Home / Our approach
How we practice midlife medicine
Guideline-based, unhurried and coordinated. No pellets, no supplements store, no membership required.
What we follow
The Menopause Society position statements, ACOG guidance and the US Preventive Services Task Force for screening. When evidence is uncertain we say so.
What we do not do
- Hormone pellets or compounded bioidentical hormones
- Saliva or routine blood hormone panels to "diagnose" menopause
- Supplement sales
- A required membership fee; visits are billed to insurance
Who delivers care
Vandana Palagiri, MD (Internal Medicine and Obesity Medicine), with our nurse practitioners, registered dietitian and Duke-trained health coach. Pelvic floor physical therapy, gynecology and mental health are coordinated with trusted partners and the VPMC Mental Wellness team.
How follow-up works
Six to eight weeks after starting treatment, then every three to six months, in person or by video. Portal messages are answered within one business day.
Ready for a plan that fits?
45-minute first visit, most insurance accepted.