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Originally approved as an anti-epilepsy medication and later found to help treat binge eating."}],"markDefs":[],"style":"normal"},{"_key":"fb155d706071","_type":"block","children":[{"_key":"0b9aa89352da0","_type":"span","marks":["strong"],"text":"Pros"},{"_key":"0b9aa89352da1","_type":"span","marks":[],"text":"\nAffordable. Works well for binge eating. Few side effects."}],"markDefs":[],"style":"normal"},{"_key":"7ab13038f576","_type":"block","children":[{"_key":"213b1afa052b0","_type":"span","marks":["strong"],"text":"Cons"},{"_key":"213b1afa052b1","_type":"span","marks":[],"text":"\nDoesn’t cause significant weight loss for everyone. 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Weekly dosing."}],"markDefs":[],"style":"normal"},{"_key":"f10e8c447cf9","_type":"block","children":[{"_key":"5eba3b47eb4c0","_type":"span","marks":["strong"],"text":"Cons"},{"_key":"5eba3b47eb4c1","_type":"span","marks":[],"text":"\nRisk of GI upset, especially at higher doses. 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Similar effectiveness and side effects as the injection while being slightly cheaper."}],"markDefs":[],"style":"normal"},{"_key":"e1df08d497e2","_type":"block","children":[{"_key":"3838d27e572a0","_type":"span","marks":["strong"],"text":"Cons"},{"_key":"3838d27e572a1","_type":"span","marks":[],"text":"\nNewest option. Least likely to be covered by insurance. 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Weekly dosing."}],"markDefs":[],"style":"normal"},{"_key":"e814fed90d88","_type":"block","children":[{"_key":"ccfa33d5c3c60","_type":"span","marks":["strong"],"text":"Cons"},{"_key":"ccfa33d5c3c61","_type":"span","marks":[],"text":"\nMay cause rapid weight loss and more GI side effects. Expensive and variable insurance coverage."}],"markDefs":[],"style":"normal"}]}]}],"name":"Screen size","unmetModules":[{"_key":"4142a7849bc7","_type":"tableModule","backgroundColor":"bccream","spacing":"pys","subTable":{"_type":"table","rows":[{"_key":"200851f2bbef","_type":"tableRow","cells":["<b>Medication (Brand Name)</b>","<b>Active Ingredient </b>","<b>How it works</b>","<b>Pros & Cons</b>"]}]},"table":{"_type":"table","rows":[{"_key":"10cef1c88836","_type":"tableRow","cells":["Contrave","Bupropion + Naltrexone","Not fully known. Potentially treating food cravings (naltrexone) and mood issues (bupropion)","<b>Pros:</b> More affordable than GLP1s. 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Thank you for the great service!","Title":"Brittany F., Tia Patient","_key":"d80b064ea06b","_type":"inline"},{"Content":"I have a lifelong history of extremely severe medical anxiety due to several traumatic instances in childhood, and rarely being listened to by doctors in adulthood. Everyone at your practice has been gentle, informative, and operates through a trauma-informed lens. I've never felt so heard by my providers, and until today, I’ve never walked away feeling like I was glad I sought treatment. After my first lab sample collection today and sharing a little bit about it I have at least three friends who are also signing up for care with Tia.","Title":"Lillian N., Tia Patient","_key":"f16a80231de2","_type":"inline"},{"Content":"I’ve been a Tia patient for over a year now, and the quality of care I’ve received has been unlike any healthcare experience I’ve ever had. What struck me first is the continuity of the care I receive. All of the questions and information gathered when I first signed up helped to create both a comprehensive medical history as well as a snapshot of my current conditions. But the best part? Whether my visit is virtual or in-person, I never, ever feel rushed. My physician and nurse practitioners are empathetic and understanding. If you want holistic healthcare, try Tia. You won’t be disappointed.","Title":"Natalie D., Tia Patient","_key":"995b939291ee","_type":"inline"}]},{"_key":"b3b130bcb8f3","_type":"editorialText","editorialText":[{"_key":"88a360f65dc9","_type":"cta","text":[{"_key":"089cc2bcc445","_type":"block","children":[{"_key":"d3ada71a90d4","_type":"span","marks":[],"text":"Book a Weight & Metabolic Health visit"}],"markDefs":[],"style":"h2"},{"_key":"08dc1094385d","_type":"block","children":[{"_key":"474383e77aec","_type":"span","marks":[],"text":"Weight and metabolic health can shape everything from your energy and mood to hormones and long-term wellness. Whether you’re navigating unexplained weight changes, managing conditions like insulin resistance, or just wanting a clearer picture of your metabolic health, Tia’s care team provides personalized, compassionate support to help you understand what’s going on and build a plan that helps you feel your best."}],"markDefs":[],"style":"normal"},{"_key":"74d560714076","_type":"buttonBlock","items":[{"_key":"6f1c8ef326ee","_type":"singleButton","addWidgetCopy":true,"backgroundColor":"bcorange","linkCta":"Book a visit","linkType":"join-scroll-shape","redirectURL":"serviceLines=primary_care,longevity","signupH1Copy":"Let's get you scheduled","signupSubcopy":"We need some basic info to find you the right weight & metabolic health doctor and book your first visit."}],"onlyStackButtons":false}]},{"_key":"b2e79cd30b57","_type":"block","children":[{"_key":"a14724a0680b","_type":"span","text":""}],"style":"normal"}]},{"_key":"ac2b20f5cc3c","_type":"faqModule","cta":"See full FAQ","faqs":[{"_id":"d8ebe8c6-addb-456a-a4a8-b0e6cfba2fc3","_type":"faq","_createdAt":"2026-03-02T20:47:13Z","_rev":"mTY7Fq3mpkUfad5Xz0LtFq","_updatedAt":"2026-03-02T20:47:24Z","answer":[{"_key":"2e83a60299fc","_type":"block","children":[{"_key":"358d93d6217f0","_type":"span","marks":[],"text":"Women experiencing stubborn weight gain, PCOS, menopause-related changes, fatigue, or metabolic syndrome symptoms."}],"markDefs":[],"style":"normal"}],"question":"Who should schedule a metabolic health consultation?","id":"822afa9f-354b-58f3-94d8-b36e1ac762fe","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"1f2740fc55e24b52c5caa9be89451e0c","counter":977,"owner":"gatsby-source-sanity"}},{"_id":"1c7883bc-164b-4af1-9390-e5f1a120a127","_type":"faq","_createdAt":"2026-03-02T20:47:44Z","_rev":"75p5s3JN4VtlIkrkQH7KmT","_updatedAt":"2026-03-02T20:48:07Z","answer":[{"_key":"e4d6e5984ae3","_type":"block","children":[{"_key":"38abad645cc90","_type":"span","marks":["strong"],"text":"Maybe."},{"_key":"38abad645cc91","_type":"span","marks":[],"text":" Metabolic health is not determined by BMI alone. You may qualify if you have insulin resistance, PCOS, or other cardiometabolic risk factors."}],"markDefs":[],"style":"normal"}],"question":"Can I qualify for medical weight loss if my BMI isn’t very high?","id":"1ffd85e3-75b5-5eef-9a2f-62316dfb4efb","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"895ea26a7ed2fabb264c9b65a3b7927e","counter":979,"owner":"gatsby-source-sanity"}},{"_id":"146e09b7-5012-4ee4-919a-954bd4594f29","_type":"faq","_createdAt":"2026-03-02T20:48:17Z","_rev":"42tmL6AQnk3AV45gmami7h","_updatedAt":"2026-03-02T20:48:27Z","answer":[{"_key":"c03d03595a11","_type":"block","children":[{"_key":"46f829dc9f8f0","_type":"span","marks":[],"text":"You’ll meet with a Tia provider to discuss your full health history, symptoms, and goals. We may order labs and explore tools like nutrition changes or medication if appropriate. You’ll leave with a care plan built around your needs and goals."}],"markDefs":[],"style":"normal"}],"question":"What happens at a weight & metabolic health visit?","id":"72df2784-542e-5488-b096-e6244687b116","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"c501b9b06460eebbbc021a4e7a41a13a","counter":980,"owner":"gatsby-source-sanity"}},{"_id":"68cf5ea9-eba8-4dcf-a223-cfc28db18020","_type":"faq","_createdAt":"2026-03-02T20:48:40Z","_rev":"75p5s3JN4VtlIkrkQHA4tS","_system":{"base":{"id":"68cf5ea9-eba8-4dcf-a223-cfc28db18020","rev":"42tmL6AQnk3AV45gmao9C7"}},"_updatedAt":"2026-03-02T20:50:49Z","answer":[{"_key":"6d1c2d72e91e","_type":"block","children":[{"_key":"b1a130f2e35f0","_type":"span","marks":[],"text":"We treat weight as part of a bigger picture, not just a number to fix. Our care is designed specifically for women, factoring in life stage, hormones, mental health, and more. Whether you’re navigating PCOS or exploring GLP-1s, we create a personalized, evidence-based plan and stay with you to adjust it over time."}],"markDefs":[],"style":"normal"}],"question":"What makes Tia’s weight & metabolic health care different?","id":"2eb19701-dc5a-5793-aeb1-6db08244d09c","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"9c8744132184a825d5199a22f7420da0","counter":978,"owner":"gatsby-source-sanity"}},{"_id":"2f4adc18-6035-496d-9c37-5e91eff3ee93","_type":"faq","_createdAt":"2026-03-02T20:51:16Z","_rev":"mTY7Fq3mpkUfad5Xz0Nero","_updatedAt":"2026-03-02T20:51:24Z","answer":[{"_key":"2128096e15f9","_type":"block","children":[{"_key":"04194f4eb0b40","_type":"span","marks":[],"text":"Testing is based on what is clinically indicated and may include fasting glucose, HbA1c, insulin levels, lipid panels, thyroid labs and liver enzymes. We want to make sure we’re treating the whole you, not just the number on the scale."}],"markDefs":[],"style":"normal"}],"question":"What lab tests may be used? ","id":"70a2b19c-36fa-5f55-882a-e9823433c653","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"a7b32e32c5706a8f34f9aca9c2ddaf64","counter":981,"owner":"gatsby-source-sanity"}},{"_id":"fd50af17-6dad-44c4-a18c-c8eb7eb1f5ac","_type":"faq","_createdAt":"2026-03-02T20:51:32Z","_rev":"42tmL6AQnk3AV45gmaoQtJ","_updatedAt":"2026-03-02T20:51:50Z","answer":[{"_key":"45bf2c24ccd1","_type":"block","children":[{"_key":"9e604dd7314c0","_type":"span","marks":[],"text":"Your care doesn’t stop after a single appointment. Whether you’re starting GLP-1s, tapering off of them, adjusting nutrition, or changing movement routines, we’re here with you every step of the way. You’ll have regular follow-ups to check in on your progress and update your plan."}],"markDefs":[],"style":"normal"}],"question":"What happens after my first visit or prescription?","id":"fbef44dc-606b-5529-b7bd-0dc74d2ee07e","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"8ca05c9937344335f4700cf62aebda5e","counter":982,"owner":"gatsby-source-sanity"}},{"_id":"58456f1d-0b6b-4574-89c6-a22498556d48","_type":"faq","_createdAt":"2026-03-02T20:52:09Z","_rev":"75p5s3JN4VtlIkrkQHCh4X","_updatedAt":"2026-03-02T20:52:16Z","answer":[{"_key":"635c240b36c1","_type":"block","children":[{"_key":"affcfe598c670","_type":"span","marks":[],"text":"Yes. Tia offers virtual care across CA, AZ, NY, NJ, and MA and in-person care in New York, San Francisco, Los Angeles, and Scottsdale."}],"markDefs":[],"style":"normal"}],"question":"Do you offer virtual visits?","id":"4ae45727-99a2-55cd-9c61-1a7289ea7dc0","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"7d8309a3a7367b77d08b84bbd31f5537","counter":983,"owner":"gatsby-source-sanity"}}],"title":"FAQs"},{"_key":"d4be39589aa7a0e3fa2089fd06f4e282","_type":"faqModule","cta":"See full FAQ","faqs":[{"_id":"01409523-3384-40e3-a5eb-359b45b881c7","_type":"faq","_createdAt":"2026-03-02T20:56:43Z","_rev":"75p5s3JN4VtlIkrkQHFokl","_updatedAt":"2026-03-02T20:56:50Z","answer":[{"_key":"866d18990212","_type":"block","children":[{"_key":"032e5a1786430","_type":"span","marks":[],"text":"Metabolic health refers to how well your body regulates blood sugar, insulin, cholesterol, blood pressure, and fat storage. When metabolic function is impaired, it can lead to insulin resistance and difficulty with weight loss."}],"markDefs":[],"style":"normal"}],"question":"What is metabolic health?","id":"69bf366e-4b89-5bdc-a068-919e4fb12069","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"ebf3a7797f4d5d6f311753f575ec5f84","counter":985,"owner":"gatsby-source-sanity"}},{"_id":"9cbb98bd-3a6e-4c0d-94e3-1b28e57fb8a4","_type":"faq","_createdAt":"2026-03-02T20:56:58Z","_rev":"75p5s3JN4VtlIkrkQHG0GV","_system":{"base":{"id":"9cbb98bd-3a6e-4c0d-94e3-1b28e57fb8a4","rev":"75p5s3JN4VtlIkrkQHFuk6"}},"_updatedAt":"2026-03-02T20:57:24Z","answer":[{"_key":"63a234f78824","_type":"block","children":[{"_key":"dee3f1d5335a0","_type":"span","marks":[],"text":"A clinician-supervised approach to weight management that addresses hormones, metabolism, chronic stress, and underlying health conditions. It may include lab testing, lifestyle changes, and prescription medications."}],"markDefs":[],"style":"normal"}],"question":"What is medical weight loss?","id":"b8c59ffa-6fab-5908-a7ae-28e1560f4938","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"6a316c25f1e4f189971f6adfccbbbc27","counter":984,"owner":"gatsby-source-sanity"}},{"_id":"0a69ffa4-11de-4102-bf5c-0bec04d36484","_type":"faq","_createdAt":"2026-03-02T20:59:33Z","_rev":"42tmL6AQnk3AV45gmaq6SG","_updatedAt":"2026-03-02T20:59:40Z","answer":[{"_key":"3a2078dbe8da","_type":"block","children":[{"_key":"8a3fe780100f0","_type":"span","marks":[],"text":"Insulin resistance occurs when your cells don’t respond properly to insulin, leading to elevated blood sugar and increased fat storage. It is a major driver of weight gain, PCOS, and metabolic syndrome."}],"markDefs":[],"style":"normal"}],"question":"What is insulin resistance?","id":"b79ac77b-d76b-59c5-8054-15f5a0a9d7cb","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"ce57fecc9e2e774957541323778b48c1","counter":986,"owner":"gatsby-source-sanity"}},{"_id":"4e50319c-4265-4630-a298-3e07be72cb1b","_type":"faq","_createdAt":"2026-03-02T20:59:50Z","_rev":"mTY7Fq3mpkUfad5Xz0Q5vQ","_system":{"base":{"id":"4e50319c-4265-4630-a298-3e07be72cb1b","rev":"75p5s3JN4VtlIkrkQHH1jj"}},"_updatedAt":"2026-03-02T21:00:05Z","answer":[{"_key":"2318725d87fb","_type":"block","children":[{"_key":"42b4dfaaef090","_type":"span","marks":[],"text":"A cluster of conditions including abdominal weight gain, high blood pressure, abnormal cholesterol, and elevated blood sugar. It increases cardiovascular risk and is closely linked to insulin resistance."}],"markDefs":[],"style":"normal"}],"question":"What is metabolic syndrome?","id":"5a86e335-f57f-5aa4-b39f-55273b9c3b1d","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"f8749a39f79534f5612d1d752a1065bc","counter":10088,"owner":"gatsby-source-sanity"}},{"_id":"e2a26fbe-1610-4348-ba3b-848d9154ff4d","_type":"faq","_createdAt":"2026-03-02T21:00:31Z","_rev":"42tmL6AQnk3AV45gmarSIG","_updatedAt":"2026-03-02T21:00:42Z","answer":[{"_key":"7924685b3b6a","_type":"block","children":[{"_key":"6ca57ea9558b0","_type":"span","marks":[],"text":"Yes. Declining estrogen levels can contribute to increased visceral fat, insulin resistance, and changes in cholesterol. A women-centered plan can help address these specific shifts."}],"markDefs":[],"style":"normal"}],"question":"Can menopause affect metabolic health?","id":"fa57dc62-0cda-5237-b04f-623973566639","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"f9b58401238067f075a59e981a4792b2","counter":987,"owner":"gatsby-source-sanity"}},{"_id":"6304931f-8157-4945-ba53-0bd5b0aee888","_type":"faq","_createdAt":"2026-03-02T21:00:52Z","_rev":"42tmL6AQnk3AV45gmarVhg","_updatedAt":"2026-03-02T21:00:58Z","answer":[{"_key":"50c260b83d3e","_type":"block","children":[{"_key":"90ece11a33c10","_type":"span","marks":[],"text":"Chronic stress can increase cortisol levels, which can worsen insulin resistance and promote abdominal fat storage. Our care includes attention to stress and nervous system regulation."}],"markDefs":[],"style":"normal"}],"question":"How does chronic stress impact weight and metabolism?","id":"36625b97-9b57-5c8d-8752-020b6b3bd203","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"24ec30d6b93474db2454f552d21b619d","counter":989,"owner":"gatsby-source-sanity"}}],"title":"Understanding Metabolic Health"},{"_key":"3993364a23c47cf0e18fb19322a74ae5","_type":"faqModule","cta":"See full FAQ","faqs":[{"_id":"1aed3d83-8a87-435a-9dc0-82e879b845c3","_type":"faq","_createdAt":"2026-03-02T21:01:59Z","_rev":"mTY7Fq3mpkUfad5Xz0Rb7H","_updatedAt":"2026-03-02T21:02:13Z","answer":[{"_key":"a938a02d2e9f","_type":"block","children":[{"_key":"20a2596939090","_type":"span","marks":["strong"],"text":"Yes, if clinically appropriate."},{"_key":"20a2596939091","_type":"span","marks":[],"text":" Your provider will work with you to determine if these medications are right for your body."}],"markDefs":[],"style":"normal"}],"question":"Does Tia prescribe GLP-1s?","id":"75a1350b-ca9b-57d1-a6bd-6dcbc7800f57","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"8616faca36be1fb4428fba8ea9727731","counter":990,"owner":"gatsby-source-sanity"}},{"_id":"51139a2c-3aaf-487a-9a7b-f87940de57cb","_type":"faq","_createdAt":"2026-03-02T21:02:24Z","_rev":"75p5s3JN4VtlIkrkQHJxRH","_updatedAt":"2026-03-02T21:03:06Z","answer":[{"_key":"32b7c15b2400","_type":"block","children":[{"_key":"98b4561c7bc50","_type":"span","marks":[],"text":"GLP-1 receptor agonists (such as semaglutide and tirzepatide) are medications that regulate appetite and blood sugar. They reduce hunger and improve insulin sensitivity."}],"markDefs":[],"style":"normal"}],"question":"What are GLP-1 medications?","id":"393a80fd-0808-5bc6-9895-d086a8ecc00f","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"834b1e4ece2717cead3f9ccaba567174","counter":988,"owner":"gatsby-source-sanity"}},{"_id":"2cdbfc71-3d59-4676-b129-ce8875ee9c1a","_type":"faq","_createdAt":"2026-03-02T21:03:23Z","_rev":"mTY7Fq3mpkUfad5Xz0Sbjx","_updatedAt":"2026-03-02T21:05:13Z","answer":[{"_key":"a3946ae7e21e","_type":"block","children":[{"_key":"753e133090b00","_type":"span","marks":[],"text":"They mimic a natural hormone that signals fullness to the brain and stabilizes blood sugar. This helps reduce cravings and lower caloric intake."