Dr. Casiano is a gynecologist who left traditional practice after more than a decade to open a small direct-pay office in Marietta. She sees every patient herself, with no nurse practitioners or physician assistants, and first visits run a full hour. Women in perimenopause or menopause can book single visits or a year-long hormone program that covers planning, dose changes and monitoring. You need one in-person visit to start, and some follow-ups can then be done by video. She is also board certified in obesity medicine and uses an InBody body composition scan for metabolic and weight care. The practice also offers a limited ongoing membership with portal messaging and labs included.
Jackie Piasta runs a small solo membership practice in East Cobb focused on hormones, perimenopause and menopause, and midlife metabolic health. New patients start with a nurse-led pre-visit to line up labs and then an hour-long consultation with her, and ongoing care after that requires joining the membership. Members message the team through a portal and a text line, and follow-ups run 30 to 40 minutes in person or by video. She prescribes estrogen, progesterone and testosterone but does not offer hormone pellets. She is also an obesity medicine specialist who prescribes GLP-1 weight medications and treats thyroid, bladder and bone problems. New patient appointments are booking two to three months out, and she teaches menopause care to nurse practitioner students at Vanderbilt.
Dr. Vogel runs an independent pain practice in Marietta, and menopause care is one part of a wider practice built around pelvic, sexual and nerve pain. He opened one of Georgia's first stand-alone menopause clinics in 1997 and has written about bioidentical hormones. His women's health care includes hormone therapy, other medications and herbal options. For women who can't use hormones and haven't found relief elsewhere, he offers stellate ganglion blocks for hot flashes. He also treats vulvodynia, pelvic floor pain and low sexual desire, and patients can refer themselves. Visits are in person, with telehealth consults when travel is hard.
