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Bladder leaks, urgency, dryness and pain: treatable, and we talk about it
Genitourinary symptoms affect more than half of women after menopause and get worse without treatment. They respond well to simple, safe care.
Dryness, irritation, pain with intimacy, recurring UTIs
Thinning of vaginal and urethral tissue from estrogen loss. Low-dose vaginal estrogen reverses it in most women within weeks, is safe for nearly everyone, and cuts recurrent urinary infections. Non-hormonal moisturizers and other prescription options exist when needed.
Leaking with a cough, sneeze or run; urgency
We sort stress from urge incontinence, treat the tissue, review medications and fluids, and refer to pelvic floor physical therapy, which has strong evidence. Where appropriate we discuss in-office options, including electromagnetic pelvic floor stimulation, and surgical referral for the minority who need it.
Pressure or bulge
Pelvic organ prolapse is common and often managed without surgery. We evaluate, coordinate with gynecology or urogynecology, and treat the symptoms that go with it.
Common questions
Is vaginal estrogen safe after breast cancer?
For many women, yes, with their oncologist's agreement; the amount absorbed is very small. We coordinate with your oncology team before prescribing.
Is this a gynecology practice?
No. We are internal medicine physicians with a focus on perimenopause and menopause. We treat the symptoms and the long-term risks that come with this stage, including heart, bone, weight, sleep and mood, and we work with your OB/GYN when a procedure or gynecologic exam is needed.
Do I need a referral?
No. Book directly online, or call or text. If you have an OB/GYN or primary care provider, we send them a summary with your permission.
Is hormone therapy safe?
For most healthy women within ten years of menopause or under 60, current guidelines consider hormone therapy a reasonable and effective option for bothersome symptoms. Some conditions change that answer, which is why the first visit is a full medical review. We follow the Menopause Society guidance and explain the trade-offs plainly.
Is it covered by insurance?
Visits are billed to your insurance as medical visits through Privia Medical Group. Medications are usually covered with a standard copay. See the insurance page.
Can I do visits by video?
Yes. After the first visit most follow-ups can be by secure video anywhere in Virginia.
You do not have to put up with it.
A 45-minute consult that takes your symptoms seriously and looks at the whole picture.