}],"markDefs":[],"style":"normal"}],"question":"How do GLP-1 weight loss injections work?","id":"c8abbb40-1d94-5899-80f2-2d1ea009d584","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"ab2f835a2301cc6da29f7fd01a40c1c7","counter":991,"owner":"gatsby-source-sanity"}},{"_id":"3b7d4c94-9b83-4576-8e89-51a275e1e299","_type":"faq","_createdAt":"2026-03-02T21:03:40Z","_rev":"42tmL6AQnk3AV45gmat39b","_system":{"base":{"id":"3b7d4c94-9b83-4576-8e89-51a275e1e299","rev":"mTY7Fq3mpkUfad5Xz0SGw0"}},"_updatedAt":"2026-03-02T21:04:52Z","answer":[{"_key":"ee2f0f84d185","_type":"block","children":[{"_key":"e67d6bc3914d0","_type":"span","marks":[],"text":"No. These are typically self-administered as weekly injections at home. Your provider will teach you how to safely inject. Follow-ups can be virtual or in-person."}],"markDefs":[],"style":"normal"}],"question":"Do I need to visit the clinic for GLP-1 injections?","id":"b87b5ef2-0716-5569-833b-ec93cc9c9133","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"42ee1f4638b35e932633a80b98a514a1","counter":993,"owner":"gatsby-source-sanity"}},{"_id":"a734336a-dd9a-43ba-b3ad-455068d83157","_type":"faq","_createdAt":"2026-03-02T21:05:39Z","_rev":"mTY7Fq3mpkUfad5Xz0SmpF","_system":{"base":{"id":"a734336a-dd9a-43ba-b3ad-455068d83157","rev":"75p5s3JN4VtlIkrkQHLEJN"}},"_updatedAt":"2026-03-02T21:06:38Z","answer":[{"_key":"f09e4f12bb1b","_type":"block","children":[{"_key":"aacb2f97f1f20","_type":"span","marks":[],"text":"They are FDA-approved and widely studied. At Tia, GLP-1s are viewed as one tool within a broader metabolic health strategy, not a standalone solution."}],"markDefs":[],"style":"normal"}],"question":"Are GLP-1 medications safe for long-term use?","id":"a8f8513c-c31f-5f2d-a878-a4b1f453237e","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"f285d147d5498c7b98ddbbfcf08a384e","counter":992,"owner":"gatsby-source-sanity"}},{"_id":"f37b58a5-39c7-49b9-b838-66afea62c9bf","_type":"faq","_createdAt":"2026-03-02T21:07:02Z","_rev":"75p5s3JN4VtlIkrkQHLpeD","_system":{"base":{"id":"f37b58a5-39c7-49b9-b838-66afea62c9bf","rev":"75p5s3JN4VtlIkrkQHLjjh"}},"_updatedAt":"2026-03-02T21:07:27Z","answer":[{"_key":"526567567c06","_type":"block","children":[{"_key":"d743b24b820f0","_type":"span","marks":[],"text":"We may prescribe semaglutide or dual GIP/GLP-1 medications like tirzepatide based on your health profile."}],"markDefs":[],"style":"normal"}],"question":"Which GLP-1 medications does Tia prescribe? ","id":"2a55d711-fbb1-56f3-970d-43f2e60a44f8","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"b82b60ae8d9c3360ad0e867cf9e3967c","counter":994,"owner":"gatsby-source-sanity"}},{"_id":"df415be1-f5d6-49e7-b5a0-1158cad3c264","_type":"faq","_createdAt":"2026-03-02T21:07:54Z","_rev":"42tmL6AQnk3AV45gmatVFz","_updatedAt":"2026-03-02T21:08:38Z","answer":[{"_key":"1d46c874b830","_type":"block","children":[{"_key":"38755f7361ff0","_type":"span","marks":[],"text":"Yes, in some cases (e.g., switching from semaglutide to tirzepatide). This must be medically supervised to ensure proper dosing adjustments."}],"markDefs":[],"style":"normal"}],"question":"Can I switch from one GLP-1 medication to another?","id":"05f609c8-95a4-5af2-b611-42621f836dfe","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"dba01fb8901bfdd4dd8158aa6bc39c92","counter":995,"owner":"gatsby-source-sanity"}},{"_id":"3e05dbd2-bf7b-49c5-8bc4-1c090cbbf71e","_type":"faq","_createdAt":"2026-03-02T21:08:19Z","_rev":"75p5s3JN4VtlIkrkQHM4ey","_updatedAt":"2026-03-02T21:08:29Z","answer":[{"_key":"3ce9ba7c1d4a","_type":"block","children":[{"_key":"3d271189718e","_type":"span","marks":[],"text":"Results vary based on metabolism, hormone balance, and lifestyle changes. Clinical trials show significant potential when combined with comprehensive care."}],"markDefs":[],"style":"normal"}],"question":"How much weight can I lose with GLP-1 medications?","id":"527ab6a1-ce90-5918-8c30-130d7e6968ca","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"d1bef007e5d792bcbdc5ec9d803937f0","counter":997,"owner":"gatsby-source-sanity"}},{"_id":"674bfb86-891a-49c0-99ad-bd51a5dd06d7","_type":"faq","_createdAt":"2026-03-02T21:08:47Z","_rev":"mTY7Fq3mpkUfad5Xz0TIqB","_updatedAt":"2026-03-02T21:09:31Z","answer":[{"_key":"c184bb297794","_type":"block","children":[{"_key":"e7d75c309735","_type":"span","marks":[],"text":"For some women with PCOS and insulin resistance, these medications can improve metabolic markers and support weight management."}],"markDefs":[],"style":"normal"}],"question":"Can GLP-1 medications help with 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And the list, literally, goes on."}],"markDefs":[],"style":"normal"},{"_key":"d0ccb8edb63b","_type":"block","children":[{"_key":"15923643307b0","_type":"span","marks":[],"text":"It goes without saying that perimenopause (the time period that precedes menopause when symptoms first appear) and menopause are naturally-occurring conditions that can be unnaturally disruptive, debilitating, and difficult to navigate."}],"markDefs":[],"style":"normal"},{"_key":"f5e43db329ab","_type":"block","children":[{"_key":"536a7a0f65380","_type":"span","marks":[],"text":"Thankfully, "},{"_key":"d8efb70f5d8f","_type":"span","marks":["9da0a079d2ff"],"text":"menopause is having a moment"},{"_key":"6356cb7447e5","_type":"span","marks":[],"text":" and, hopefully, a moment that will last. Media outlets, social media influencers, and medical practitioners are paying more attention. And many forward-thinking health and wellness companies are developing new products to help educate and ease the minds and bodies of the 2+ million people who reach menopause each year in the US."}],"markDefs":[{"_key":"9da0a079d2ff","_type":"externalLink","linkType":"text","url":"https://www.nytimes.com/2023/07/28/podcasts/the-daily/menopause-symptoms-treatment.html"}],"style":"normal"},{"_key":"3d8d3b010e07","_type":"block","children":[{"_key":"3c6aa453df530","_type":"span","marks":[],"text":"Hopefully, this overview will also educate and ease a few minds, and help demystify and destigmatize a natural and unavoidable bodily process that should be respected as a rite of passage worth honoring and understanding."}],"markDefs":[],"style":"normal"},{"_key":"c1ced7e34b12","_type":"sectionHeader","headerLevel":"h2","title":"What is menopause?"},{"_key":"90e08928968e","_type":"block","children":[{"_key":"f7697d3cc7220","_type":"span","marks":["d12d9d683bb1"],"text":"Menopause"},{"_key":"79130f6e0cf9","_type":"span","marks":[],"text":" is a natural biological process that marks the end of a person’s menstrual cycles and fertility, and its diagnosis is confirmed after an individual has gone 12 consecutive months without a menstrual cycle. At this stage, ovaries stop producing estrogen and stop releasing eggs. The time period leading up to menopause, when people start experiencing changes in their menstrual cycles, hot flashes, and other symptoms is called "},{"_key":"f7697d3cc7222","_type":"span","marks":["strong"],"text":"perimenopause."},{"_key":"f7697d3cc7223","_type":"span","marks":[],"text":" As perimenopause marches toward menopause, many people start experiencing more and more menopause symptoms (including irregular periods), but ovulation still occurs and a perimenopausal person can still get pregnant."}],"markDefs":[{"_key":"d12d9d683bb1","_type":"internalLink","linkType":"text","reference":{"_ref":"04cda285-9d18-465d-8ff2-9329d8f3eed6","_type":"reference"}}],"style":"normal"},{"_key":"14e21f59e1b9","_type":"cta","backgroundColor":"bccream","ctaImage":{"_type":"image","asset":{"_ref":"image-19d1947899730f4c922afaaf4bb0172f61920694-1912x1116-png","_type":"reference"}},"text":[{"_key":"ecff53171ee0","_type":"block","children":[{"_key":"cd3a8f95d123","_type":"span","marks":[],"text":"Are you experiencing symptoms of menopause and need medical support? Join Tia and schedule an appointment at the clinic nearest you. "}],"markDefs":[],"style":"large"},{"_key":"2140d8470f02","_type":"block","children":[{"_key":"97c29cdcfa1e","_type":"span","marks":["em"],"text":"Located in New York, Phoenix, San Francisco, and Los Angeles."}],"markDefs":[],"style":"normal"},{"_key":"a7cbcbf254b9","_type":"buttonBlock","items":[{"_key":"eb262e8d9692","_type":"singleButton","backgroundColor":"bcorange","linkCta":"Book an appointment","linkType":"join-scroll-shape"}]}]},{"_key":"d45bb1ee0343","_type":"sectionHeader","headerLevel":"h2","title":"How long does perimenopause last? When does menopause begin?"},{"_key":"6c24f9a2925c","_type":"block","children":[{"_key":"91e92d080dd20","_type":"span","marks":[],"text":"The average duration of perimenopause is around four years, although it can last just a few months or extend as long as a decade. Characterized by irregular menstrual cycles and other symptoms related to hormonal fluctuations, perimenopause usually starts in your 40s. Some people experience symptoms for a few months. Some people have symptoms for several years. Typically, menopause begins in a person’s late 40s or early 50s, but the exact age varies widely. "},{"_key":"b79c00b4498b","_type":"span","marks":["93a9b908032e"],"text":"The average age of onset of menopause is 51."},{"_key":"11a6aa8f5825","_type":"span","marks":[],"text":" Menopause (and menopausal symptoms) can also be prematurely triggered by having a hysterectomy or having the ovaries surgically removed."},{"_key":"91e92d080dd25","_type":"span","marks":["strong"],"text":" "},{"_key":"91e92d080dd26","_type":"span","marks":[],"text":"Many factors, which are notoriously difficult to identify and predict, can influence the timing of menopause, including genetics, reproductive history, certain health conditions and treatments (cancer therapy), and some lifestyle habits (smoking)."}],"markDefs":[{"_key":"93a9b908032e","_type":"annotation","text":[{"_key":"7237b9e759f0","_type":"block","children":[{"_key":"be285cfc96730","_type":"span","marks":["strong"],"text":"Did you know?"}],"markDefs":[],"style":"normal"},{"_key":"f68735f29882","_type":"block","children":[{"_key":"896f937b20020","_type":"span","marks":[],"text":"The average age of menopause onset is typically between 40 to 58 years old with an average age of onset being 51 years old, although this can vary significantly from person to person."}],"markDefs":[],"style":"normal"}]}],"style":"normal"},{"_key":"e7fda33ae3ac","_type":"sectionHeader","headerLevel":"h3","title":"  What are the symptoms of menopause and perimenopause?"},{"_key":"60076b2c6789","_type":"block","children":[{"_key":"ed2ec74860650","_type":"span","marks":[],"text":"Menopause is associated with a variety of symptoms, but the duration and severity of these symptoms vary among people. Additionally, some symptoms will be temporary and resolve on their own while others may persist and require medical attention. Every situation is specific and anyone experiencing bothersome menopausal symptoms should "},{"_key":"031d4e337038","_type":"span","marks":["0b7cad051c32"],"text":"consult her healthcare provider"},{"_key":"08777dd5f26b","_type":"span","marks":[],"text":" to discuss management options."}],"markDefs":[{"_key":"0b7cad051c32","_type":"internalLink","linkType":"text","reference":{"_ref":"6b861435-f6fe-4c96-893c-77732c7ab389","_type":"reference"}}],"style":"normal"},{"_key":"3715a8f741af","_type":"block","children":[{"_key":"ee698a806c840","_type":"span","marks":[],"text":"In some cases, your provider might recommend a blood test to check your follicle-stimulating hormone (FSH) and estradiol (E2) levels. Although a high FSH can be a sign of perimenopause, a single FSH reading isn’t a reliable indicator since day-to-day hormone levels fluctuate dramatically. Truthfully, it can be difficult to distinguish the hormonally-based symptoms of perimenopause from more general changes due to life transitions – aging, midlife events, children leaving home, career and relationship changes – so it’s unlikely all perimenopausal symptoms are due to hormonal fluctuations alone. "}],"markDefs":[],"style":"normal"},{"_key":"d98e6aaa03b9","_type":"block","children":[{"_key":"a5849c13626a0","_type":"span","marks":[],"text":"Common symptoms of menopause include:"}],"markDefs":[],"style":"h3"},{"_key":"ade222b02d3a","_type":"block","children":[{"_key":"8b18ae0174f70","_type":"span","marks":["strong"],"text":"Irregular Menstrual Cycles:"},{"_key":"770b1a0084cd","_type":"span","marks":[],"text":" Declining estrogen levels can make periods more unpredictable, and with less progesterone to regulate growth of the endometrium, the uterine lining may become thicker before it sheds. This can result in heavier periods. "},{"_key":"58cfe246d9c3","_type":"span","marks":["55e48e88ad57"],"text":"Fibroids"},{"_key":"28d1ebae9bca","_type":"span","marks":[],"text":" and endometriosis, both of which are fueled by estrogen, might become more troublesome too."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"55e48e88ad57","_type":"internalLink","linkType":"text","reference":{"_ref":"f158fe1b-1e16-4ebf-b284-ccbb466ed379","_type":"reference"}}],"style":"normal"},{"_key":"7fbf20a9be29","_type":"block","children":[{"_key":"c368f5ef1a1c0","_type":"span","marks":["strong"],"text":"Hot Flashes and Night Sweats:"},{"_key":"e8e4010af1d3","_type":"span","marks":[],"text":" An estimated 30-35% of perimenopausal and menopausal people suffer sudden waves of body heat with flushing and sweating that can last 5-10 minutes. These episodes can occur at night while sleeping too."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"9aaadbfd6e3c","_type":"block","children":[{"_key":"c8e6b49ba5990","_type":"span","marks":["strong"],"text":"Sleep Disturbances:"},{"_key":"a7b2d7013c7c","_type":"span","marks":[],"text":" About 40% of perimenopausal people have sleep problems – trouble falling and staying asleep. This can lead to insomnia and fractured sleep problems and, of course, contribute to fatigue and fogginess."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"aaa4a26267ea","_type":"block","children":[{"_key":"102af7898b230","_type":"span","marks":["strong"],"text":"Vaginal Changes:"},{"_key":"0c0234f5cdb2","_type":"span","marks":[],"text":" During late perimenopause, falling estrogen levels can cause vaginal tissue to become thinner, drier, and less elastic, which can lead to itching, irritation, painful sexual intercourse, and an increase in "},{"_key":"2a2426de24b6","_type":"span","marks":["50c1f9d7954d"],"text":"urinary tract infections (UTIs)."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"50c1f9d7954d","_type":"internalLink","linkType":"text","reference":{"_ref":"5dc6f871-a243-459e-8f06-43f0af3d8915","_type":"reference"}}],"style":"normal"},{"_key":"2f67c515436b","_type":"block","children":[{"_key":"da99edf08b4a0","_type":"span","marks":["strong"],"text":"Mood Symptoms:"},{"_key":"9cb5cfbcce8c","_type":"span","marks":[],"text":" Hormonal fluctuations during perimenopause might contribute to mood changes, including irritability, anxiety, and depression. That said, studies haven’t proven a definitive correlation between hormone levels and new mood symptoms. Of course, the unpredictability of perimenopause can be stressful and provoke irritability on its own. The best predictors of mood symptoms, in general, are life stress, poor overall health, and personal and family history."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"12b54f7845c0","_type":"block","children":[{"_key":"d9a21046b3eb0","_type":"span","marks":["strong"],"text":"Fatigue:"},{"_key":"1191da13a004","_type":"span","marks":[],"text":" Some people experience increased fatigue and lack of energy during perimenopause."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a709b47abf4e","_type":"block","children":[{"_key":"32d9fe4f81b60","_type":"span","marks":["strong"],"text":"Changes in Libido:"},{"_key":"97aa786cf023","_type":"span","marks":[],"text":" Some people report lower desire and more difficulty being aroused."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"627789f6856e","_type":"block","children":[{"_key":"e174048c04d10","_type":"span","marks":["strong"],"text":"Memory and Concentration Issues:"},{"_key":"0ec4569fce33","_type":"span","marks":[],"text":" Perimenopause can affect memory, concentration, and cognitive function."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0a8eb57ea9ae","_type":"block","children":[{"_key":"41ae5bfac29c0","_type":"span","marks":["strong"],"text":"Joint and Muscle Pain:"},{"_key":"e5b0ae7ec30d","_type":"span","marks":[],"text":" Perimenopause can be associated with joint and muscle pain."