By MaryBeth Matzek | Photo courtesy Tes Jordens
Dr. Tes Jordens was a family medicine practitioner working at a large healthcare provider and frequently had female patients come in mentioning vague symptoms, including fatigue, moodiness and trouble sleeping. She would run a few lab tests, but nothing unusual turned up. She was unsure of how to help.
One day, a woman with some of those same symptoms came in, but this one was different. She said she was in menopause and wanted to go on hormone therapy.
“At that point, I honestly did not know much about it, but I did more research and kept learning. The woman I worked with began to feel better,” Dr. Jordens says. “I continued to learn on my own. They never taught us this stuff in medical school.”
The more Dr. Jordens learned, the more she realized women in perimenopause and menopause had a growing need for care. She also felt there wasn’t enough time in a standard office visit to discuss what was all going on.
That led to the founding of 1988, her telehealth practice focused on midlife care. The name pays tribute to the first year that women could get a business loan on their own.
“I believe in empowering women, including their health,” Dr. Jordens says.
Launching a new business takes courage since you never know what the response will be. That’s how Miranda Zuhlke felt when launching Midlife Rising, her longevity-focused women’s health education and speaking platform.
“Opening a business focused on women in perimenopause and menopause was never on my bingo card,” says Zuhlke, who previously worked in emergency medicine. “But the clinical gap in care was ridiculous and no one else was closing it. So I did.”
Zuhlke had finished a long infertility journey and found herself in perimenopause, which inspired her own business journey.
“I knew clinically that it didn’t need to be this way and I didn’t need to deal with all of these symptoms,” says Zuhlke, a certified physician’s assistant with a doctorate in medical science.
She’s also a Menopause Society-certified provider and an American Association of Sexuality Educators, Counselors and Therapists (AASECT) certified sex counselor.
While she was in family practice, Dr. Jordens says getting 10 minutes with a patient was standard. Now through 1988, an initial appointment with a patient takes an hour.
“Patients fill out their histories ahead of time so I can really listen to their symptoms and what they’re looking for, and the next third I spend going over what I heard her tell me, talk about hormone therapy and if there’s any concerns there,” she says. “The final third is about how we can move forward. Do we need to do labs? What does a plan look like?”
1988 does not take insurance and is a private-pay clinic but women can use HSA or FSA accounts to pay for services.
CHANGING RECOMMENDATIONS
Medical schools do not teach much — or anything — about menopause as part of the regular curriculum. Some schools are looking to change that, since half of the population goes through menopause.
In recent years, confusion has surrounded whether hormone therapy is the right choice for women navigating perimenopause and menopause. Before 2002, hormone therapy was widely prescribed and considered a standard, evidence-based treatment for managing menopausal symptoms. That changed when a Women’s Health Initiative (WHI) study was halted early after researchers reported increased risks of breast cancer, stroke and heart attack among women taking a combination of estrogen and progestin. In response, many physicians moved away from prescribing hormone therapy, leaving countless women to manage challenging menopause symptoms without the treatment options they once relied on.
In the late 2010s, researchers looked more closely at the WHI study, and concluded hormones could be safely prescribed for women under age 60 or within 10 years of menopause.
For better or worse, Dr. Jordens says social media has played a role in more women asking about hormones as they enter perimenopause and menopause.
“There’s a lot of good information out there — and some bad information — but there are some influencers like Dr. Mary Claire Haver that some women follow who have good advice,” she says.
“And women talk to each other and learn a friend is taking hormones and how it has made a difference in their symptoms.”
Zuhlke never pictured herself in front of a room of women talking about menopause, but that’s precisely what she does with Midlife Rising. She provides clinical care and evidence-based information that covers hormone health and hormone therapy, building menopause- inclusive workplaces and navigating burnout and identity in midlife.
“I often ask women, ‘Who is taking care of you?’ and they break down crying, because no one has asked,” she says. “My goal is to empower them with concrete, actionable steps so they can start to feel better.”
Zuhlke says it’s essential for women to advocate for their own health.
“We need to stop accepting that we feel this way just because of our age,” she says. “Track your symptoms before every appointment and bring a list. If your provider won’t listen, find one who will. Women don’t just deserve to survive this age — they deserve to feel phenomenal in it.”
LEADING THE MOVEMENT
Finding balance is integral to A New Way Forward, a clinic run by Dr. Sheryl Spitzer-Resnick that focuses on perimenopause and menopause health.
Dr. Spitzer-Resnick was on the forefront of the perimenopause and menopause health arenas, having opened her Madison clinic in 2016, which also focuses on natural thyroid treatments. She meets with patients virtually or in person, and focuses on symptom management and the root cause of the disease.
A New Way Forward is a private-pay clinic and does not accept insurance.
BEYOND THE SYMPTOMS
For Dr. Amanda L. Schmehil-Micklos, her interest in treating women with perimenopause and menopause is personal.
“I was having symptoms myself, and I had a partner certified in menopause care and she helped me. What a difference it makes when you get the right treatment!” says Dr. Schmehil-Micklos, a specialist in obstetrics and gynecology with Associated Physicians, who sought additional training and became a certified menopause physician.
Dr. Schmehil-Micklos says women are talking to each other about what they are going through. Those who have used hormones are sharing how much they feel better, she adds.
“For so long, we didn’t have much to offer women going through menopause, but within the past five years, our thinking has changed,” she adds. “Now with hormone treatment, we can help women feel a lot better.”
