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Accepted by most major insurance plans with more on the way.

It’s not you, it’s your hormones.

During perimenopause, hormone levels, especially estrogen, fluctuate wildly. These ups and downs trigger physical and emotional symptoms (think puberty in reverse).

Personalized perimenopause treatment

Your Midi clinician will listen to your symptoms, review your health history, then design the Care Plan that’s best for you.
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Your Midi treatment may include:

Hormonal medication: Both contraceptives and HRT can ease certain symptoms.  (Reminder: You can still ovulate during perimenopause, so pregnancy is a real possibility.)
Non-hormonal meds: Recommended for women who shouldn’t use hormones, or prefer to avoid them.
Supplements + botanicals: We recommend evidence-based solutions curated by Midi's expert physicians.
Lifestyle coaching: Small changes—from stress management techniques to diet tweaks—can make a big difference during perimenopause.


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“The year I turned 40, everything began to shift. Brain fog set in, irritability, anxiety, weight gain, no libido. Nothing worked until I found Midi. I’m one month into my regimen and have never felt better!! My clinician gave me back the intimacy in my marriage, the patience I longed for again with my family, and my sanity.”

—S.M., 42, Midi patient
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“After years of suffering from insomnia, my clinician’s understanding of hormones and knowledge of the latest research in safety for bioidentical HRT provided a solution. I am so grateful to her and to MIDI for seeing us women in perimenopause and helping us live healthier, happier lives!”

—T.M., 50, Midi patient
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“I couldn’t get help for my perimenopause symptoms like trouble sleeping. My doctors told me I was too young for hormone therapy, but my Midi clinician actually listened to me. She prescribed HRT in the form of the patch and treatment for my sleep issues. It was a relief to learn there’s a cure for what I’m going through!”

—M.H., 47, Midi patient
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Meet Midi’s Clinical Leaders

Our perimenopause protocols are defined by Midi’s medical advisors, doctors with decades of experience in women’s midlife health. 

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Designed by top-tier specialists

Our protocols are crafted by doctors with decades of experience in women’s midlife health, and delivered by trained and certified clinicians.

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Deeply personalized

We listen to your experience and work closely with you to build a Care Plan that fits your medical history, genetics, and approach to health.

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Flexible and proactive

Your body is always changing. We adjust your plan in response, fine-tuning your treatment to provide meaningful, lasting relief.

Dr Mindy Goldman Headshot


Clinical Professor, Department of Ob/Gyn and Reproductive Sciences at UCSF and Midi Chief Clinical Officer

cancer & survivorship

DR. Pauline Maki headshot
Professor of Psychiatry, Psychology and OB/GYN at University of Illinois Chicago

Brain health, mental health, depression, & hormonal health

DR. Sheila Bouldin headshot
DR. sheila bouldin
professor of OB/GYN and director of the Women’s Health Division at the University of Mississippi Medical Center

hormone health, obesity & public health

TORI HUDSON, N.d. headshot
professor and former medical director at national university of natural medicine

botanical medicine, & naturopathic remedies

Dr. Lauren Greenberg headshot
Dr. Lauren Greenberg
board-certified plastic surgeon

Menopausal hair & skin changes, breast cancer reconstruction

Dr. Lauren Greenberg headshot
Dr. Don Dizon
Director of Medical Oncology at Rhode Island Hospital

Survivorship & sexual health

Dr. Lauren Greenberg headshot
Dr. Robert Aptekar
President, Integrative Women’s Care

Bone health, osteoporosis prevention & treatment

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Designed to be better in every way

What we treat
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All clinicians trained in midlife care

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Expertise in hormone replacement therapy

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Protocols designed by experts in hormonal change

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Midi Clinicians assigned to every patient

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24/7 access to guidance & support

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Flexible follow-ups & adjustments, until you feel better

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How it works

In perimenopause, your body changes. Your care should, too.

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What are you experiencing?

Select all of your symptoms.

Trouble sleeping
Period problems
Brain fog
Hot flashes
Weight changes

Book your virtual visit

Take a few minutes to set up your account, enter insurance, tell us about your symptoms, and choose a time to meet your clinician.

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Cheri Barzottini, NP

Meet your Midi clinician

Discuss your symptoms and health history in depth with a nurse practitioner trained in perimenopause and menopause.

Hormone levels: FSH, E2, AMH, testosterone free and total
Vitamin & mineral tests: Ferritin, vitamin D, vitamin B12

Get the tests you need

If bloodwork or imaging can help us personalize your treatment, we’ll send you to a convenient local facility that accepts your insurance

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Dr. Mindy goldman
Follow-up visit

Discuss how your plan is going


Integrate Midi into your health routine

Get all the virtual follow-ups you need to dial your treatment and take preventative steps. We’ll partner with your other doctors, and refer you for in-person treatment when needed.

Transparent pricing

Midi’s care coordinators are available to help you get maximum coverage from your insurance, both for your prescriptions and your Midi visits. If you’re uninsured or Midi care is out of network under your plan, we also offer cash payment for services. 

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Service offering



Initial visit

The Midi Essential Visit gives you ample time for an in-depth conversation.

Only pay standard co-pay and deductible


Continued care visits

Follow up visits fine-tune your Care Plan and safeguard your future health.

Only pay standard co-pay and deductible

$120 - $250

depending on visit length and care complexity

Initial visit

The Midi Essential Visit allows time for an in-depth conversation with a trained clinician.


Standard co-pay and deductible



Continued care visits

Ongoing visits let us fine-tune your care, address new symptoms, and safeguard your future health.


Standard co-pay and deductible


$120 - $250

depending on visit length and care complexity

Frequently asked questions

What is perimenopause?

Perimenopause is defined as the months or years leading up to menopause. During this time, estrogen levels are dropping, but not in a steady way. Instead, they may fluctuate wildly, triggering physical and emotional symptoms.

What is the typical age for perimenopause?

Perimenopause typically starts between 40 and 50, but some women experience it earlier (it in their 30s) or later (in their 50s).

How long does perimenopause last?

The average length is four to six years, but perimenopause can last up to ten years.

How do I know when perimenopause is over?

Once it’s been 12 months since your last menstrual cycle, perimenopause is over and you’ve reached menopause. The average age of menopause is 51.

Can I get pregnant during perimenopause?

Yes, you can still ovulate during perimenopause, so pregnancy is a real possibility. But certain types of hormonal birth control can provide protection and help manage hot flashes and mood swings.

How do I know if it’s perimenopause or PCOS?

Symptoms of polycystic ovary syndrome (PCOS) can be similar to perimenopause. These include irregular or missed periods, mood changes, weight gain, and difficulty sleeping. But PCOS-specific symptoms include acne, facial hair growth, and skin darkening. Your Midi clinician may order blood tests or a pelvic ultrasound to check for PCOS.

Are perimenopause at-home tests reliable?

At-home kits promise to ID if you’ve reached perimenopause. The problem: Hormone levels fluctuate wildly at this stage, so a single test can’t accurately pinpoint your body's overall levels. That’s why Midi doesn’t usually recommend hormone testing. One exception: If you’re having irregular periods during perimenopause, we may test your hormones to see if your ovaries are still functioning.