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"656f597c778c","_type":"cta","backgroundColor":"bccream","text":[{"_key":"c230ca1aa93b","_type":"block","children":[{"_key":"7ba7eaedf5e8","_type":"span","marks":[],"text":"Seeking medical treatment for your menopause symptoms? Join Tia and schedule an appointment at the clinic nearest you. "}],"markDefs":[],"style":"large"},{"_key":"558a632bc9cd","_type":"block","children":[{"_key":"0ab606ba06a1","_type":"span","marks":["em"],"text":"Online and in-person care in  "},{"_key":"0b8b87106331","_type":"span","marks":["em","f36c40ce94f5"],"text":"Los Angeles"},{"_key":"ae3229c7ab72","_type":"span","marks":["em"],"text":", "},{"_key":"2c07c2dc3df2","_type":"span","marks":["em","a7306f3d0823"],"text":"San Francisco"},{"_key":"2a9114898a0f","_type":"span","marks":["em"],"text":", "},{"_key":"4bc7fefada85","_type":"span","marks":["em","bd0e04d442f6"],"text":"New York"},{"_key":"51d7f74ca2cb","_type":"span","marks":["em"],"text":", and "},{"_key":"e452e2b3e660","_type":"span","marks":["em","825f68de9c12"],"text":"Scottsdale"}],"markDefs":[{"_key":"bd0e04d442f6","_type":"internalLink","linkType":"text","reference":{"_ref":"96ced8ef-d692-4f97-8032-88f1a8828219","_type":"reference"}},{"_key":"a7306f3d0823","_type":"internalLink","linkType":"text","reference":{"_ref":"ae75d891-a665-438a-9fed-e2ea4eecf06e","_type":"reference"}},{"_key":"f36c40ce94f5","_type":"internalLink","linkType":"text","reference":{"_ref":"e377a479-e152-4105-bfd8-cd8af403f8d8","_type":"reference"}},{"_key":"825f68de9c12","_type":"internalLink","linkType":"text","reference":{"_ref":"85cda481-9e09-4c4a-aaf6-c5662d8b2613","_type":"reference"}}],"style":"normal"},{"_key":"898c2ec08249","_type":"buttonBlock","items":[{"_key":"eb262e8d9692","_type":"singleButton","backgroundColor":"bcorange","linkCta":"Book an appointment","linkType":"join-scroll-shape"}]}]},{"_key":"882e91133bb5","_type":"sectionHeader","headerLevel":"h2","title":"Are there ways to treat these symptoms?"},{"_key":"5c2fac9148df","_type":"block","children":[{"_key":"82d35adf7d870","_type":"span","marks":[],"text":"The short answer: Yes. There are several useful treatment strategies for managing perimenopause and menopause symptoms, including non-prescription remedies, medical interventions, and lifestyle changes. As always, it’s essential to discuss new, bothersome, or worsening symptoms with a healthcare provider to determine the best approach."}],"markDefs":[],"style":"normal"},{"_key":"b69ac3514d9b","_type":"block","children":[{"_key":"5a14aa889c8c0","_type":"span","marks":["strong"],"text":"Hot Flashes:"},{"_key":"5bea122f88a3","_type":"span","marks":[],"text":" The first rule of thumb is to avoid possible triggers (you’ll know them), like warm air temperatures, hot beverages, and spicy foods. For example, dressing in layers so you can quickly remove layers is always a good idea. Some people find relief with certain medications, like SSRI antidepressants, gabapentin, and clonidine, but there are side effects that need to be considered. For severe hot flashes, estrogen replacement is the only true fix."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"ef42059b45fa","_type":"block","children":[{"_key":"4088cba37d890","_type":"span","marks":["strong"],"text":"Irregular Periods:"},{"_key":"9c4c84ba2db7","_type":"span","marks":[],"text":" Low-dose "},{"_key":"76ac60f57833","_type":"span","marks":["c7e786d5337a"],"text":"birth control"},{"_key":"e3a623c4fce5","_type":"span","marks":[],"text":" can be a good choice here. By suppressing ovulation, these meds modulate menstrual flow, regulate periods, and stabilize endometriosis. They also protect against endometrial and ovarian cancer, stave off hot flashes, reduce vaginal dryness, and prevent bone loss."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"c7e786d5337a","_type":"internalLink","linkType":"text","reference":{"_ref":"ca742657-6062-42c7-8a48-c476af18b8fc","_type":"reference"}}],"style":"normal"},{"_key":"31eb498bb545","_type":"block","children":[{"_key":"951bb5742c030","_type":"span","marks":["strong"],"text":"Vaginal Dryness:"},{"_key":"dc26cd0f7d61","_type":"span","marks":[],"text":" Low-dose contraceptives or vaginal estrogen therapy can help relieve this symptom. But there are other approaches. Vaginal moisturizers can improve moisture and elasticity and lubricants (find a good water-based lube) can make intercourse less painful. Additionally, sexual activity seems to improve vaginal tone and help maintain a healthy acidic environment that can be protective against infections."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"eb42eaab4002","_type":"block","children":[{"_key":"f5fd4244528c0","_type":"span","marks":["strong"],"text":"Non-prescription Remedies:"},{"_key":"993ea1fc1391","_type":"span","marks":[],"text":" Some people find relief using products like soy-based supplements, black cohosh, and herbal remedies, but efficacy varies. Definitely discuss their usage with a care provider."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"fd28d3289274","_type":"block","children":[{"_key":"f4bdf49169f30","_type":"span","marks":["strong"],"text":"Bone Health:"},{"_key":"3d2a8014b530","_type":"span","marks":[],"text":" Maintaining bone health is a crucial consideration during menopause and calcium and Vitamin D are two supplements often recommended to reduce the risk of osteoporosis."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"bf3473d9cf6c","_type":"sectionHeader","headerLevel":"h2","title":"What lifestyle changes help with symptoms?"},{"_key":"d9fe7d087a15","_type":"block","children":[{"_key":"f3f9ed35960b0","_type":"span","marks":[],"text":"Adopting certain lifestyle changes can help manage symptoms of perimenopause and menopause and contribute to overall health and wellbeing. Here are some lifestyle habits that might beneficial:"}],"markDefs":[],"style":"normal"},{"_key":"20c63ef6cfc2","_type":"block","children":[{"_key":"9f1c21090a2e0","_type":"span","marks":["strong"],"text":"Regular exercise:"},{"_key":"0ecc137527be","_type":"span","marks":[],"text":" Both aerobic exercises and strength training helps manage weight, boost mood, and improve sleep."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3bbf05974e50","_type":"block","children":[{"_key":"e38020f728230","_type":"span","marks":["strong"],"text":"Healthy Diet:"},{"_key":"3484656c645c","_type":"span","marks":[],"text":" Consuming a well-balanced diet rich in fresh fruits and vegetables, whole grains, healthy oils, and lean proteins is never a bad move."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"291f0c4d3e00","_type":"block","children":[{"_key":"6eff8886f79a0","_type":"span","marks":["strong"],"text":"Stress Management:"},{"_key":"6aa586e71727","_type":"span","marks":[],"text":" Practicing stress-reducing techniques, like meditation, yoga, deep breathing, and mindfulness can have positive impacts on mood and wellbeing."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a6205c5533b4","_type":"block","children":[{"_key":"639af82f71b70","_type":"span","marks":["strong"],"text":"Adequate Sleep:"},{"_key":"de8584740427","_type":"span","marks":[],"text":" Thoughtful sleep hygiene – consistent sleep schedule, comfortable sleep environment (dark and cool), relaxing before bedtime – might help alleviate symptoms."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"d602eb80deaa","_type":"block","children":[{"_key":"88ed4533e8e20","_type":"span","marks":["strong"],"text":"Reduce Caffeine and Alcohol:"},{"_key":"bf0febc28041","_type":"span","marks":[],"text":" They can contribute to poor sleep and exacerbate hot flashes."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0e4e5061c170","_type":"block","children":[{"_key":"9f35a5dc83380","_type":"span","marks":["strong"],"text":"Stay Hydrated:"},{"_key":"a027a0cca821","_type":"span","marks":[],"text":" A good habit for overall health."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2b05d190282c","_type":"block","children":[{"_key":"0d83a9cfd73e0","_type":"span","marks":["strong"],"text":"Maintain a Healthy Weight:"},{"_key":"b4378d4e5a5e","_type":"span","marks":[],"text":" Good eating habits + regular exercise. A healthy weight can alleviate symptoms and reduce the risk of health conditions."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"af0af70861bd","_type":"block","children":[{"_key":"ebd2780861940","_type":"span","marks":[],"text":"A reminder: Treatment decisions should be personalized based on your own health history, personal preferences, and subjective symptomology. Regular check-up and check-ins with a provider are essential for monitoring progress and adjusting the plan."}],"markDefs":[],"style":"normal"},{"_key":"9bc5b0c54591","_type":"sectionHeader","headerLevel":"h2","title":"Take control of your own menopausal journey"},{"_key":"cb1f41ec9822","_type":"block","children":[{"_key":"779cb5a7eb6f0","_type":"span","marks":[],"text":"Perimenopause and menopause are natural biological processes that all women face, usually beginning in their forties, that cause numerous symptoms related to declining supplies of estrogen and progesterone. Hot flashes tend to get the most buzz, but other symptoms (vaginal dryness, mood changes, sleep disturbances) can be just as disruptive and discomforting. Thankfully, there are many ways to manage these symptoms and many more lifestyle adjustments that can lighten the emotional and physical load of perimenopause and menopause as well. And while several important studies have demonstrated an association between menopausal symptoms and lower quality of life, many menopausal women report positive aspects associated with this life stage as well. So, we leave you with a few good reasons to have hope:"}],"markDefs":[],"style":"normal"},{"_key":"f93f75a2528a","_type":"block","children":[{"_key":"b18afccd7dae0","_type":"span","marks":[],"text":"No more periods or menstrual symptoms. Sex without worrying about pregnancy. Disappearing body hair. Shrinking uterine fibroids. A renewed zest for life. More confidence. Increased bonding with other women."}],"markDefs":[],"style":"normal"},{"_key":"db400d5c57a8","_type":"block","children":[{"_key":"1ad3e73a828a0","_type":"span","marks":[],"text":"If you are experiencing symptoms of perimenopause or menopause, "},{"_key":"32702f1a263d","_type":"span","marks":["e0939ceffeec"],"text":"sign up for a Tia membership"},{"_key":"2cc35918e9a7","_type":"span","marks":[],"text":" and schedule an appointment with the "},{"_key":"c8facb103468","_type":"span","marks":["c22b429e3c04"],"text":"clinic nearest you"},{"_key":"ca44e39c3822","_type":"span","marks":[],"text":". Tia's clinics are located in New York, Arizona, Los Angeles, and San Francisco. Let Tia’s team of sexual and reproductive health experts address your concerns with the highest quality, most comfortable gynecological care around."}],"markDefs":[{"_key":"e0939ceffeec","_type":"internalLink","linkType":"text","reference":{"_ref":"6b861435-f6fe-4c96-893c-77732c7ab389","_type":"reference"}},{"_key":"c22b429e3c04","_type":"internalLink","linkType":"text","reference":{"_ref":"9b061bf7-f926-43be-8614-aa477d9eed59","_type":"reference"}}],"style":"normal"}],"image":{"_type":"image","asset":{"_ref":"image-b4ef50ded71558247ddd327ea57d5bcf00542abe-2800x1600-png","_type":"reference"}},"publishedAt":"2024-01-23T23:50:06.826Z","slug":{"_type":"slug","current":"menopause-perimenopause"},"status":"production","title":"Navigating Menopause: Beyond the Hot Flashes","topics":[{"_key":"3ec48801944a","_ref":"1a5231d2-13dc-41ea-ac2d-ad5fd81a36e7","_type":"reference"}],"updatedAt":"2026-08-10T21:13:00.000Z"},"metaInformation":{"_type":"metaCard","metaDescription":"Discover the unfiltered truth about menopause – from hot flashes to hormonal changes. Our comprehensive guide navigates symptoms, treatment options, and lifestyle changes, empowering women to embrace this transformative journey with confidence and ease. Break the silence surrounding menopause and find solace in understanding, managing, and celebrating this natural transition. Explore beyond the heat and discover a balanced, holistic approach to well-being. Your guide to a positive menopause experience starts here.","metaTitle":"Navigating Menopause: Beyond the Hot Flashes","openGraphDescription":"Discover the unfiltered truth about menopause – from hot flashes to hormonal changes. Our comprehensive guide navigates symptoms, treatment options, and lifestyle changes, empowering women to embrace this transformative journey with confidence and ease. Break the silence surrounding menopause and find solace in understanding, managing, and celebrating this natural transition. Explore beyond the heat and discover a balanced, holistic approach to well-being. 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But fear not. While menopause can challenge your sexual health, there are more ways than ever to manage these changes and reignite your sex drive, before, during, and after menopause."}],"markDefs":[{"_key":"cb270f0dde95","_type":"externalLink","linkType":"text","url":"https://asktia.com/services/menopause-perimenopause-assessment/"}],"style":"normal"},{"_key":"6c1299311cb1","_type":"sectionHeader","headerLevel":"h2","title":"The menopause and sex drive connection"},{"_key":"cef79a1e47e4","_type":"block","children":[{"_key":"74660f254cbf0","_type":"span","marks":[],"text":"The numbers tell a clear story. "},{"_key":"22880bac30c1","_type":"span","marks":["6631c5a6927f"],"text":"Research"},{"_key":"c75c5e932a76","_type":"span","marks":[],"text":" shows that up to "},{"_key":"74660f254cbf1","_type":"span","marks":["strong"],"text":"75% of women"},{"_key":"74660f254cbf2","_type":"span","marks":[],"text":" experience changes in their sexual function during the menopause transition, including declines in desire, arousal, lubrication, and satisfaction. Among the most commonly "},{"_key":"b993c34128a6","_type":"span","marks":["7bb58ab1cc02"],"text":"reported symptoms"},{"_key":"45e9d0dfd4cd","_type":"span","marks":[],"text":": low sexual desire (affecting 40 - 55% of women), poor lubrication (25 - 30%), and "},{"_key":"08e396983b6b","_type":"span","marks":["8d87b2acd4f4"],"text":"painful sex"},{"_key":"6f38cd8cb628","_type":"span","marks":[],"text":", known medically as dyspareunia (12 - 45%)."}],"markDefs":[{"_key":"6631c5a6927f","_type":"externalLink","linkType":"text","url":"https://pubmed.ncbi.nlm.nih.gov/27801705/"},{"_key":"7bb58ab1cc02","_type":"externalLink","linkType":"text","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC6780739/"},{"_key":"8d87b2acd4f4","_type":"externalLink","linkType":"text","url":"https://asktia.com/services/pain-with-sex/"}],"style":"normal"},{"_key":"dfec59909b89","_type":"block","children":[{"_key":"2f78ebc7ade30","_type":"span","marks":[],"text":"The culprit? Declining reproductive hormones, estrogen, progesterone, and testosterone, all of which play a significant role in sexual health. But the experience isn't the same for everyone. Some women notice little change in their libido, while others experience a dramatic decrease. In some cases, lower estrogen and progesterone levels actually make the effects of testosterone more apparent, which can increase libido for a subset of women."}],"markDefs":[],"style":"normal"},{"_key":"9f37b9d30ac5","_type":"sectionHeader","headerLevel":"h2","title":"The impact of menopause on sex drive and libido"},{"_key":"91eb1d66330b","_type":"block","children":[{"_key":"02099da8ed840","_type":"span","marks":[],"text":"Perimenopause (before menopause)"}],"markDefs":[],"style":"h3"},{"_key":"7bcc1e11380d","_type":"block","children":[{"_key":"da75a4f210fe0","_type":"span","marks":[],"text":"Perimenopause typically begins in the mid-40s and can last anywhere from four to ten years. During this stage, hormones don't just decline - they fluctuate wildly, triggering hot flashes, mood swings, irregular periods, sleep disruption, and changes in sexual desire."}],"markDefs":[],"style":"normal"},{"_key":"5b989774ec6a","_type":"block","children":[{"_key":"98549a67445a0","_type":"span","marks":[],"text":"As estrogen levels decrease, vaginal dryness, discomfort during sex, and reduced sexual interest become increasingly common. Hot flashes and night sweats cause physical exhaustion that further dampens libido. Many women also experience emotional shifts - irritability, anxiety, or depression - that make intimacy feel less appealing."}],"markDefs":[],"style":"normal"},{"_key":"af9c7002bf65","_type":"block","children":[{"_key":"eac88d05c3a40","_type":"span","marks":["strong"],"text":"Perimenopause solution:"}],"markDefs":[],"style":"normal"},{"_key":"2d67a7407d63","_type":"block","children":[{"_key":"cdc32c7b480a0","_type":"span","marks":["em"],"text":"First things first — it's essential to determine if perimenopause or menopause is the most likely culprit of your concerns, as symptoms can overlap with other conditions. "},{"_key":"45744dd007fc","_type":"span","marks":["em","6c78e95a3894"],"text":"Tia's Perimenopause/Menopause Assessment"},{"_key":"ee0e5d8dab0e","_type":"span","marks":["em"],"text":" is the best place to start. Once you have clarity on where you are in your transition, managing perimenopause and sex drive requires addressing both the physical and emotional layers. Maintaining open communication with your partner, engaging in pelvic floor exercises, and using lubricants or vaginal moisturizers can meaningfully improve comfort and desire. Hormone replacement therapy (HRT) may also be an option for some women."