Downtown Drs. Brown is a small concierge primary care office in downtown Lexington, started in 2018 by Cady Brown and her husband Ryan, both internal medicine physicians. She holds Menopause Society certification, and the practice lists menopause and hormone therapy in its women's health services alongside everyday internal medicine work like thyroid and heart risk. Membership buys an annual physical that ends in a written wellness plan, plus direct phone, text and email access to her doctor between visits. Care happens in person at the Mill Street office, and virtual visits are used mainly when a member is away from home. The practice has reached the size it wants, so new patients join a waiting list. No pharmaceutical reps are allowed in the office, and there are no nurse practitioners or physician assistants, so members see their own doctor every visit.
Marnatti sees women at UK HealthCare's Women's Health Primary Care clinic in Lexington, and she is one of two clinicians who staff the health system's Midlife Health and Menopause Clinic. She joined the women's health practice in 2020 and moved into the menopause clinic when it opened in February 2025. That clinic runs Tuesday mornings as a consult service, and it pulls in UK specialists in bone health, nutrition and integrative medicine when a woman needs them. Visits are booked through the women's health clinic, and she also keeps a general primary care panel, so the same woman can bring her blood pressure or her bone density to the visit. On hormones she is plain about the evidence. After the FDA removed its black box warning she went on the health system's podcast to say the old label frightened women and prescribers away from treatment, and that she still weighs age, time since the last period and health history before starting anything.
