—and I’d really like someone to help me deal with my symptoms.

Thus the doctor on the screen in front of me. She is a menopause specialist, certified by the North American Menopause Society, and I’m hoping to get the answers I need to feel better.

Before My Appointment

Before my appointment with Dr. Meserve, I completed a medical assessment form that included a detailed medical history on the CurieMD website, and I read the FAQs

Now Dr. Meserve reviews my history with me: the medications I take (only my migraine meds), diagnoses, or surgeries I’ve had (I have not had a hysterectomy), cancer (none). We establish that I am not a smoker, that my cholesterol is borderline high, and that I took birth control pills for years after my daughter was born.

I don’t have recent bloodwork (a lipid panel, metabolic panel, thyroid test, and complete blood count) to provide in this initial consultation, but I can see my regular doctor for that later. There aren’t any red flags in my medical history. My mammogram is current, and Dr. Meserve reviewed it, so no worries there either. 

With that out of the way, we discuss my life a little, and she asks about my menopause symptoms, which are not debilitating, though they are disruptive. I tell her what I’ve already tried, and she walks me through the short-term implications of menopause and the long-term effects of living in an estrogen-deficient body, which is normal for postmenopausal women. Bone loss? Dementia? For all my self-education, I didn’t know these things.

Dr. Meserve then explains what bioidentical hormone therapy is—I’m very happy to learn it’s plant-based, made from yams—and then she tells me about the benefits and risks. I’ve already done a lot of reading about hormone therapy as a treatment for my symptoms, and I ask a few questions to be sure I understand what I’ve read. For many women, Dr. Meserve explains, the benefits of hormone therapy outweigh the risks, which are about the same as drinking a glass of wine several days a week.

What We Decide

After learning more about it, I agree with Dr. Meserve’s recommendation to try hormone replacement therapy. She specifically recommends estradiol, taken once daily in pill form. She explains that it’s FDA approved, plant-based, and bioidentical, which makes me feel good about how safe it will be. After talking it all over with her, I feel really good about this decision and the fact that I might have some relief soon. 

It feels like I’ve finally found someone who will listen to my concerns and not brush me off with “what you’re going through is all normal” or “just hang in there—it gets better.” 

The appointment was fast (just 20 minutes), so it was really convenient, but I feel like Dr. Meserve fully listened to me and my concerns, which hasn’t always been my experience with doctors.

After My Visit

After the visit, Dr. Meserve sent my prescription to CurieMD’s mail-order pharmacy partner. The pills will arrive at my door in the next few days. It’s easier than a trip to CVS.

By the way, the visit cost me nothing. I was able to use my FSA money to pay for my prescription (which costs $33 per month). 

There’s no hormone testing needed, Dr. Meserve explained to me, because hormone tests are not a reliable guide for whether a woman has the “right amount” of hormones. Since optimal hormone levels for postmenopausal women have not been established and each woman is unique, how my symptoms respond to the hormone therapy will tell us what we need to know. In three months, I’ll have a follow-up visit that will cost less than 40 bucks—the doctor will adjust my prescription if needed.

I’m eager to receive my prescription and get on the path to feeling better. This perimenopause thing? It hasn’t been fun. Talking to Dr. Meserve and getting a prescription made me feel like there’s hope and that I’ll soon feel more like myself again.

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