}],"markDefs":[{"_key":"6c78e95a3894","_type":"externalLink","linkType":"text","url":"https://asktia.com/services/menopause-perimenopause-assessment/"}],"style":"normal"},{"_key":"35c360ca30e4","_type":"block","children":[{"_key":"4eb042c0ab650","_type":"span","marks":[],"text":"Menopause (the transition)"}],"markDefs":[],"style":"h3"},{"_key":"7094855faf82","_type":"block","children":[{"_key":"cecb887eeea50","_type":"span","marks":[],"text":"Once you've gone 12 months without a period, you've officially reached menopause — which in the United States typically occurs around age 51. At this stage, estrogen levels are significantly lower, leading to further sexual health changes, including vaginal atrophy (thinning and dryness of the vaginal tissues), which can make "},{"_key":"30d64b691f69","_type":"span","marks":["2e1934d38ea5"],"text":"sex painful"},{"_key":"af4e642d92cf","_type":"span","marks":[],"text":". Testosterone, which also plays a role in sexual desire, also tends to decline during menopause."}],"markDefs":[{"_key":"2e1934d38ea5","_type":"externalLink","linkType":"text","url":"https://asktia.com/services/pain-with-sex/"}],"style":"normal"},{"_key":"3579b8909cb6","_type":"block","children":[{"_key":"d2fa30709d780","_type":"span","marks":[],"text":"Here's something worth holding onto: regardless of age or menopausal status, sexual interest continues for many women. The Study of "},{"_key":"293e0d5b2fee","_type":"span","marks":["fd13af54d899"],"text":"Women's Health Across the Nation (SWAN)"},{"_key":"ccd664182354","_type":"span","marks":[],"text":" — one of the largest studies of midlife women's health - found that 76% of middle-aged women reported sex was moderately or extremely important to them. Women often stop initiating sex during this phase not always because they've lost interest, but because they anticipate pain or frustration. These issues are historically underreported and undertreated, often dismissed as an inevitable part of aging. They are not."}],"markDefs":[{"_key":"fd13af54d899","_type":"externalLink","linkType":"text","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC5994393/"}],"style":"normal"},{"_key":"42f2b1ff62d6","_type":"block","children":[{"_key":"c34f9a57635b0","_type":"span","marks":["strong"],"text":"Menopause solution:"}],"markDefs":[],"style":"normal"},{"_key":"75edd4a197ce","_type":"block","children":[{"_key":"3e55e91aa0870","_type":"span","marks":["em"],"text":"Once there is clarity that menopause is confirmed by your primary care physician, (schedule Tia's "},{"_key":"ebf083ca12f8","_type":"span","marks":["em","c02477ca6b9b"],"text":"Hormone and Vitality Assessment"},{"_key":"bdd83f7f906c","_type":"span","marks":["em"],"text":") a clearer treatment path opens up. Hormone replacement therapy (HRT) is a key treatment for many women at this stage. Estrogen therapy can help reduce vaginal dryness and improve sexual comfort. Local treatments, such as vaginal estrogen creams or rings, can target vaginal symptoms directly without affecting the rest of your body."}],"markDefs":[{"_key":"c02477ca6b9b","_type":"externalLink","linkType":"text","url":"https://asktia.com/services/hormone-testing/"}],"style":"normal"},{"_key":"523a70d5f91a","_type":"block","children":[{"_key":"09180387f7590","_type":"span","marks":[],"text":"Postmenopause (after menopause)"}],"markDefs":[],"style":"h3"},{"_key":"623cfeb0f26f","_type":"block","children":[{"_key":"407359c854a60","_type":"span","marks":[],"text":"Postmenopause marks the years following your final period, and while many menopause symptoms may ease, some sexual health issues persist. Vaginal dryness can remain, and lower libido can still be a challenge. The emotional impact of aging and shifting body image can also affect your confidence and sexual desire."}],"markDefs":[],"style":"normal"},{"_key":"da386c7bf9ff","_type":"block","children":[{"_key":"757c8149ff0b0","_type":"span","marks":[],"text":"Women spend, on average, one-third of their lives in the postmenopausal stage. Sexuality continues to be moderately or extremely important to many women in this phase — yet very few discuss sexual health concerns with their healthcare providers."}],"markDefs":[],"style":"normal"},{"_key":"bc1f89c9803a","_type":"block","children":[{"_key":"8c811e1584a20","_type":"span","marks":["strong"],"text":"Postmenopause solution:"}],"markDefs":[],"style":"normal"},{"_key":"0899b7947dcf","_type":"block","children":[{"_key":"75cbc8faeafd","_type":"span","marks":["em"],"text":"Focusing on overall well-being, such as maintaining a healthy diet, managing stress, and staying active, can help boost your energy and sex drive. Some women find that exploring non-hormonal treatments, such as lubricants, can help make sex more comfortable. For postmenopausal women experiencing persistent low libido, FDA-approved medications like Addyi (flibanserin) "},{"_key":"8ac3a104e8c7","_type":"span","marks":["em","5db74c3bebfa"],"text":"are now available"},{"_key":"1d5bb13524d5","_type":"span","marks":["em"],"text":", the first non-hormonal pill specifically approved for low sexual desire in postmenopausal women under 65. Mental health support, like therapy, can also help with emotional barriers to intimacy."}],"markDefs":[{"_key":"5db74c3bebfa","_type":"externalLink","linkType":"text","url":"https://asktia.com/article/addyi-flibanserin-for-low-libido/"}],"style":"normal"},{"_key":"c51e728f56be","_type":"sectionHeader","headerLevel":"h2","title":"How to increase your sex drive before, during, and after menopause"},{"_key":"39be409f71b8","_type":"block","children":[{"_key":"677f5f68e3e10","_type":"span","marks":[],"text":"Here are practical strategies to enhance your libido and sexual satisfaction at every stage of menopause:"}],"markDefs":[],"style":"normal"},{"_key":"072b8e524295","_type":"block","children":[{"_key":"69d76ad07c9e0","_type":"span","marks":[],"text":"Hormone replacement therapy (HRT)"}],"markDefs":[],"style":"h3"},{"_key":"c706a2bfef7e","_type":"block","children":[{"_key":"ef64eabade940","_type":"span","marks":[],"text":"HRT can be a game-changer for women experiencing significant changes in sex drive due to hormonal fluctuations. Estrogen therapy can relieve vaginal dryness and discomfort, while testosterone therapy may help boost libido. For women who are not candidates for systemic HRT, local treatments (such as vaginal estrogen creams or rings) can target symptoms like vaginal atrophy without affecting the entire body."}],"markDefs":[],"style":"normal"},{"_key":"a519373cdaa0","_type":"block","children":[{"_key":"3c7bbda3a0410","_type":"span","marks":[],"text":"Addyi (Flibanserin): A historic new option for low libido"}],"markDefs":[],"style":"h3"},{"_key":"fa39e4cda33d","_type":"block","children":[{"_key":"8d49f30ad3cd0","_type":"span","marks":[],"text":"In a landmark development for women's sexual health, the FDA approved an expanded indication for "},{"_key":"8d49f30ad3cd1","_type":"span","marks":["strong","c4f5345a658b"],"text":"Addyi (flibanserin)"},{"_key":"8d49f30ad3cd2","_type":"span","marks":[],"text":" in December 2025, making it the first and only FDA-approved oral treatment for low sexual desire in postmenopausal women under the age of 65."}],"markDefs":[{"_key":"c4f5345a658b","_type":"externalLink","linkType":"text","url":"https://asktia.com/article/addyi-flibanserin-for-low-libido/"}],"style":"normal"},{"_key":"569967f97601","_type":"block","children":[{"_key":"fdf1f951777a0","_type":"span","marks":[],"text":"Addyi is designed for women under 65 with acquired, generalized HSDD meaning low sexual desire that developed after a period of normal desire and occurs in any sexual situation."}],"markDefs":[],"style":"normal"},{"_key":"328bed07b4e2","_type":"block","children":[{"_key":"89d0381e51cf0","_type":"span","marks":[],"text":"Pelvic floor exercises (Kegels)"}],"markDefs":[],"style":"h3"},{"_key":"7a508da38796","_type":"block","children":[{"_key":"379c9e46611a0","_type":"span","marks":[],"text":"Strengthening your pelvic floor muscles with Kegel exercises can improve sexual function and sensation, particularly after menopause. These exercises help improve blood flow to the genital area, which can enhance arousal and make orgasm easier to achieve. Regular pelvic floor exercises can also help reduce urinary incontinence, another common issue after menopause. If you’re having persistent pain with sex, you may be referred to a pelvic floor physical therapist for additional evaluation and tailored treatment."}],"markDefs":[],"style":"normal"},{"_key":"a5d790b2df07","_type":"block","children":[{"_key":"3f450704c3790","_type":"span","marks":[],"text":"Lubricants and vaginal moisturizers"}],"markDefs":[],"style":"h3"},{"_key":"49a0bef5274a","_type":"block","children":[{"_key":"5b336acd9d590","_type":"span","marks":[],"text":"Vaginal dryness can be a major turn-off during menopause. To make sex more comfortable, use a water-based lubricant or vaginal moisturizer before and during intercourse. A 2025 study published in "},{"_key":"5b336acd9d591","_type":"span","marks":["em"],"text":"Menopause"},{"_key":"5b336acd9d592","_type":"span","marks":[],"text":", the journal of The Menopause Society, found that women who maintained regular sexual activity showed a significantly lower prevalence of vulvar pain, irritation, and dryness — and that orgasm and satisfaction scores did not decline with age."}],"markDefs":[],"style":"normal"},{"_key":"7eb1cc613668","_type":"block","children":[{"_key":"076c7c3bc6ed0","_type":"span","marks":[],"text":"Open communication with your partner"}],"markDefs":[],"style":"h3"},{"_key":"79fd5cc792c3","_type":"block","children":[{"_key":"50ffc8e2c8980","_type":"span","marks":[],"text":"Communication is key to a healthy sexual relationship during menopause. Be open with your partner about any changes you're experiencing. Discussing your desires, boundaries, and concerns in a nonjudgmental way can foster intimacy and help you both find new ways to connect. Couples therapy and/or sexual therapy can help facilitate."}],"markDefs":[],"style":"normal"},{"_key":"e983618604d3","_type":"block","children":[{"_key":"94f263d134c50","_type":"span","marks":[],"text":"Prioritize mental health"}],"markDefs":[],"style":"h3"},{"_key":"c9665ee7e181","_type":"block","children":[{"_key":"23ef6f2494960","_type":"span","marks":[],"text":"Emotional well-being plays a huge role in sexual health. Managing stress, addressing feelings of anxiety or depression, and working on body image can all have positive effects on libido. Research from the "},{"_key":"3b688acadc7a","_type":"span","marks":["56c7b46d702c"],"text":"Seattle Midlife Women's Health Study"},{"_key":"8bd5bb406232","_type":"span","marks":[],"text":" confirms that higher perceived stress is significantly associated with lower sexual desire across the menopausal transition. Seeking therapy or counseling to address these emotional shifts can help improve your relationship with your body and your sexual identity."}],"markDefs":[{"_key":"56c7b46d702c","_type":"externalLink","linkType":"text","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC2834444/"}],"style":"normal"},{"_key":"0cc054428d75","_type":"block","children":[{"_key":"29072b3163320","_type":"span","marks":[],"text":"Non-hormonal options"}],"markDefs":[],"style":"h3"},{"_key":"d34d9a3298df","_type":"block","children":[{"_key":"04b094cf5cfe0","_type":"span","marks":[],"text":"If you're not interested in hormone therapy, there are still options. Over-the-counter vaginal moisturizers can help maintain moisture in the vaginal area, and lubricants can reduce discomfort during intercourse. For women who experience anxiety or low mood, mindfulness, relaxation techniques, or cognitive-behavioral therapy (CBT) can help improve mental and emotional barriers to sex. As of December 2025, Addyi also provides a non-hormonal prescription option for women who meet the criteria for HSDD."}],"markDefs":[],"style":"normal"},{"_key":"d149c7587a76","_type":"block","children":[{"_key":"15e4684590280","_type":"span","marks":[],"text":"Explore new forms of intimacy"}],"markDefs":[],"style":"h3"},{"_key":"9fc1ea7560c6","_type":"block","children":[{"_key":"d919279f12d20","_type":"span","marks":[],"text":"Sex isn't the only way to connect with your partner. Many women find that exploring other forms of intimacy, such as massage, cuddling, or focusing on foreplay, can strengthen emotional bonds and reignite desire. Engaging in new forms of erotic play, like using erotic audio or fantasizing together, can also add excitement back into your sexual life."}],"markDefs":[],"style":"normal"},{"_key":"1b80e581e8f1","_type":"cta","backgroundColor":"bcoat","text":[{"_key":"425f26f154d5","_type":"block","children":[{"_key":"27d92116883b0","_type":"span","marks":[],"text":"Ready to feel more like yourself again?"}],"markDefs":[],"style":"h3"},{"_key":"102e111799ee","_type":"block","children":[{"_key":"13b6a786c6730","_type":"span","marks":[],"text":"Changes in libido during perimenopause and menopause are common, but that does not mean you have to just live with them. Tia’s providers take a whole-person approach to menopause care, helping you navigate hormonal changes, vaginal health, emotional well-being, and intimacy concerns with personalized support and evidence-based treatment options."}],"markDefs":[],"style":"normal"},{"_key":"6a45d14b865e","_type":"block","children":[{"_key":"863222435c8e0","_type":"span","marks":[],"text":"Whether you're exploring HRT, looking for non-hormonal solutions, or simply trying to better understand what’s happening in your body, your care team is here to help you feel supported at every stage of the transition."}],"markDefs":[],"style":"normal"},{"_key":"69aabe323bfd","_type":"buttonBlock","items":[{"_key":"4b8c761f68e0","_type":"singleButton","addWidgetCopy":false,"backgroundColor":"bcorange","linkCta":"Book an 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Your skin plan works with your primary care, hormones, and overall well-being."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3f19861735cf","_type":"block","children":[{"_key":"96831d59d40d","_type":"span","marks":["strong"],"text":"Expert-Led Aesthetic & Medical Care:"},{"_key":"3b55061dc749","_type":"span","marks":[],"text":" Our team includes licensed medical providers who are specially trained in the services they deliver—from performing skin biopsies to administering neurotoxins, like Botox. This ensures safe, evidence-based treatments you can trust."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"86249c82f31a","_type":"block","children":[{"_key":"eb1080c279b6","_type":"span","marks":["strong"],"text":"One Stop for Convenience and Confidence:"},{"_key":"96825a5b62f2","_type":"span","marks":[],"text":" You get a full spectrum of services from an Yearly Skin Check to Clinical Wrinkle Care, eliminating the need to visit multiple, disconnected providers. We create a personalized plan designed for confidence-boosting results."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"5d508e97b35b","_type":"block","children":[{"_key":"6cea32cb92f7","_type":"span","marks":["strong"],"text":"Insurance Accepted for Medical Needs:"},{"_key":"eb362327d1a9","_type":"span","marks":[],"text":" Medical dermatology appointments, like treating infections or performing cryotherapy, are billed to your insurance. You can get care for conditions like acne, rosacea, or rashes from your primary care team, helping you skip the long specialist wait times."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"5414d9de3332","_type":"buttonBlock","items":[{"_key":"839e6c12f157","_type":"singleButton","backgroundColor":"bcorange","linkCta":"Book an appointment","linkType":"join-scroll-shape","redirectURL":"serviceLines=skincare"}],"onlyStackButtons":false},{"_key":"f93a0288579f","_type":"block","children":[{"_key":"34ccfa04041c","_type":"span","marks":[],"text":"Takes 3–5 minutes to create an account • No membership fee to book • Insurance accepted"}],"markDefs":[],"style":"small"}],"textAboveMedia":false,"videoDisplay":"container"},{"_key":"d79d346186a7","_type":"spacer","backgroundColor":"bcoat","spacing":"pym"},{"_key":"7b748e85a0be","_type":"layoutSection","addOverlay":false,"alignItems":"center","backgroundColor":"bcoat","columns":1,"contentTone":"dark","direction":"row","gap":"none","items":[{"_key":"c2c2626aa371","_type":"layoutBox","alignItems":"stretch","border":"none","borderRadius":"none","columns":2,"direction":"column","gap":"md","items":[{"_key":"d86f65f3bf00","_type":"layoutText","text":[{"_key":"27845dd3a508","_type":"block","children":[{"_key":"76ab7a7caaa0","_type":"span","marks":["fontSerif"],"text":"FAQs"}],"markDefs":[],"style":"h2"}]}],"justifyContent":"flex-start","layoutMode":"flex","mobileColumns":1,"mobileDirection":"column","paddingBottom":"none","paddingLeft":"none","paddingRight":"none","paddingTop":"none","title":"FAQs"}],"justifyContent":"center","layoutMode":"grid","mobileColumns":1,"paddingX":"md","paddingY":"none","showDividers":false,"title":"Title"},{"_key":"5c1daca816cc","_type":"faqModule","backgroundColor":"bcoat","cta":"See full FAQ","faqs":[{"_id":"eaf5599a-232b-4614-a61f-01121be310da","_type":"faq","_createdAt":"2025-11-03T15:45:18Z","_rev":"PrR35qa3j6WvH6znGwgvrp","_system":{"base":{"id":"eaf5599a-232b-4614-a61f-01121be310da","rev":"hHoj97MU0iZOueKSEfqc9b"}},"_updatedAt":"2026-06-22T18:58:00Z","answer":[{"_key":"9e8745fe302a","_type":"block","children":[{"_key":"7bc51d5c86980","_type":"span","marks":[],"text":"Anyone with suspicious moles, a family history of skin cancer or new skin changes should book an annual skin exam with our expert providers. We’ll do a head-to-toe check to spot early warning signs, perform biopsies if needed, and give you peace of mind that your skin is being taken seriously."