This post shares my personal experience and is not medical advice. I am not a medical professional—just a woman dealing with perimenopause and sharing what the process has looked like for me. Every person’s health history, risks, symptoms and treatment needs are different. Please reach out to your own medical provider or a menopause-focused provider such as Midi Health for support tailored to you.
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Three years ago this September, I booked my first appointment with Midi Health. I had spent several years dealing with symptoms I did not understand, and a friend finally asked me over breakfast if it was possible I was in perimenopause.
I started researching and quickly realized that she was probably right. At the same time, I kept seeing women share stories online about feeling dismissed or not heard by their doctors. Then I found Midi: a virtual clinic focused on perimenopause and menopause care that worked with my insurance and could help with both hormone therapy and medical weight-loss options.
I decided to book a consultation. Three years later, I am very glad I did.
What led me to seek help for perimenopause
My most disruptive symptoms were sleep problems and night sweats, but the list was much longer than that. I was dealing with rage and frustration, mood swings, brain fog, joint pain, itchy ears and an inability to lose weight no matter how focused I was.
The rage was so unfamiliar that I would call my work bestie, explain what had happened and ask, “Should I be this mad, or is it the hormones?” Usually, the answer was about 50/50.
I have always struggled with my weight, but I had also always been able to lose weight when I focused on it. For roughly two years before starting treatment, nothing I tried would move the scale more than about five pounds.
Because I have a hormonal IUD and do not get periods, I also did not have a changing menstrual cycle as an obvious signal that something new was happening in my body. I simply knew that I did not feel like myself.
What my first Midi Health appointment was like
Like most medical appointments, the process began with online questionnaires. During my first telehealth visit, my clinician worked through a detailed list of symptoms to understand what I was experiencing.
She acknowledged almost immediately that I was checking a lot of boxes and that it was a good time to explore options that might help. That moment mattered. I felt heard, and I finally had someone with relevant expertise helping me understand what could come next.
Midi describes its care as specialized support for women in perimenopause and menopause, delivered through virtual visits. Availability and insurance participation vary, so it is important to check the current details for your state and health plan directly with Midi and your insurer.
My experience with HRT
I began with a 0.0375 mg estradiol patch, changed twice weekly. Over time, we increased that to 0.05 mg.
Because my hormonal IUD supplies progestin, I did not initially add oral progesterone. When sleep continued to be a problem, my Midi clinician and I decided to add it. I now take 200 mg of progesterone.
The night sweats began improving almost overnight. The rage and mood swings took longer, but I am now feeling meaningful improvement there too.
At a recent check-in, we discussed whether to raise my estradiol dose because I was experiencing more frustration and mood issues. At the same time, I was dealing with extreme stress at work that was beginning to resolve. We decided to hold my dose steady a little longer. That turned out to be the right choice for me: as those external stressors eased, my moods improved too.
That is one of the things I value about ongoing care. There is no single switch that “cures” perimenopause. For me, it has been a process of identifying symptoms, checking in and deciding with my clinician whether an adjustment makes sense.
Hormone therapy is not appropriate for everyone and has potential benefits and risks that depend on a person’s health history. The American College of Obstetricians and Gynecologists offers a helpful overview, but the decision belongs in a conversation with your own qualified provider.
My GLP-1 experience through Midi
In addition to treating my perimenopause symptoms, I wanted help with the weight-loss resistance I had been experiencing. I started with compounded semaglutide, later switched to compounded tirzepatide and now use branded Zepbound through the LillyDirect self-pay program.
GLP-1 medications can have side effects, but I have been fortunate that mine have been minimal and mostly limited to occasional nausea. I find that being intentional about eating—even when I am not particularly hungry—helps me avoid many of those issues.
I lost about five pounds during my first month on HRT, and the downward trend continued after adding GLP-1 treatment. All in, I am down approximately 65 pounds. I would like to lose at least another 50.
The pace has been slower than I would ideally like, but I also recognize that gradual progress may be more sustainable for me than very rapid loss. This is my result, not a promise of what anyone else will experience.
A necessary caution: compounded GLP-1 products are not the same as FDA-approved medications. The FDA explains that compounded drugs are not reviewed for safety, effectiveness or quality before they are marketed and has raised concerns about dosing errors, fraudulent products and adverse events. Anyone considering a GLP-1—compounded or branded—should discuss the benefits, risks and source of the medication with a licensed clinician.
What my care has cost
My insurance has covered my regular Midi visits when they address perimenopause, subject to my usual copays and deductible. My HRT is also covered, and I pay roughly $20 per month.
Unfortunately, my plan does not cover weight-loss treatment or medication. When I received compounded GLP-1 medication through Midi, I generally paid between $250 and $300 per month. I now pay about $450 per month for Zepbound through LillyDirect, down from $500 when I first started.
Prices, insurance coverage and program terms change, so those numbers should be treated only as a snapshot of my own costs. Check current pricing directly with your provider, pharmacy, insurer and the official Zepbound savings and coverage page.
I am very aware that I am fortunate to have an income that lets me invest in a medication that has been life-changing for me. Paying hundreds of dollars every month is simply not accessible to everyone, and I do not want to gloss over that reality.
What ongoing care with Midi has been like
My experience has been helpful and supportive. Periodic check-ins give me space to talk through what has improved, what is still bothering me and what adjustments might be worth considering.
My own gynecologist has been supportive of my HRT prescription through Midi. A new primary care doctor, however, was horrified that I was using Midi and insisted that I should work with my gynecologist instead.
I understand the value of coordinated care, and I make sure my providers know what I am taking. At the same time, I am pleased with the quality of care I have received and the improvements in my quality of life. Since my gynecologist is comfortable with Midi managing this part of my care, I do not currently see a reason to change.
Would I recommend Midi Health?
Based on my experience, yes. I appreciate working with a team focused specifically on perimenopause and menopause care, and I have never felt as though I needed to persuade my clinician that my symptoms were real.
That does not mean Midi is the only good option or that every patient will have the same experience. Your gynecologist, primary care clinician or another menopause specialist may be the right fit. What matters is finding a qualified provider who listens, considers your complete medical history and helps you make informed decisions.
If you recognize yourself in any of these symptoms, I encourage you not to struggle alone. Reach out to your own medical provider or explore a menopause-focused option such as Midi Health to start the conversation.
What I wish I had known sooner
I wish I had understood perimenopause earlier so that I could have asked for help sooner. At the time my symptoms began, people were not talking about this transition nearly as openly as they are now. Without periods as a clue, I did not know how to connect the dots.
I am thankful every day for the friend who brought it up over breakfast three years ago. Since then, I have been vocal with other women about my symptoms, my treatment and where I found support. The more honestly we talk about these experiences, the easier it becomes for someone else to recognize that she may need help too.
Two books I also recommend are The Menopause Manifesto by Dr. Jen Gunter and The New Menopause by Dr. Mary Claire Haver.
Being heard did not solve everything overnight. It did, however, give me a path forward—and that has made a tremendous difference in how I feel and how I approach this stage of my life.
Again, I am not a medical professional, and this article reflects only my personal experience. Please consult your own healthcare provider or a menopause-focused provider such as Midi Health before making decisions about HRT, GLP-1 medications or any other treatment.
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