I work with women ages 35 and above who are seeking primary care and/or perimenopause/menopause hormone services.

This is for women who are frustrated with the lack of access in their area and are wanting to have a partner in health who is knowledgeable in menopausal and common hormone issues in women. This is for you if you want a healthcare relationship where you feel heard, prioritized, and accompanied through your own unique journey.

Women who have issues that require in-person evaluation and treatment (such as prolapse, IUD placements, severe urinary incontinence, abnormal pap screenings). Additionally, women who prefer to have only in-person services or have all services by one provider would not be a good fit for this clinic.

We will have virtual visits at a frequency that makes sense for each woman. Generally this means once every 3-6 months, but some women need closer monitoring. Between visits, patients can reach me via the HIPAA-compliant patient portal for questions or concerns.

I do not take health insurance. This allows for my time to be spent taking care of patients rather than on administration. This allows more flexibility to treat you based on best practices, not based on the dictates of insurance company protocols or plan limitations. However, women may choose to use their insurance benefits for hormone or medication prescriptions or labs.

You can use your insurance, however, this does not guarantee coverage of any lab studies, medications or hormone therapies as this telemedicine clinic is not associated with any health insurance provider including Medicare.

Hormone therapy is one of the most effective treatments available for bothersome hot flashes and night sweats. If hot flashes and night sweats are disrupting your daily activities and sleep, HT may improve sleep and fatigue, mood, ability to concentrate, and overall quality of life. Treatment of bothersome hot flashes and night sweats is the principal reason women use HT. Hormone therapy also treats vaginal dryness and painful sex associated with menopause. Hormone therapy keeps your bones strong by preserving bone density and decreasing your risk of osteoporosis and fractures. If preserving bone density is your only concern, and you do not have bothersome hot flashes, other treatments may be recommended instead of HT.

The North American Menopause Society

Hormone replacement therapy has a bad reputation. In 2002 it was widely reported a study called the Women's Health Initiative found a link between hormone therapy and an increased risk of blood clots, heart disease, stroke, and breast cancer. Naturally, doctors mostly stopped prescribing HRT. However, newer studies have since been completed that have found that HRT is much safer than initially reported when used within certain parameters. We know that every drug, hormone, or medical intervention has both benefits and risks associated with it. I will discuss the pros and cons of any proposed treatment and we will decide together what is the best approach for you.

Yes. There are different options to help ease symptoms. These include conventional medicines and supplements.

Women with a history of the following disorders are not candidates for HRT.

• Blood clotting disorders

• Heart attack, Coronary Heart Disease, or other Cardiovascular Heart Disease

• Breast cancer

• Severe Liver Disease

• Stroke

This can vary for each woman and can range from a few weeks to 3 months. Dosages can be adjusted as needed to maximize their effect and help ease symptoms, improve mood, energy, and sleep.

For most women, yes. In my experience, approximately 90 to 95% of menopause and perimenopause concerns can be safely and effectively managed through telehealth. Menopause care is primarily based on understanding your symptoms, menstrual history, health history, risk factors, and treatment goals. Most of this information comes from a detailed conversation rather than a physical exam. When needed, I can order labs, mammograms, bone density scans, or other testing locally.

Every patient completes a comprehensive intake questionnaire covering medical, surgical and family history, medications, symptoms, lifestyle factors, and health screenings. I evaluate cardiovascular risk, breast cancer risk, blood clot risk, osteoporosis risk, and any potential contraindications to hormone therapy. Depending on your situation, I may recommend laboratory testing, mammograms, bone density scans, pelvic ultrasounds, or additional evaluations before starting treatment. My goal is to always provide thoughtful, individualised, evidence based care.

Mammogram is the absolute must screening before we can start any HRT. Depending on risk factors and personal history, some women would also benefit from a pelvic ultrasound. We will discuss this during our initial consultation.

Yes. This work is meant to complement the work you are doing with your PCP, midwife, women’s health provider, or gynecologist. Often different providers are interested in different aspects of care or do not have the time, training, or interest to dedicate to working in this area.

Yes, as much as possible. These hormones are processed from plants (soy, wild yams), and are available in both FDA-approved prescriptions made by pharmaceutical companies, as well as compounding pharmacies. Either way, the base or active ingredients/hormones are essentially the same.

For clinical questions or concerns, you can always reach out to me via your patient portal messaging system in order to ensure messages are kept private and confidential as per HIPAA regulations. For non-clinical questions or concerns not related to your medical care, I can be reached at info@marissacortesmendez.com, or via phone at 505-226-0011.

Testosterone therapy may be helpful for women and is recommended for certain select cases. Otherwise, I do not prescribe any controlled substances in my practice, this includes any opioids or benzodiazepines.

As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks. Hormone therapy might slightly increase your risk of stroke or blood clots in the legs or lungs (especially if taken in pill form). If started in women aged older than 65 years, HT might increase the risk of dementia. If you have a uterus and take estrogen with progesterone, there is no increased risk of cancer of the uterus. Hormone therapy (combined estrogen and progestogen) might slightly increase your risk of breast cancer if used for more than 4 to 5 years. Using estrogen alone (for women without a uterus) does not increase breast cancer risk at 7 years but may increase risk if used for a longer time. Some studies suggest that HT might be good for your heart if you start before age 60 or within 10 years of menopause. However, if you start HT further from menopause or after age 60, HT might slightly increase your risk of heart disease. Although there are risks associated with taking HT, they are not common, and most go away after you stop treatment.

The North American Menopause Society