}],"markDefs":[],"style":"normal"}],"question":"Who should book an Yearly Skin Exam?","id":"d7327834-50ed-57f1-9f6b-e318121301d7","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"2e56046285d3bd2302b958bb3f8cf29e","counter":1044,"owner":"gatsby-source-sanity"}},{"_id":"55232a17-cba2-49d7-98c3-a5119fd2fdd9","_type":"faq","_createdAt":"2025-11-03T15:45:36Z","_rev":"Nts8i4d4YcoSFzvfLw5PDe","_updatedAt":"2025-11-03T15:45:44Z","answer":[{"_key":"15276923f185","_type":"block","children":[{"_key":"1ed1860509c90","_type":"span","marks":[],"text":"Anybody who’s not sure where to start, wants expert guidance on their skin goals, or is curious about which treatments or services are right for them. A consultation is the best first step if you’re weighing options and want a personalized plan."}],"markDefs":[],"style":"normal"}],"question":"Who should book a Skin Care Consultation?","id":"244d24db-5de0-538c-8890-5145830446b7","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"af0c255bee5dcee602cded7af334d586","counter":571,"owner":"gatsby-source-sanity"}},{"_id":"de2e9816-b6aa-4751-a9bd-29280da949ac","_type":"faq","_createdAt":"2025-11-03T15:45:58Z","_rev":"Nts8i4d4YcoSFzvfLw5aqe","_updatedAt":"2025-11-03T15:46:07Z","answer":[{"_key":"2ad0abd65e98","_type":"block","children":[{"_key":"b4ec1e25de120","_type":"span","marks":[],"text":"Yes. We treat acne, rashes, and more with prescriptions, procedures and integrative support. Our team evaluates what is driving your symptoms and create a personalized treatment plan."}],"markDefs":[],"style":"normal"}],"question":"Does Tia treat acne and rashes? ","id":"d8f53f4b-f755-585d-8d88-fe0ddc9d47c9","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"62706cba3f44c58280e6a0f890310214","counter":572,"owner":"gatsby-source-sanity"}},{"_id":"8ba83098-8987-404a-b8b0-b3185c3babcd","_type":"faq","_createdAt":"2025-11-03T15:46:20Z","_rev":"Nts8i4d4YcoSFzvfLw5cee","_updatedAt":"2025-11-03T15:46:28Z","answer":[{"_key":"dce47740d901","_type":"block","children":[{"_key":"b3315ab27fdb0","_type":"span","marks":[],"text":"Most dermatology clinics or med-spas only focus on the surface. At Tia, we see your skin as a part of your whole health. That means, we connect skin changes to hormones, stress, and lifestyle factors. Your care is coordinated across one team, from primary care to aesthetics, so nothing gets missed."}],"markDefs":[],"style":"normal"}],"question":"What makes Tia’s skin care different?","id":"4761298a-4983-55ad-baa2-8fe5c9fc94e6","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"8fa556bf0f37ea13a0a394951ab60345","counter":573,"owner":"gatsby-source-sanity"}},{"_id":"1458ed03-cf04-459a-bddc-a522d46a25c0","_type":"faq","_createdAt":"2025-11-03T15:46:41Z","_rev":"hHoj97MU0iZOueKSEfr3Yd","_updatedAt":"2025-11-03T15:47:17Z","answer":[{"_key":"e7447b2baa20","_type":"block","children":[{"_key":"486ef9239b730","_type":"span","marks":[],"text":"Medical dermatology visits like Annual Skin Exam and procedures such as biopsies or cryotherapy are typically covered by insurance. Aesthetic services like Wrinkle Care, peels or red light therapy are elective and not covered."}],"markDefs":[],"style":"normal"}],"question":"Which skin care appointments are covered by insurance?","id":"058d2643-8ce8-5b16-8cc0-2902228aa3c2","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"87260d560b2ab8c9df8d96b27ab8d0bf","counter":574,"owner":"gatsby-source-sanity"}},{"_id":"8334d844-16f1-4a36-b94f-ea71fc63be8c","_type":"faq","_createdAt":"2025-11-03T15:47:37Z","_rev":"hHoj97MU0iZOueKSEfr8Sp","_updatedAt":"2025-11-03T15:47:47Z","answer":[{"_key":"d992e537eb94","_type":"block","children":[{"_key":"5fc7d72dd39d0","_type":"span","marks":[],"text":"No, you will be seeing a Tia primary care provider (a Nurse Practitioner, Physician's Assistant, or Doctor) who has received specialized training in dermatology. They are equipped to handle many skin concerns. If your condition requires the care of a board-certified dermatologist, our team will provide a referral."}],"markDefs":[],"style":"normal"}],"question":"Will I be seeing a board-certified dermatologist for my medical skin care visits?","id":"bd1865cf-5a32-5ff5-921d-c7ceec544583","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"eef30262b74a35e86ba338169411b4c0","counter":575,"owner":"gatsby-source-sanity"}}]}],"serviceImage":{"_type":"image","asset":{"_id":"image-54a3c7d0f7bc9097d06182e12d8d529f7578ec1f-800x600-webp","_type":"sanity.imageAsset","_createdAt":"2025-07-28T15:12:23Z","_rev":"4l1AtK0518mAL0oHXPWHGi","_updatedAt":"2025-07-28T15:12:23Z","assetId":"54a3c7d0f7bc9097d06182e12d8d529f7578ec1f","extension":"webp","metadata":{"_type":"sanity.imageMetadata","blurHash":"V6IDdZ0002O?00:k~pD*0LyD01KPE1xZ-o.R0LI;-:v}","dimensions":{"_type":"sanity.imageDimensions","aspectRatio":1.3333333333333333,"height":600,"width":800},"hasAlpha":true,"isOpaque":false,"lqip":"data:image/png;base64,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","palette":{"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","background":"#734c39","foreground":"#fff","population":4.94,"title":"#fff"},"darkVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#663520","foreground":"#fff","population":6.61,"title":"#fff"},"dominant":{"_type":"sanity.imagePaletteSwatch","background":"#663520","foreground":"#fff","population":6.61,"title":"#fff"},"lightMuted":{"_type":"sanity.imagePaletteSwatch","background":"#c6a995","foreground":"#000","population":6.51,"title":"#fff"},"lightVibrant":{"_type":"sanity.imagePaletteSwatch","background":"#eba07e","foreground":"#000","population":4.28,"title":"#fff"},"muted":{"_type":"sanity.imagePaletteSwatch","background":"#a26955","foreground":"#fff","population":4.13,"title":"#fff"},"vibrant":{"_type":"sanity.imagePaletteSwatch","background":"#b06642","foreground":"#fff","population":0.33,"title":"#fff"}}},"mimeType":"image/webp","originalFilename":"skin_care2_1.webp","path":"images/8qqycr4y/production/54a3c7d0f7bc9097d06182e12d8d529f7578ec1f-800x600.webp","sha1hash":"54a3c7d0f7bc9097d06182e12d8d529f7578ec1f","size":73568,"uploadId":"U9dOpNuqaHxnvzhyWL3G4GBRpgRNST3f","url":"https://cdn.sanity.io/images/8qqycr4y/production/54a3c7d0f7bc9097d06182e12d8d529f7578ec1f-800x600.webp","id":"image-54a3c7d0f7bc9097d06182e12d8d529f7578ec1f-800x600-webp","parent":null,"children":["8c031b68-51cc-5cf2-83f0-65613859ac47"],"internal":{"type":"SanityImageAsset","contentDigest":"d3e3b3d9ee579fab77fbd229f7a12fb3","counter":1284,"owner":"gatsby-source-sanity"}}},"shortDescription":"Whether you’re dealing with a rash, acne, signs of aging, or just want to feel more confident in your skin, we’re here to find solutions that work for you and your goals, including topicals, injectables, and safe, effective procedures.","showDefaultHero":false,"showToc":true,"slug":{"_type":"slug","current":"skin-care"},"title":"Skin Care"},"meta":{"_type":"metaCard","metaDescription":"Discover Tia's expanded skin care services designed to improve your skin's health, confidence, and beauty. 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Like, did you know that you can get a test to see the mix of sizes of plaque in your bloodstream? At the end of the visit, I walked away with a clear understanding of my five and ten year risk of a heart event. Spoiler alert, my risk is low and Tashina gave me thoughtful, actionable steps I can take now to help keep it that way!  I walked out wishing that everyone I know could have this visit, but ESPECIALLY the women in my life. If you are a Tia patient, or are thinking about becoming one, I can’t recommend this visit enough!”","Title":"Lindsey C","_key":"40b6cb4ea54c","_type":"inline"}]},{"_key":"dd94e4f302ad","_type":"spacer","backgroundColor":"bccream","spacing":"pys"},{"_key":"d6ff6f0ba7a3","_type":"shape","shapeColor":"secondary-1","shapeType":"shape-4"},{"_key":"4a147fddf86e","_type":"spacer","spacing":"pys"},{"_key":"8181ece22169","_type":"faqModule","faqs":[{"_id":"b7983d1f-8172-49c2-afa5-9f83edf0c6bb","_type":"faq","_createdAt":"2025-08-11T19:35:22Z","_rev":"R4nGrzZLYFVpJgoZuVyswL","_system":{"base":{"id":"b7983d1f-8172-49c2-afa5-9f83edf0c6bb","rev":"jECG3r5EXZCzgpgXPSzwTc"}},"_updatedAt":"2025-08-21T17:50:42Z","answer":[{"_key":"b899e1a99547","_type":"block","children":[{"_key":"729ee1af1cb10","_type":"span","marks":[],"text":"Longevity isn’t just about living longer, it’s about feeling better, staying sharp, and improving your quality of life as you age. At Tia, we define longevity as extending your health span instead of just your lifespan."}],"markDefs":[],"style":"normal"},{"_key":"10d5ed067d97","_type":"block","children":[{"_key":"7d5de15668170","_type":"span","marks":[],"text":"Our care is designed to improve specifically to help women stay healthier for longer and focuses on the systems that matter the most for women as they age: heart health, cognitive health, inflammation, and more."}],"markDefs":[],"style":"normal"}],"question":"What is Longevity?","id":"aa43d9d3-bd1c-5384-ade8-21a69d3a2bed","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"aa6923072414cf428f312ea8f653e1f1","counter":10120,"owner":"gatsby-source-sanity"}},{"_id":"954b1a53-356f-4f54-a432-34159d096bd8","_type":"faq","_createdAt":"2025-08-11T19:35:44Z","_rev":"R4nGrzZLYFVpJgoZuVyv67","_system":{"base":{"id":"954b1a53-356f-4f54-a432-34159d096bd8","rev":"4WeTGovBgJroi8c0Ln4dbn"}},"_updatedAt":"2025-08-21T17:51:02Z","answer":[{"_key":"77a3e9950855","_type":"block","children":[{"_key":"99e2db9093bd0","_type":"span","marks":[],"text":"Tia’s Women’s Longevity Assessment is for anyone who wants to better understand their long-term health, even if they feel fine today. It’s especially great for women in their 20s, 30s, 40s, and 50s who are thinking about prevention. Whether you are curious about getting answers with lab testing, wanting to catch health issues early, or just want clarity about your future health, this appointment is a proactive step towards improving your health so you feel your best for longer."}],"markDefs":[],"style":"normal"}],"question":"Who should book the Women’s Longevity Assessment?","id":"2e3cb3db-3374-5535-b747-5cf542bf3d65","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"00e0389dcb7ef88a26c83ea78c19a9d9","counter":10053,"owner":"gatsby-source-sanity"}},{"_id":"45c7ccf5-7d0d-4d41-8b61-cf44debe889e","_type":"faq","_createdAt":"2025-08-11T19:36:11Z","_rev":"R4nGrzZLYFVpJgoZuVyvOZ","_system":{"base":{"id":"45c7ccf5-7d0d-4d41-8b61-cf44debe889e","rev":"jECG3r5EXZCzgpgXPSzy3Y"}},"_updatedAt":"2025-08-21T17:51:06Z","answer":[{"_key":"30d64867db42","_type":"block","children":[{"_key":"c5eff736f2c00","_type":"span","marks":[],"text":"Most longevity services are built around male biology, a long list of unnecessary labs, and a DIY approach that leaves you with a confusing PDF of results. Tia’s longevity care is different. It’s built for women by women’s health experts with proactive screening, evidence-based and whole-person care that’s tailored to your health risks, life stages, and future health goals."}],"markDefs":[],"style":"normal"},{"_key":"1a05acb513d8","_type":"block","children":[{"_key":"7794bb261d9c0","_type":"span","marks":[],"text":"We focus on tests that actually matter for how women age and your unique biology. Every visit includes 1:1 time with a care provider that helps interpret your results from a women’s health lens and partners with you to come up with a personalized care plan."}],"markDefs":[],"style":"normal"},{"_key":"bf4440b6b711","_type":"block","children":[{"_key":"6ce624b34e650","_type":"span","marks":[],"text":"We help you address the conditions that impact your quality of life, build resilience against chronic stress."}],"markDefs":[],"style":"normal"},{"_key":"3c494ff8f132","_type":"block","children":[{"_key":"0b6b1e6b59290","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"}],"question":"What makes Tia’s Longevity care different? ","id":"d25c4a79-5c42-5e2e-aa7a-4c780b564f1c","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"5833c40d341a462f3b8d18958f70b179","counter":10119,"owner":"gatsby-source-sanity"}},{"_id":"d53af64f-d48b-430a-acec-26ffaff93e16","_type":"faq","_createdAt":"2025-08-11T19:36:41Z","_rev":"R4nGrzZLYFVpJgoZuW1sil","_system":{"base":{"id":"d53af64f-d48b-430a-acec-26ffaff93e16","rev":"QkrnrKEy1qjcFbqbms2ho9"}},"_updatedAt":"2025-08-21T17:52:26Z","answer":[{"_key":"1bf4478c56fe","_type":"block","children":[{"_key":"b7c0cd0129140","_type":"span","marks":[],"text":"Tia’s Women’s Longevity assessment is a 30-minute virtual or in-person visit designed to understand your health goals, risks and priorities. You’ll meet 1:1 with a Tia provider to review your personal and family medical history, discuss lifestyle factors, and share what you want to focus on."}],"markDefs":[],"style":"normal"},{"_key":"6a6d16c3fe91","_type":"block","children":[{"_key":"cfc525cd3fbb0","_type":"span","marks":[],"text":"Together, you’ll decide which advanced labs and screenings make sense for you, including testing for metabolism, inflammation, heart health, cognitive health, and more. Your provider will partner with you to develop a personalized holistic care plan, which may include referrals, follow-up steps, or additional testing.\n"}],"markDefs":[],"style":"normal"}],"question":"What happens during a Women’s Longevity Assessment? ","id":"054c0db6-0c6e-5f19-b923-6859faf98761","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"64a64dabf2db0bf998a536cf2dcbe3e9","counter":376,"owner":"gatsby-source-sanity"}},{"_id":"43e8d58a-e7b8-4352-9f2e-11018e03a561","_type":"faq","_createdAt":"2025-08-11T19:37:15Z","_rev":"YTnLU30AG6EGaIpmvjRMaH","_system":{"base":{"id":"43e8d58a-e7b8-4352-9f2e-11018e03a561","rev":"QkrnrKEy1qjcFbqbms2xDl"}},"_updatedAt":"2025-08-21T17:52:45Z","answer":[{"_key":"e93ea1c2e70d","_type":"block","children":[{"_key":"1e9cd346ca170","_type":"span","marks":[],"text":"Yes, the Women’s Longevity Assessment is now offered virtually! You can choose to have your appointment in-clinic or virtually."}],"markDefs":[],"style":"normal"}],"question":"Can I get the Women's Longevity Assessment virtually? ","id":"c2e9d5b7-a873-5a16-9713-569cdb13d8f8","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"66209a34775244318d85028585e06894","counter":10052,"owner":"gatsby-source-sanity"}},{"_id":"353a7648-f7ab-4f30-a1ff-104f29b14a26","_type":"faq","_createdAt":"2025-09-12T14:46:00Z","_rev":"K9ndBc5fXoqzIFFJt9M4sb","_system":{"base":{"id":"353a7648-f7ab-4f30-a1ff-104f29b14a26","rev":"5KAiCqcY3rs0Bq2bmlzAeU"}},"_updatedAt":"2025-10-16T16:12:50Z","answer":[{"_key":"bcfab2f95c4f","_type":"block","children":[{"_key":"fbf738350b5d0","_type":"span","marks":[],"text":"Your Women’s Longevity Assessment goes beyond a routine annual exam. It takes a deeper look at your long-term health using advanced screening tools, genetic testing, and labs to assess heart, metabolic, inflammatory, and cognitive health. Together with your provider, you’ll build a personalized plan to help you stay healthier, longer."}],"markDefs":[],"style":"normal"},{"_key":"5a1a295880d3","_type":"block","children":[{"_key":"5f09ef7eff69","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"7dd707ce7067","_type":"block","children":[{"_key":"bb4d6291ec470","_type":"span","marks":[],"text":"Because this visit involves medical evaluation and care planning beyond standard preventive care, it’s not billed as a preventive annual exam and may be subject to a copay or deductible."}],"markDefs":[],"style":"normal"}],"question":"How is the Women's Longevity Assessment different than an Annual Exam?","id":"f05f9613-bb43-5a4d-92c2-bfb5554e400a","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"dc7fcc0582e2e812594bbe54abe5037e","counter":413,"owner":"gatsby-source-sanity"}}],"title":"Longevity FAQs"},{"_key":"cf77d5b90059","_type":"spacer","spacing":"pys"},{"_key":"44f60ec5f38d","_type":"spacer","backgroundColor":"bcoat","spacing":"pys"},{"_key":"00e0993f264c","_type":"furtherReading","articles":[{"_id":"959debc0-e8ca-42d3-a2e3-57aaa7a2827c","_type":"editorial","_createdAt":"2025-05-06T15:08:23Z","_rev":"PDv0MBj1H2qsMYGlFzqQa3","_updatedAt":"2025-06-10T23:57:34Z","content":{"_type":"articleTabs","main":{"_type":"articleContent","articleColor":"bcraspberry","articleType":{"_ref":"289b3a6c-1e4d-4435-bcf1-904a0995a934","_type":"reference"},"authors":[{"_key":"36bb1e0b964b","_ref":"1d6ce256-595a-4357-89ae-bda37a32224e","_type":"reference"}],"cardImage":{"_type":"image","asset":{"_ref":"image-489407a06ce090d10f48c5945511b1638169f11d-1934x1354-png","_type":"reference"}},"editorialText":[{"_key":"3992852b8e4d","_type":"block","children":[{"_key":"0f8e42ab63f00","_type":"span","marks":["strong"],"text":"A Women-First Approach to Longevity — Starting with the Heart"}],"markDefs":[],"style":"h1"},{"_key":"16217be74de6","_type":"block","children":[{"_key":"1f3d3010078a0","_type":"span","marks":[],"text":"When we set out to design Tia’s approach to "},{"_key":"7fa7c275609e","_type":"span","marks":["578ae6611b61"],"text":"longevity"},{"_key":"08a0fd9a69b5","_type":"span","marks":[],"text":", we didn’t begin with the usual question: "},{"_key":"1f3d3010078a1","_type":"span","marks":["em"],"text":"What’s the most comprehensive list of biomarkers we can run?"