A virtual women's specialty care platform for complex hormonal, metabolic and gynecological conditions, where menopause and perimenopause sit alongside PCOS, endometriosis, thyroid disease, fibroids and primary ovarian insufficiency. Each patient is assigned one medical provider, either an obstetrician-gynecologist, an endocrinologist or a women's health nurse practitioner, plus a registered dietitian, and stays with both. Care starts with a 30-minute medical visit and a 45-minute nutrition visit, broad hormonal and metabolic labs, then check-ins every week or two. Prescribing is optional and patient-directed, covering transdermal and oral estradiol, micronized progesterone, a non-hormonal drug for hot flashes, weight medication and thyroid replacement, and a separate arm ships custom-compounded medication to patients.
Tiffani Hughson is a certified nurse midwife at Maiden Lane Medical, a large multi-specialty practice in lower Manhattan. Her practice profile lists her as a telemedicine provider, so visits with her are virtual for patients in New York. She trained in full-scope obstetrics and gynecology and now focuses on perimenopause, menopause and women's sexual health. She manages hormone therapy alongside routine gynecologic care. The practice offers oral and transdermal hormone therapy, vaginal estrogen and DHEA, and non-hormonal medicines. Visits are booked online through the practice's 24/7 telemedicine scheduler.
Mulberry OBGYN is a solo practice on Centre Street in Lower Manhattan, started by Dr. Nyein so that patients see the same physician at every visit. Perimenopause and menopause are the center of the practice, alongside sexual health, surgical gynecology and a concierge pregnancy program. He begins with a long history of cycles and symptoms rather than a single blood test, and uses labs and imaging only where they add something. For hormones he favors regulated FDA-approved preparations and advises against compounded protocols and pellets, and he will consider testosterone only for diagnosed low desire. Because he is also a minimally invasive and robotic surgeon, he can work up abnormal bleeding in his own office with ultrasound, endometrial sampling or hysteroscopy. He is an osteopathic physician who offers hands-on osteopathic manipulative treatment to some patients, and he is the next generation of a family that has cared for women in New York for more than fifty years.
Kostant is one of several gynecologists at Carnegie Women's Health, the gynecology office of a high risk pregnancy group called Maternal Fetal Medicine Associates on the Upper East Side. Her own page says she handles annual exams, pregnancy planning and perimenopausal and menopausal symptoms, and that she does office and outpatient surgery herself. The practice describes menopause care as starting with blood work to check hormone levels, then choosing between hormone therapy with estrogen and progesterone or a low dose antidepressant. Carnegie also does BioTE hormone pellets, but the site names two other doctors with that service rather than her. Visits are requested through a form on the site, and you pick either the office or a Zoom appointment when you fill it in. Because the group's main business is high risk obstetrics, midlife care sits in the same office as genetic cancer screening and a nutritionist.
