# New menopause guidance is here

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The menopause playbook got an upgrade

Menopause care just got a long overdue update. For the first time in more than a decade, the American College of Obstetricians and Gynecologists (ACOG) revised its guidance.

What’s changed could affect the way you manage your symptoms now and protect your health for the years ahead. Here’s what the new guidance means for your care:

When you start HRT matters: If it’s a fit for you, hormone therapy can help with hot flashes and disrupted sleep. And it’s best not to wait until you’ve been dealing with symptoms for years. In general, HRT benefits are more likely to outweigh risks if you start before age 60 or within 10 years of menopause. A Midi clinician can help you understand if now’s the right time to start HRT.

You and your clinician have many solutions to discuss: If you prefer to skip hormones or can’t take them, ACOG suggests non-hormonal meds for hot flashes, such as Veozah and Lynkuet, as well as certain antidepressants. At Midi, we consider all of these options (and more!) when putting together your Care Plan.

Your Care Plan can include more than medication: ACOG says cognitive behavioral therapy (CBT), mindfulness, exercise, clinical hypnosis, and acupuncture can all play a role alongside medical treatment — and at Midi, we agree 100%. A clinician can guide you toward these wellness therapies and resources during your virtual visit.

The big takeaway? Menopause care should be individualized and take age, health history, and individual risk factors into account. That’s the approach Midi has long taken: Your clinician starts by listening, then helps you explore hormone and non-hormone options to build a Care Plan around your symptoms and goals.

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Meet your new nutrition partner

“Just tell me what to eat!” We heard you! Midi is collaborating with Berry Street to help you figure out what to put on your plate. Connect with a registered dietitian for 1-on-1 virtual support, personalized meal ideas, and guidance for goals like increasing protein, lowering cholesterol, and eating well on a GLP-1.

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“Midi gave me my life back.”

- Andrea G., Midi patient

In spring 2023, I just wasn’t feeling like myself. I was irritable, tearful at work for no reason, and even questioning my career.

My primary care doctor said my labs looked great and suggested more strength training — I was already working out 5-6 days a week. My OB/GYN’s hormone tests came back normal, too, and she suggested it might be depression or anxiety. That didn’t sit right. I’m a mom of three, a teacher, and the person managing our household. I left feeling frustrated and unheard.

Then I heard perimenopause being talked about on Instagram, along with a recommendation for Midi. They took my insurance, so I booked a visit right away.

From the start, my Midi clinician listened and believed me. She explained what was happening in my body and talked me through my options. We decided on an estrogen patch and progesterone. Within a few days, my sleep improved. About a week in, I felt happier, calmer, and more like myself. My coworkers even asked if I was okay because I seemed so much happier.

Three years later, I’m still with Midi and feeling great. I’m so grateful I found a clinician who listened.

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Midi Health, 195 Page Mill Road Suite 103, Palo Alto, CA 94306, United States

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