},{"_key":"1f3d3010078a2","_type":"span","marks":[],"text":" Or even: "},{"_key":"1f3d3010078a3","_type":"span","marks":["em"],"text":"How do we help women biohack their way to optimal health?"}],"markDefs":[{"_key":"578ae6611b61","_type":"internalLink","linkType":"text","reference":{"_ref":"eba0d59e-6d57-478c-b60a-23bd2d253f74","_type":"reference"}}],"style":"normal"},{"_key":"38e2ee343023","_type":"block","children":[{"_key":"7093494d8e5c0","_type":"span","marks":[],"text":"We started with something simpler and more human: if aging has become one of the most fearsome processes of life for women, how do we work to demystify this natural and beautiful foundation of life? How might we, as women, find confidence, rather than more fear and need, across this time?"}],"markDefs":[],"style":"normal"},{"_key":"9e2384a07936","_type":"block","children":[{"_key":"ddc3eb4d5ac90","_type":"span","marks":[],"text":"Because here’s the truth: A huge industry has been created to make women afraid of aging and of the way our bodies look with age. We've been made to fear our breasts, our skin, our hair - and now, we're being told we need even more - more drugs, more tests - to outsmart and out-medicate our bodies from their natural flow. Now we need to trust dashboards of data reporting on “optimized” numbers that ignore how we feel in our own bodies and our own minds.But, in reality, women don’t need another overwhelming list of things to do, things to monitor, ways to improve (ways we are not hitting the mark). We don’t need to be told—again—that we’re not good enough or that we need to be supplemented, monitored, or augmented to be healthy or desirable."}],"markDefs":[],"style":"normal"},{"_key":"f0afcdc49dd6","_type":"block","children":[{"_key":"d195b96327650","_type":"span","marks":[],"text":"We just need clear, succinct and actionable ways to be healthy, and then let us be … "},{"_key":"d195b96327651","_type":"span","marks":["em"],"text":"confident and free of worry. "},{"_key":"d195b96327652","_type":"span","marks":[],"text":"We need to know what’s "},{"_key":"d195b96327653","_type":"span","marks":["em"],"text":"essential"},{"_key":"d195b96327654","_type":"span","marks":[],"text":" to protect our long-term health — and where we can give ourselves permission to simply be."}],"markDefs":[],"style":"normal"},{"_key":"570e1b9582da","_type":"block","children":[{"_key":"b78912ec857b0","_type":"span","marks":[],"text":"That’s why we started with the foundation: "},{"_key":"b78912ec857b1","_type":"span","marks":["strong"],"text":"the heart."}],"markDefs":[],"style":"normal"},{"_key":"c4d5b37b26f5","_type":"block","children":[{"_key":"8a887da6f3aa","_type":"span","marks":["em"],"text":"\"...most longevity programs skip cardiovascular screening entirely — even though heart disease kills more women than all forms of cancer combined.\""}],"markDefs":[],"style":"h3"},{"_key":"298600b50b1e","_type":"block","children":[{"_key":"f8686f620b450","_type":"span","marks":[],"text":"Despite being the leading cause of death in women, heart health is often left out of longevity care altogether. In fact, "},{"_key":"f8686f620b451","_type":"span","marks":["strong"],"text":"most longevity programs skip cardiovascular screening entirely"},{"_key":"f8686f620b452","_type":"span","marks":[],"text":" — even though heart disease kills more women than all forms of cancer combined."}],"markDefs":[],"style":"normal"},{"_key":"47325a97243b","_type":"block","children":[{"_key":"1b70ccc459aa0","_type":"span","marks":[],"text":"And when women "},{"_key":"1b70ccc459aa1","_type":"span","marks":["em"],"text":"do"},{"_key":"1b70ccc459aa2","_type":"span","marks":[],"text":" have heart attacks, the symptoms are often missed or misdiagnosed. Fatigue, jaw pain, nausea, and back pain? These are common signs of a cardiovascular event in women — and they rarely show up in textbooks written around male physiology."}],"markDefs":[],"style":"normal"},{"_key":"37801af40d00","_type":"block","children":[{"_key":"f58117ade1190","_type":"span","marks":[],"text":"At Tia, we believe longevity starts with listening differently — to the data, to the evidence, and most importantly, to women."}],"markDefs":[],"style":"normal"},{"_key":"f4cc235c3689","_type":"block","children":[{"_key":"4021cf995ae30","_type":"span","marks":[],"text":"So we built a new kind of offering: "},{"_key":"4021cf995ae31","_type":"span","marks":["strong"],"text":"The Women’s Longevity Assessment"},{"_key":"4021cf995ae32","_type":"span","marks":[],"text":", designed by women’s health experts to put heart health at the center of your care."}],"markDefs":[],"style":"normal"},{"_key":"f853f0fb8253","_type":"sectionHeader","headerLevel":"h2","title":"What’s Included"},{"_key":"67af0d465ff2","_type":"block","children":[{"_key":"095ec354eba70","_type":"span","marks":[],"text":"Our Women’s Longevity Assessment combines advanced labs with in-person testing and 1:1 provider guidance — translating your results into a personalized care plan."}],"markDefs":[],"style":"normal"},{"_key":"2564b87d3be1","_type":"block","children":[{"_key":"1e61ab2adaeb0","_type":"span","marks":[],"text":"We included labs that "},{"_key":"1e61ab2adaeb1","_type":"span","marks":["em"],"text":"actually matter"},{"_key":"1e61ab2adaeb2","_type":"span","marks":[],"text":" for women — including markers your regular doctor may not test for, like "},{"_key":"1e61ab2adaeb3","_type":"span","marks":["strong"],"text":"Lipoprotein(a)"},{"_key":"1e61ab2adaeb4","_type":"span","marks":[],"text":", a genetic cholesterol marker that 1 in 5 women carry, yet few have ever heard of. (It can triple your risk of early heart disease and stroke — and isn’t picked up on a standard lipid panel.)"}],"markDefs":[],"style":"normal"},{"_key":"97b7bdad724b","_type":"block","children":[{"_key":"ec92ab3254ad0","_type":"span","marks":[],"text":"You’ll also get:"}],"markDefs":[],"style":"normal"},{"_key":"310962ceb2c8","_type":"block","children":[{"_key":"14b1b908f6b20","_type":"span","marks":["strong"],"text":"Cardio-metabolic health"},{"_key":"14b1b908f6b21","_type":"span","marks":[],"text":": Lipid panel, ApoB, A1c, insulin resistance"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2de60f22b67d","_type":"block","children":[{"_key":"7a08c3876d890","_type":"span","marks":["strong"],"text":"Inflammation & arterial health"},{"_key":"7a08c3876d891","_type":"span","marks":[],"text":": hs-CRP, Lp-PLA2, fibrinogen, homocysteine"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"d0551434f582","_type":"block","children":[{"_key":"7b96465966610","_type":"span","marks":["strong"],"text":"Genetic & advanced cholesterol markers"},{"_key":"7b96465966611","_type":"span","marks":[],"text":": Lp(a), ion mobility fractionation"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"dc6b17081c4f","_type":"block","children":[{"_key":"8555083151330","_type":"span","marks":["strong"],"text":"Organ function"},{"_key":"8555083151331","_type":"span","marks":[],"text":": CMP, CBC, uric acid, microalbumin"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"6cd033b4d08b","_type":"block","children":[{"_key":"0d2f1488c13b0","_type":"span","marks":[],"text":"Because in midlife, many women begin to experience subtle shifts — changes in metabolism, energy, mood — but their labs still come back “normal.” We call these the "},{"_key":"0d2f1488c13b1","_type":"span","marks":["strong"],"text":"whispers"},{"_key":"0d2f1488c13b2","_type":"span","marks":[],"text":" before the storm. And our job is to hear them."}],"markDefs":[],"style":"normal"},{"_key":"d3dbfc1282cb","_type":"sectionHeader","headerLevel":"h2","title":"What Happens After the Lab Work"},{"_key":"f55df9fc34e0","_type":"block","children":[{"_key":"d41e9f2127000","_type":"span","marks":[],"text":"You’re not a lab report. You’re a whole person — with a body, a history, and a future. That’s why your provider walks through your results with you in the context of your goals, your symptoms, and your vision for aging well."}],"markDefs":[],"style":"normal"},{"_key":"fc4f50998d09","_type":"block","children":[{"_key":"0002888e9e080","_type":"span","marks":[],"text":"This is not a one-size-fits-all protocol or a printout of supplement recs. It’s a conversation, and a care plan that’s personalized — and "},{"_key":"0002888e9e081","_type":"span","marks":["em"],"text":"actionable"},{"_key":"0002888e9e082","_type":"span","marks":[],"text":"."}],"markDefs":[],"style":"normal"},{"_key":"48621f4d143a","_type":"block","children":[{"_key":"fc9db9fd7b8b0","_type":"span","marks":[],"text":"If you need deeper expertise, we’ll connect you with top-tier cardiologists across the country — and stay by your side throughout."}],"markDefs":[],"style":"normal"},{"_key":"2f5cbcc71322","_type":"block","children":[{"_key":"cea14c10ee430","_type":"span","marks":[],"text":"Because real longevity care isn’t about chasing perfection. It’s about understanding your body, trusting your path, and caring for yourself with confidence — today, tomorrow, and for all the years to come."}],"markDefs":[],"style":"normal"},{"_key":"29328ae0490c","_type":"sectionHeader","headerLevel":"h2","title":"What’s Next"},{"_key":"3e352b8073f0","_type":"block","children":[{"_key":"3f00502482e70","_type":"span","marks":[],"text":"We’re starting with heart health because the evidence is clearest and the opportunity for impact is greatest. But there’s so much more ahead. This year, we’ll be expanding our longevity offering to support women in more ways — including brain health, hormonal shifts, autoimmune conditions, cancer risk, and beyond."}],"markDefs":[],"style":"normal"},{"_key":"e360253bee82","_type":"cta","backgroundColor":"bcoat","text":[{"_key":"7787dc2a07d5","_type":"block","children":[{"_key":"a0a356e8214e","_type":"span","marks":["strong"],"text":"Now Available"},{"_key":"b97f425c37e6","_type":"span","marks":[],"text":" "}],"markDefs":[],"style":"large"},{"_key":"a50984c1003b","_type":"block","children":[{"_key":"7629794f4f0a","_type":"span","marks":[],"text":"Book your "},{"_key":"8021950b39f2","_type":"span","marks":["strong"],"text":"Women’s Longevity Assessment"},{"_key":"5966a8927770","_type":"span","marks":[],"text":", our foundational offering."}],"markDefs":[],"style":"large"},{"_key":"b9e15356374b","_type":"buttonBlock","items":[{"_key":"1df07b17a47f","_type":"singleButton","backgroundColor":"bcpoppy","linkCta":"Book your Women’s Longevity Assessment","linkType":"join-scroll-shape","reference":{"_ref":"eba0d59e-6d57-478c-b60a-23bd2d253f74","_type":"reference"}}],"onlyStackButtons":false}]},{"_key":"51ac630cc34f","_type":"block","children":[{"_key":"cb93c1805ef0","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"}],"image":{"_type":"image","asset":{"_ref":"image-489407a06ce090d10f48c5945511b1638169f11d-1934x1354-png","_type":"reference"}},"publishedAt":"2025-05-06T15:50:00.000Z","slug":{"_type":"slug","current":"youre-more-than-your-numbers-new-kind-of-longevity-care-for-women"},"status":"production","title":"You're More Than Your Numbers: A New Kind of Longevity Care for Women","topics":[{"_key":"b9d21a1d9748","_ref":"52909ed4-6c00-4b08-bfee-cee50984c63b","_type":"reference"},{"_key":"d181e0b8820c","_ref":"2059d0d8-f950-4194-a53f-a51970c4fd07","_type":"reference"}]},"metaInformation":{"_type":"metaCard","metaDescription":"Discover a new kind of longevity care designed by women, for women — starting with the heart. 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Recent research has demonstrated specific cognitive deficits in individuals with hyperandrogenic PCOS, particularly in executive functions, often exacerbated by insulin resistance."},{"_key":"9016889e49dc","_type":"span","marks":["em"],"text":"1"},{"_key":"8c93e9176ac1","_type":"span","marks":[],"text":" A There are multifaceted mechanisms through which estrogen and androgens influence brain health, from their roles as neurosteroids produced within the brain to their modulation of neurogenesis, synaptic plasticity, neurotransmitter systems, and neuroinflammation via diverse receptor pathways."},{"_key":"f7147ee1575a","_type":"span","marks":["em"],"text":"2"},{"_key":"f2039ceb4f39","_type":"span","marks":[],"text":" There is a complex interplay of hyperandrogenism, insulin resistance, and inflammation as key drivers of PCOS-related cognitive alterations, which can lead to structural brain changes like reduced white matter integrity, even in younger adults."},{"_key":"63cc5f1a4fff","_type":"span","marks":["em"],"text":"11"},{"_key":"9745c2ae90a9","_type":"span","marks":[],"text":" This research in the way that PCOS implicates traditional brain functioning in females can be extrapolated to broader findings about estrogen’s enduring neuroprotective impact across the lifespan, its role in cognitive aging and neurodegenerative diseases, and the potential for targeted hormonal and lifestyle interventions to preserve brain health."},{"_key":"d4e6c5be6f32","_type":"span","marks":["em"],"text":"8"}],"markDefs":[],"style":"normal"},{"_key":"15a928ef15c1","_type":"sectionHeader","headerLevel":"h2","title":"Introduction: Hormonal Influences on Brain Health"},{"_key":"dc0c2e0571dd","_type":"block","children":[{"_key":"3cfdbfb1095c0","_type":"span","marks":[],"text":"Polycystic Ovary Syndrome (PCOS) is a highly prevalent endocrine disorder affecting an estimated 7-10% of women of childbearing age."},{"_key":"7fd44427ac36","_type":"span","marks":["em"],"text":"13"},{"_key":"248af40d17fa","_type":"span","marks":[],"text":" It is primarily recognized for its reproductive manifestations, including oligomenorrhea (infrequent menstruation), hyperandrogenism (elevated androgen levels), and infertility."},{"_key":"c1515fd0cb2e","_type":"span","marks":["em"],"text":"12"},{"_key":"3fa52444981c","_type":"span","marks":[],"text":" Beyond its well-known reproductive and cutaneous sequelae (aka cystic acne), PCOS is increasingly understood as a multi-system disorder associated with a significant adverse cardiometabolic profile. This profile commonly includes insulin resistance, obesity, dyslipidemia, hypertension, and chronic inflammation, all of which contribute to a heightened risk of conditions like type 2 diabetes."},{"_key":"2f7109cc29a2","_type":"span","marks":["em"],"text":"12"},{"_key":"98a7973a492a","_type":"span","marks":[],"text":" The systemic metabolic and hormonal disruptions characteristic of PCOS are now recognized to extend their influence to brain structure and function, impacting mental health and cognitive outcomes across the lifespan."},{"_key":"a77f9827650d","_type":"span","marks":["em"],"text":"13"}],"markDefs":[],"style":"normal"},{"_key":"75b1b791e256","_type":"block","children":[{"_key":"2519034fd61e0","_type":"span","marks":[],"text":"Hormones of the hypothalamic-pituitary-gonadal (HPG) axis, including estrogens and androgens, are not merely peripheral regulators of reproductive function but also potent neurosteroids."},{"_key":"8e3284114efd","_type":"span","marks":["em"],"text":"4"},{"_key":"deec871bb986","_type":"span","marks":[],"text":" These steroid hormones exert profound and multifaceted effects on the development, maintenance, and ongoing function of the central nervous system throughout an individual's life."},{"_key":"d70c347729cf","_type":"span","marks":["em"],"text":"20"},{"_key":"4aa644389c23","_type":"span","marks":[],"text":" They are intricately involved in modulating fundamental neurobiological processes such as neural differentiation, proliferation (neurogenesis, the act of building new brain circuits), and synaptic plasticity."},{"_key":"4a7fefaa7f6d","_type":"span","marks":["em"],"text":"2"},{"_key":"32b9fb79367f","_type":"span","marks":[],"text":" Furthermore, these hormones influence various neurotransmitter systems, collectively supporting cognitive resilience and adaptive brain remodeling."},{"_key":"b123427659a6","_type":"span","marks":["em"],"text":"2"},{"_key":"1fa50560c7cd","_type":"span","marks":[],"text":" The observed sex differences in cognitive functioning, as well as in the vulnerability and manifestation of several psychiatric and neurological diseases—such as Alzheimer's disease (AD) and schizophrenia—strongly underscore the pervasive influence of these sex hormones on overall brain health and disease trajectories."},{"_key":"ddb9919f42f0","_type":"span","marks":["em"],"text":"4"}],"markDefs":[],"style":"normal"},{"_key":"90ecf7d8c71c","_type":"block","children":[{"_key":"e536e28f3e150","_type":"span","marks":[],"text":"Cognitive impacts observed in individuals with PCOS is not broadly discussed, despite an evolving landscape of research demonstrating the clear role of estrogen/androgen in shaping brain anatomy and function."},{"_key":"83ca15f2d8b5","_type":"span","marks":["em"],"text":"1"},{"_key":"a2547710137d","_type":"span","marks":[],"text":" The intricate molecular and cellular mechanisms by which estrogen and androgens influence brain function are critical for understanding the way in which estrogen could impact the brain. While research is evolving in this space, elevating recent findings is pertinent to the broader conversation. There are many implications of these hormonal influences for understanding general brain health, cognitive aging, and neurodegenerative disease risk, thereby integrating specific PCOS findings into a wider neuroendocrinological context. We are simultaneously excited about the research to date and eager for further focus on these critical insights for the overall field of women’s health."}],"markDefs":[],"style":"normal"},{"_key":"401ad7fa2f09","_type":"sectionHeader","headerLevel":"h2","title":"Cognitive Function in Polycystic Ovary Syndrome (PCOS): Specific Findings and Broader Evidence"},{"_key":"c77012fb38c1","_type":"block","children":[{"_key":"a0532839034f0","_type":"span","marks":[],"text":"The investigation into cognitive function in reproductive-aged individuals with PCOS has yielded significant findings, highlighting specific areas of vulnerability. (A seminal study categorized subjects into two groups: hyperandrogenic NIH-PCOS (n=35), characterized by clinical or biochemical hyperandrogenism alongside oligomenorrhea or polycystic ovaries, and non-androgenic PCOS (n=13), presenting with only oligomenorrhea and polycystic ovaries without hyperandrogenism.1)"}],"markDefs":[],"style":"normal"},{"_key":"6476d91884fa","_type":"block","children":[{"_key":"3d6b6fe9666d0","_type":"span","marks":[],"text":"hyperandrogenism is a medical condition characterized by elevated levels of androgens, often referred to as \"male hormones\" like testosterone, which are critical for women's health when in balance. While it can occur in both sexes, it is more common in women."}],"markDefs":[],"style":"normal"},{"_key":"d890def21fd0","_type":"block","children":[{"_key":"1cf6fa162fa70","_type":"span","marks":[],"text":"In women, hyperandrogenism is a clinical characteristic of Polycystic Ovary Syndrome (PCOS), affecting 60-80% of women with the condition and accounting for about 70% of hyperandrogenism cases overall. When androgen levels are high and out of balance, they can contribute to a range of hormonal, metabolic, reproductive, and psychological issues. Symptoms may include acne, seborrhea, hair loss on the scalp, increased body or facial hair (hirsutism), and infrequent or absent menstruation. Complications can also include high blood cholesterol and diabetes"}],"markDefs":[],"style":"normal"},{"_key":"c029a7e68176","_type":"block","children":[{"_key":"a13b30ed187e0","_type":"span","marks":[],"text":"A core finding of this study was that individuals with hyperandrogenic (high androgen) NIH-PCOS demonstrated significantly lower relative performance in executive functions when compared to their non-androgenic counterparts."},{"_key":"24ad5e73f6d1","_type":"span","marks":["em"],"text":"1"},{"_key":"df66a8dbc8d1","_type":"span","marks":[],"text":" This deficit was not generalized but specific, manifesting in subdomains such as verbal fluency, working memory, and cognitive control. These functions were assessed using a battery of neuropsychological tests, including the Delis-Kaplan System (Stroop, Trail Making for cognitive control; Design and Verbal Fluency for generativity) and Wechsler Adult Intelligence Scale (WAIS) Digit Span and Wechsler Memory Scale Symbol Span for working memory."},{"_key":"cd0c296d5c24","_type":"span","marks":["em"],"text":"1"},{"_key":"5a3db000ee58","_type":"span","marks":[],"text":" The study further revealed that among NIH-PCOS subjects, those with co-occurring insulin resistance exhibited the lowest performance on the composite executive function score. This observation underscores that insulin resistance acts as a significant exacerbating factor for cognitive impairment in this population."},{"_key":"d3fc622431fe","_type":"span","marks":["em"],"text":"1"},{"_key":"a13b30ed187e2","_type":"span","marks":[],"text":" Importantly, cognitive performance on measures of \"pre-morbid\" IQ, such as verbal and perceptual reasoning (measured with WAIS) and processing speed (measured by WAIS symbol search), was found to be similar between the hyperandrogenic and non-androgenic PCOS groups."},{"_key":"bfed51e2bc74","_type":"span","marks":["em"],"text":"1"},{"_key":"a1db8d49c012","_type":"span","marks":[],"text":" This suggests that the observed executive function deficits are not indicative of a generalized intellectual impairment but rather a specific impact on higher-order cognitive processes. The findings from this study strongly suggest a direct or indirect causal link between hyperandrogenism (high androgenism), a defining feature of NIH-PCOS, and these specific executive function deficits. The exacerbation of these deficits by insulin resistance further points to a complex interplay of hormonal and metabolic factors. The preservation of \"pre-morbid\" IQ implies that these are acquired, domain-specific impairments rather than global neurodevelopmental issues, indicating that the hormonal and metabolic dysregulation in PCOS might selectively impair neural circuits involved in these higher-order functions."}],"markDefs":[],"style":"normal"},{"_key":"6e6a1cc07a6d","_type":"block","children":[{"_key":"0b7ac09e13ad0","_type":"span","marks":[],"text":"Beyond this initial study, a growing body of evidence consistently links PCOS to cognitive alterations across different age groups. Longitudinal studies, such as the Coronary Artery Risk Development in Young Adults (CARDIA) Women's study, have tracked women with and without PCOS over a 30-year period. These studies revealed that women with PCOS at midlife (average age 54.7 years) performed significantly lower on tests of executive function (Stroop Interference Test), memory (RAVLT Long Delay Recall), and verbal abilities (Category Fluency)."},{"_key":"4e6510d21384","_type":"span","marks":["em"],"text":"11"},{"_key":"9e04677d3b33","_type":"span","marks":[],"text":" Notably, for the test measuring attention, participants with PCOS had an average score approximately 11% lower than those without the condition."},{"_key":"40159df0b469","_type":"span","marks":["em"],"text":"16"},{"_key":"578578e388d7","_type":"span","marks":[],"text":" Beyond functional deficits, these longitudinal investigations also revealed structural brain changes, specifically lower total white matter fractional anisotropy, a measure indicative of reduced white matter integrity."},{"_key":"8b47a3abfca3","_type":"span","marks":["em"],"text":"11"},{"_key":"7ead0c124389","_type":"span","marks":[],"text":" White matter is crucial for efficient information processing and connecting brain regions responsible for learning, balance, focusing, and problem-solving."},{"_key":"6d705aeb9ce5","_type":"span","marks":["em"],"text":"16"}],"markDefs":[],"style":"normal"},{"_key":"e76f3b0d4ace","_type":"block","children":[{"_key":"cfe0e45191140","_type":"span","marks":[],"text":"Moreover, alterations in white matter microstructure have been observed even in younger adult women with PCOS."}],"markDefs":[],"style":"normal"},{"_key":"362d31afbd7a","_type":"block","children":[{"_key":"b4de0c04a1500","_type":"span","marks":[],"text":"White matter is crucial for efficient brain function because it helps the brain process information and connects different areas of the brain. These connections are vital for various cognitive processes, including learning, maintaining balance, focusing attention, and problem-solving. Changes in white matter integrity, such as those observed in conditions like PCOS, can be an early indicator of alterations in the brain that may occur with aging or other health conditions."}],"markDefs":[],"style":"normal"},{"_key":"8d27ce05ff57","_type":"block","children":[{"_key":"60f5ed8f225a0","_type":"span","marks":[],"text":"Studies involving individuals with PCOS (average age 31 years) demonstrated altered white matter microstructure, characterized by a widespread reduction in axial diffusivity (diffusion along the main axis of white matter fibers) and increased tissue volume fraction (the proportion of volume filled by white or grey matter) in regions like the corpus callosum."},{"_key":"13dc46ee9f82","_type":"span","marks":["em"],"text":"15"},{"_key":"d115de4a0253","_type":"span","marks":[],"text":" These structural changes were accompanied by subtle decrements across a broad range of cognitive tests, notably independent of age, education, and body mass index (BMI)."},{"_key":"db7b5da17a6e","_type":"span","marks":["em"],"text":"15"},{"_key":"0f115156a449","_type":"span","marks":[],"text":" The consistent findings across studies, from reproductive-aged to midlife women, and the detection of white matter alterations in young adults,"},{"_key":"60f5ed8f225a2","_type":"span","marks":["strong"],"text":" "},{"_key":"8d441ab7b810","_type":"span","marks":[],"text":"strongly suggest that PCOS is associated with a long-term trajectory of accelerated cognitive aging and early-onset structural brain changes."}],"markDefs":[],"style":"normal"},{"_key":"c540daa08b82","_type":"block","children":[{"_key":"3ef640574c6b0","_type":"span","marks":[],"text":"Altered white matter microstructure, specifically reduced axial diffusivity and increased tissue volume fraction in areas like the corpus callosum, indicates compromised brain communication pathways. White matter is crucial for efficient information processing, learning, and problem-solving. These structural changes are linked to subtle declines across various cognitive tests. Importantly, these alterations are independent of age, education, and BMI, suggesting that the underlying condition (like PCOS) directly impacts brain health and function, even in younger adults."}],"markDefs":[],"style":"normal"},{"_key":"4a261f64a602","_type":"block","children":[{"_key":"5ba7fee15be00","_type":"span","marks":[],"text":"These findings imply that the condition's impact on the brain is not merely a late-life phenomenon but begins much earlier, potentially setting the stage for future cognitive decline. The fact that changes are observed independently of age, education, and BMI in younger adults indicates that the underlying PCOS pathophysiology itself, rather than just aging or obesity, drives these brain alterations."}],"markDefs":[],"style":"normal"},{"_key":"943f6622cba7","_type":"block","children":[{"_key":"4c5cc21f58ea0","_type":"span","marks":[],"text":"The following table summarizes the cognitive domains affected in PCOS and the associated factors identified in the research:"}],"markDefs":[],"style":"normal"},{"_key":"c83d2343ea02","_type":"block","children":[{"_key":"579ac47762a80","_type":"span","marks":["strong"],"text":"Table 1: Summary of Cognitive Domains Affected in PCOS and Associated Factors"}],"markDefs":[],"style":"normal"},{"_key":"df82b6abd8b0","_type":"tableModule","subTable":{"rows":[{"_key":"49f39e98-150f-491b-9983-52d22c7d904a","_type":"tableRow","cells":["Cognitive Domain","Specific Test/Measure","Observed Impact in PCOS","Associated Factors","Relevant Age Group","Source Snippets"]}]},"table":{"rows":[{"_key":"dcd1229b-30a8-49d7-bae2-96f32b6452a3","_type":"tableRow","cells":["Executive Function","Composite Score (Verbal Fluency, Working Memory, Cognitive Control)","Lower performance","Hyperandrogenism, Insulin Resistance","Reproductive-aged","1"]},{"_key":"8b3cdd70-ec4f-4538-b11b-cce288bd0251","_type":"tableRow","cells":["Executive Function","Stroop Interference Test","Lower performance","Hyperandrogenism, Insulin Resistance, Lower white matter integrity","Midlife","11"]},{"_key":"01836726-e14f-4a77-a21d-42f8b5374c6d","_type":"tableRow","cells":["Memory","RAVLT Long Delay Recall","Lower performance","Hyperandrogenism, Insulin Resistance, Lower white matter integrity","Midlife","11"]},{"_key":"621ca952-656d-4468-a5b3-f8e209973c1d","_type":"tableRow","cells":["Verbal Fluency","Category Fluency","Lower performance","Hyperandrogenism, Insulin Resistance, Lower white matter integrity","Midlife","11"]},{"_key":"63ecf791-2f06-4544-95a9-b6d35e6d2377","_type":"tableRow","cells":["Attention","Stroop Test (general)","~11% lower average score","Hyperandrogenism, Insulin Resistance","Midlife","16"]},{"_key":"b466a7fb-1e49-4b1c-81f3-105b4e2dae35","_type":"tableRow","cells":["White Matter Integrity","Total White Matter Fractional Anisotropy","Lower integrity","Hyperandrogenism, Insulin Resistance","Midlife","11"]},{"_key":"2ff739f9-a3fc-4d87-bff6-7bc04c6811f9","_type":"tableRow","cells":["White Matter Microstructure","Axial Diffusivity, Tissue Volume Fraction (Corpus Callosum)","Reduced axial diffusivity, increased tissue volume fraction","Insulin Resistance, Hyperandrogenism","Young Adults","15"]},{"_key":"6c2ef297-2b7a-4a49-8ac5-6fbc2e8cc1fc","_type":"tableRow","cells":["General Cognitive Performance","First Principal Component (broad range of tests)","Subtle decrements","Insulin Resistance, Hyperandrogenism","Young Adults","15"]}]}},{"_key":"9b2ac1ee8d19","_type":"block","children":[{"_key":"ed06e4ebed360","_type":"span","marks":["strong"],"text":"3. Mechanisms of Estrogen's Influence on Brain Function"}],"markDefs":[],"style":"normal"},{"_key":"e13664226347","_type":"block","children":[{"_key":"7eaa29a717c40","_type":"span","marks":[],"text":"Estrogen, particularly 17β-estradiol (E2), is classically recognized as a primary endocrine signal produced by the ovary, essential for female reproduction. However, E2 is also a potent neurosteroid, meaning it can be synthesized locally within the brain by neurons and astrocytes in both men and women."},{"_key":"7eaa29a717c42","_type":"span","marks":["em"],"text":"2"},{"_key":"a3064e1a8d31","_type":"span","marks":[],"text":" This local production, often referred to as neuron-derived E2 (NDE2), allows for intricate, localized control over brain function, potentially independent of systemic ovarian fluctuations."},{"_key":"8fc1baef630b","_type":"span","marks":["em"],"text":"2"},{"_key":"a44633fed113","_type":"span","marks":[],"text":" E2 is a lipophilic steroid, enabling it to readily diffuse through the blood-brain barrier (BBB) to reach the brain parenchyma, where it regulates diverse processes linked to development, reproduction, emotion, and cognition."},{"_key":"fd45bf8cf27b","_type":"span","marks":["em"],"text":"4"},{"_key":"270dfa3b8aa0","_type":"span","marks":[],"text":" The presence of neurosteroidogenesis, the local synthesis of estrogen within the brain, implies a sophisticated, localized regulatory system for brain function. This mechanism could allow the brain to buffer systemic hormonal fluctuations and maintain a stable microenvironment, or conversely, contribute to localized dysregulation in pathological states if this local synthesis is impaired or overwhelmed by peripheral imbalances."}],"markDefs":[],"style":"normal"},{"_key":"f9f9f4b0b279","_type":"block","children":[{"_key":"d438b3d8e67f0","_type":"span","marks":[],"text":"Estrogen exerts its profound effects by binding to specific estrogen receptors (ERs). Three main subtypes have been identified: Estrogen receptor alpha (ERα), estrogen receptor beta (ERβ), and G-protein-coupled estrogen receptor 1 (GPER1)."},{"_key":"f3a50175d226","_type":"span","marks":["em"],"text":"4"},{"_key":"69d126b3bb65","_type":"span","marks":[],"text":" These receptors mediate estrogen's influence through two primary signaling pathways:"}],"markDefs":[],"style":"normal"},{"_key":"5ae7be796bbf","_type":"block","children":[{"_key":"77b985a7e7450","_type":"span","marks":["strong"],"text":"Classical Genomic Actions:"},{"_key":"77b985a7e7451","_type":"span","marks":[],"text":" ERα and ERβ belong to the steroid-activated nuclear receptor family of transcription factors. Upon E2 binding, these receptors undergo conformational changes, dissociate from associated heat shock proteins, and then homo- or hetero-dimerize. The activated dimers translocate to the nucleus, where they recruit coactivators and bind to specific DNA sequences known as estrogen response elements (EREs)."},{"_key":"ccfa8410c4d8","_type":"span","marks":["em"],"text":"4"},{"_key":"4460f4d8ce05","_type":"span","marks":[],"text":" This binding mediates the transcription of target genes involved in cellular proliferation, differentiation, and survival."},{"_key":"fc50bc2637a7","_type":"span","marks":["em"],"text":"4 "},{"_key":"d44d38549d2c","_type":"span","marks":[],"text":"This classical genomic pathway is typically slower, leading to long-term cellular changes crucial for brain development and maintenance."},{"_key":"43940cf7e9ad","_type":"span","marks":["em"],"text":"5"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f9483a0fde15","_type":"block","children":[{"_key":"05161ac4032f0","_type":"span","marks":["strong"],"text":"Rapid Non-Genomic Actions:"},{"_key":"05161ac4032f1","_type":"span","marks":[],"text":" In addition to classical genomic actions, ERs can also mediate rapid, non-genomic effects that do not directly involve DNA binding."},{"_key":"4827eef70cfb","_type":"span","marks":["em"],"text":"4"},{"_key":"644617eac672","_type":"span","marks":[],"text":" These actions occur through membrane-bound estrogen receptors (mERs) or via transcriptional cross-talk, where ERs interact with other transcription factors or activate intracellular signaling cascades, such as PI3K/cAMP pathways."},{"_key":"2c153993c590","_type":"span","marks":["em"],"text":"5"},{"_key":"77225ff49feb","_type":"span","marks":[],"text":" These cascades can rapidly phosphorylate and activate transcription factors, leading to swift changes in gene expression or direct modulation of neuronal excitability and synaptic function."},{"_key":"814d473c2b9d","_type":"span","marks":["em"],"text":"5"},{"_key":"68a55aaa104a","_type":"span","marks":[],"text":" These rapid effects allow for dynamic modulation of neuronal activity and synaptic function."},{"_key":"14c432f3bc1c","_type":"span","marks":["em"],"text":"4"},{"_key":"15431e883077","_type":"span","marks":[],"text":" The existence of both classical genomic (slower, gene transcription) and rapid non-genomic (membrane-mediated, signaling cascades) actions of estrogen, mediated by distinct receptor subtypes, highlights the complexity and versatility of estrogen signaling in the brain. This mechanistic understanding is crucial for developing highly targeted therapeutic interventions, such as selective ER modulators, that can leverage specific pathways for neuroprotection while minimizing unwanted systemic side effects."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"df629a1e7e64","_type":"block","children":[{"_key":"dbdeed2dc18a0","_type":"span","marks":[],"text":"The neurobiological effects of estrogen are extensive and critical for optimal brain function:"}],"markDefs":[],"style":"normal"},{"_key":"ffe9be3f8091","_type":"block","children":[{"_key":"f02ae571a42c0","_type":"span","marks":[],"text":"Modulation of Neural Differentiation, Proliferation, and Synaptic Plasticity: Estrogen plays a pivotal role in shaping brain circuitry. NDE2, for instance, is crucial for regulating synaptic plasticity, a fundamental process underlying learning and memory formation."},{"_key":"e8185d79e9b8","_type":"span","marks":["em"],"text":"2"},{"_key":"0d18c6a3a197","_type":"span","marks":[],"text":" Estrogen receptors in the brain participate in modulating neural differentiation, promoting neurogenesis (the birth of new neurons), and influencing the density and efficacy of synapses."},{"_key":"df3b32b81d0b","_type":"span","marks":["em"],"text":"4"},{"_key":"d86839054a9d","_type":"span","marks":[],"text":" These processes are all vital for cognitive resilience and adaptive brain remodeling throughout life."},{"_key":"192a8a0b80f7","_type":"span","marks":["em"],"text":"4"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"4b51bd499278","_type":"block","children":[{"_key":"1f5a3f95b4210","_type":"span","marks":[],"text":"Influence on Neurotransmitter Systems: E2 profoundly modulates various neurotransmitter systems, including the serotonergic, dopaminergic, and glutamatergic pathways."},{"_key":"95bb7a4f8079","_type":"span","marks":["em"],"text":"5"},{"_key":"ba76e3b0b2f8","_type":"span","marks":[],"text":" These systems are fundamental to diverse brain functions such as learning, memory, reward, mood regulation, and sexual behaviors."},{"_key":"57ec39bd18fe","_type":"span","marks":["em"],"text":"5"},{"_key":"79d5d06c5b0a","_type":"span","marks":[],"text":" For example, E2 interacts with the dopaminergic system, which is implicated in cognitive aging and disorders like Parkinson's disease, where reductions in dopamine binding and receptors are observed."},{"_key":"529ca4b2e42f","_type":"span","marks":["em"],"text":"17"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"36f82675146a","_type":"block","children":[{"_key":"05509335c8aa0","_type":"span","marks":[],"text":"Role in Neuroinflammation and Neuroprotection: Estrogen has potent neuroprotective properties, particularly against inflammatory insults within the central nervous system."},{"_key":"694515fbe398","_type":"span","marks":["em"],"text":"4"},{"_key":"ac105398ed63","_type":"span","marks":[],"text":" It exerts significant anti-inflammatory effects, notably by modulating the activity of microglia, the brain's resident immune cells.9 Microglia are crucial for maintaining neuronal connectivity, clearing cellular debris, and responding to injury."},{"_key":"3beead87728e","_type":"span","marks":["em"],"text":"9"},{"_key":"038f81d51ce0","_type":"span","marks":[],"text":" However, prolonged or excessive inflammatory activation by microglia can be detrimental, contributing to neurodegenerative processes."},{"_key":"361d30c55501","_type":"span","marks":["em"],"text":"9"},{"_key":"accd0f5015f3","_type":"span","marks":[],"text":" Estrogen's ability to prevent and control inflammatory responses suggests a key role in protecting the brain from pathologies with an inflammatory component, such as Alzheimer's and Parkinson's diseases."},{"_key":"3b00f78ccb5a","_type":"span","marks":["em"],"text":"9"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"925054df16dc","_type":"sectionHeader","headerLevel":"h2","title":"Mechanisms of Androgen's Influence on Brain Function"},{"_key":"12aa0123e303","_type":"block","children":[{"_key":"80986050eded0","_type":"span","marks":[],"text":"Androgens, such as testosterone and dihydrotestosterone (DHT), are synthesized not only in the gonads and adrenal glands but also locally within the brain itself, functioning as neurosteroids."},{"_key":"a0bf5ca6c76b","_type":"span","marks":["em"],"text":"3"},{"_key":"b4df28e9804e","_type":"span","marks":[],"text":" These hormones exert physiologically important effects on the structure and function of the central nervous system in both sexes."},{"_key":"68768de6c14e","_type":"span","marks":["em"],"text":"3"},{"_key":"418aea2cf38f","_type":"span","marks":[],"text":" Androgen receptors (ARs) are widely expressed in numerous neuronal populations throughout the brain, including the neocortex, hippocampal formation, and amygdala."},{"_key":"c2ccd34b5fc8","_type":"span","marks":["em"],"text":"7"}],"markDefs":[],"style":"normal"},{"_key":"400ddbcfe991","_type":"block","children":[{"_key":"0b0284979e210","_type":"span","marks":[],"text":"The androgen receptor (AR) is a type of nuclear receptor activated by binding to androgenic hormones like testosterone or DHT.6 Similar to estrogen receptors, ARs operate through both genomic and non-genomic mechanisms:"}],"markDefs":[],"style":"normal"},{"_key":"332d141dfca4","_type":"block","children":[{"_key":"d2135bd783b10","_type":"span","marks":["strong"],"text":"Genomic Mechanisms:"},{"_key":"d2135bd783b11","_type":"span","marks":[],"text":" The primary mechanism of AR action involves the direct regulation of gene transcription."},{"_key":"80e0562bed48","_type":"span","marks":["em"],"text":"6"},{"_key":"0982b1274d2f","_type":"span","marks":[],"text":" Upon steroid binding, the AR undergoes a conformational change, releases associated heat-shock proteins, and undergoes phosphorylation."},{"_key":"ab3007354ec5","_type":"span","marks":["em"],"text":"6"},{"_key":"4bd1bbfdaffd","_type":"span","marks":[],"text":" The activated AR then translocates to the nucleus, where it dimerizes, binds to specific androgen responsive elements on DNA, and recruits coactivator proteins, leading to the transcription of target genes."},{"_key":"7ce27cf7e194","_type":"span","marks":["em"],"text":"6"},{"_key":"235cfc73256a","_type":"span","marks":[],"text":" This genomic pathway is fundamental for the development and maintenance of male sexual phenotype, but it also plays a crucial role in various other tissue types and physiological processes, including those in the brain."},{"_key":"e097edf0193c","_type":"span","marks":["em"],"text":"6"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"833fe0e60737","_type":"block","children":[{"_key":"9a627b78dfee0","_type":"span","marks":["strong"],"text":"Non-Genomic Mechanisms:"},{"_key":"9a627b78dfee1","_type":"span","marks":[],"text":" Like estrogen receptors, ARs also mediate rapid, non-genomic actions."},{"_key":"269830191ca9","_type":"span","marks":["em"],"text":"6"},{"_key":"c940b8895020","_type":"span","marks":[],"text":" Recent studies have detected AR immunoreactivity in neuronal and glial processes, including axons, dendrites, and astrocytes, in regions such as the adult rat neocortex, hippocampal formation, and amygdala."},{"_key":"b9055bf443a8","_type":"span","marks":["em"],"text":"7"},{"_key":"c62fb373b3cf","_type":"span","marks":[],"text":" This extranuclear localization suggests functional roles beyond nuclear transcription, enabling rapid modulation of neural activity. These extranuclear ARs may play an important role in the swift behavioral effects of androgens, allowing for more direct and immediate influences on neuronal function."},{"_key":"21db0aaf7330","_type":"span","marks":["em"],"text":"7"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"668ccbde5428","_type":"block","children":[{"_key":"633612bbe61c0","_type":"span","marks":[],"text":"Androgens contribute significantly to neuroplastic effects, particularly within the hippocampus, a brain region critical for learning and memory."},{"_key":"b83b5367bfcc","_type":"span","marks":["em"],"text":"3"},{"_key":"2c461c510b13","_type":"span","marks":[],"text":" These effects include synaptogenesis (the formation of new synapses) and the modulation of glial cell functions, which are essential for neuronal support and brain plasticity."},{"_key":"61bd353d3c6c","_type":"span","marks":["em"],"text":"3"},{"_key":"9e9ecec387b9","_type":"span","marks":[],"text":" Androgens also play a key role in the maintenance of male skeletal integrity via AR signaling in osteoblasts and osteocytes.6"}],"markDefs":[],"style":"normal"},{"_key":"8a843426b401","_type":"block","children":[{"_key":"ce8211fb39540","_type":"span","marks":[],"text":"While often considered \"male hormones,\" androgens are critically important for women's health when present in balanced physiological concentrations."},{"_key":"fdaaaa16d1b2","_type":"span","marks":["em"],"text":"22"},{"_key":"96179fe9514b","_type":"span","marks":[],"text":" The AR is essential for normal female fertility, required for the development and full functionality of ovarian follicles and ovulation, through both intra-ovarian and neuroendocrine mechanisms."},{"_key":"0dee8f0460f0","_type":"span","marks":["em"],"text":"6"},{"_key":"60e435ca9f88","_type":"span","marks":[],"text":" Androgens also play a role in regulating female sexual, somatic, and behavioral functions."},{"_key":"e9b90e18210d","_type":"span","marks":["em"],"text":"6"},{"_key":"6498dddc5f44","_type":"span","marks":[],"text":" However, when androgen levels are high and out of balance, a condition known as hyperandrogenism, they contribute to a range of hormonal, metabolic, reproductive, and psychological issues."},{"_key":"e3cc669c1a6f","_type":"span","marks":["em"],"text":"22"},{"_key":"fe36b77f0e77","_type":"span","marks":[],"text":" Elevated androgens can have neurotoxic effects, and imbalances, such as those commonly observed in PCOS, are linked to cognitive decline."},{"_key":"a0df7980a048","_type":"span","marks":["em"],"text":"16"},{"_key":"527b7f101a17","_type":"span","marks":[],"text":" Androgens, like estrogens, operate through both genomic and non-genomic pathways, enabling both long-term structural changes and rapid modulation of neural activity. Furthermore, their role in the female brain is complex: essential for fertility and various functions at physiological levels, yet potentially neurotoxic at elevated levels, as seen in hyperandrogenism. This highlights the importance of hormonal balance rather than just presence or absence for optimal brain function."}],"markDefs":[],"style":"normal"},{"_key":"acaf18f88973","_type":"block","children":[{"_key":"71a0c16900b90","_type":"span","marks":[],"text":"The following table provides a comparative overview of the mechanisms through which estrogen and androgens influence brain function:"}],"markDefs":[],"style":"normal"},{"_key":"a87ac6243609","_type":"block","children":[{"_key":"7a2cfc3668190","_type":"span","marks":["strong"],"text":"Table 2: Mechanisms of Estrogen and Androgen Action in the Brain"}],"markDefs":[],"style":"normal"},{"_key":"056b01205719","_type":"tableModule","subTable":{"rows":[{"_key":"537c82b3-8cf6-46b8-ae5d-b44e14632e0c","_type":"tableRow","cells":["Hormone","Receptor Subtypes","Primary Signaling Mechanisms","Key Neurobiological Effects"]}]},"table":{"rows":[{"_key":"560ef0df-40b7-43c8-9643-f2f3b13a06d1","_type":"tableRow","cells":["Estrogen (17β-estradiol)","Estrogen receptor alpha (ERα), Estrogen receptor beta (ERβ), G-protein-coupled estrogen receptor 1 (GPER1)","Genomic: Nuclear receptors (ERα, ERβ) bind E2, dimerize, translocate to nucleus, bind to Estrogen Response Elements (EREs) on DNA, regulate gene transcription (e.g., proliferation, differentiation, survival). <br> Non-Genomic: Membrane-bound ERs (mERs) or ERs interacting with other transcription factors/kinases activate rapid signaling cascades (e.g., PI3K/cAMP) without direct DNA binding.","Neurogenesis, neural differentiation, synaptic plasticity (memory, learning), modulation of neurotransmitter systems (serotonergic, dopaminergic, glutamatergic), neuroinflammation control (microglia modulation), neuroprotection."]},{"_key":"d333f472-8827-452a-b941-8f46f6cfdd6f","_type":"tableRow","cells":["Androgen (Testosterone, DHT)","Androgen Receptor (AR)","Genomic: Nuclear receptor (AR) binds androgen, undergoes conformational change, translocates to nucleus, dimerizes, binds to Androgen Responsive Elements (AREs) on DNA, regulates gene transcription (e.g., male sexual phenotype, skeletal integrity). <br> Non-Genomic: Extranuclear ARs detected in neuronal/glial processes mediate rapid behavioral effects and modulate neuronal activity.","Neuroplasticity (synaptogenesis), modulation of glial cell functions, maintenance of male skeletal integrity, regulation of female sexual/somatic/behavioral functions."]}]}},{"_key":"6851b8910cbf","_type":"sectionHeader","headerLevel":"h2","title":"The Complex Interplay: Estrogen, Androgens, and Metabolic Factors in PCOS-Related Cognitive Changes"},{"_key":"aeeadb8c5922","_type":"block","children":[{"_key":"44f6c05072040","_type":"span","marks":[],"text":"Polycystic Ovary Syndrome is characterized by a complex interplay of hormonal and metabolic dysregulations that collectively impact brain function. Hyperandrogenism, defined by elevated levels of androgens such as testosterone, is a hallmark feature of PCOS, affecting a significant majority (60-80%) of women with the condition."},{"_key":"b586c8d028ba","_type":"span","marks":["em"],"text":"14"},{"_key":"170f9a05a937","_type":"span","marks":[],"text":" While androgens are essential for female health in balanced concentrations, excess levels can have neurotoxic effects."},{"_key":"f027bea2e91b","_type":"span","marks":["em"],"text":"16"},{"_key":"1d1e0870e6e3","_type":"span","marks":[],"text":" The direct impact of hyperandrogenism on brain function is suggested by findings that hyperandrogenic NIH-PCOS is associated with lower executive function performance."},{"_key":"ddacb6a0ea3b","_type":"span","marks":["em"],"text":"1"},{"_key":"90b95fd73cfc","_type":"span","marks":[],"text":" Indirectly, hyperandrogenism is intricately intertwined with insulin resistance, establishing a bidirectional relationship where elevated insulin can induce excess ovarian testosterone secretion, and high androgens can, in turn, contribute to metabolic dysfunction."},{"_key":"b1044d1a9500","_type":"span","marks":["em"],"text":"14"},{"_key":"f648bb6b1113","_type":"span","marks":[],"text":" This hormonal-metabolic feedback loop likely exacerbates cognitive vulnerabilities, creating a compounding effect on brain health."}],"markDefs":[],"style":"normal"},{"_key":"20d19ace58b2","_type":"block","children":[{"_key":"b3e35c3b4a470","_type":"span","marks":[],"text":"The critical role of insulin resistance (IR) and subsequent hyperinsulinemia in PCOS-associated cognitive decline cannot be overstated. Insulin resistance is highly prevalent in PCOS, affecting 65-70% of women with the syndrome, often independent of obesity."},{"_key":"c7e182e349e9","_type":"span","marks":["em"],"text":"13"},{"_key":"308f8766614f","_type":"span","marks":[],"text":" Prolonged hyperinsulinemia has a direct negative effect on cognitive function by reducing the number of insulin receptors in the blood-brain barrier (BBB), thereby decreasing the transport of insulin into the brain."},{"_key":"764afbcbb3e9","_type":"span","marks":["em"],"text":"13"},{"_key":"25d6df11b3c9","_type":"span","marks":[],"text":" This impairment can lead to decreased brain glucose utilization, impacting neuronal energy metabolism, which is critical for learning, memory, and overall brain function."},{"_key":"bca49cd5e36f","_type":"span","marks":["em"],"text":"13"},{"_key":"95a3091baf70","_type":"span","marks":[],"text":" In severe cases, decreased brain glucose can even lead to seizures or irreversible brain damage."},{"_key":"b23fbd28475d","_type":"span","marks":["em"],"text":"13"},{"_key":"499c38fe327b","_type":"span","marks":[],"text":" The exacerbation of executive function deficits observed in hyperandrogenic PCOS subjects with co-occurring insulin resistance underscores its central role in cognitive impairment within this population."},{"_key":"82cc84489fff","_type":"span","marks":["em"],"text":"1"},{"_key":"7d19daf95c80","_type":"span","marks":[],"text":" The strong bidirectional relationship between insulin resistance and hyperandrogenism in PCOS creates a vicious cycle that profoundly impacts brain health. High insulin drives androgen production, and elevated androgens can worsen insulin sensitivity, leading to a compounding effect on brain glucose metabolism and overall neuronal function. This highlights metabolic dysfunction as a primary, modifiable driver of cognitive decline in PCOS."}],"markDefs":[],"style":"normal"},{"_key":"a0c59b23f395","_type":"block","children":[{"_key":"699c0559af4e0","_type":"span","marks":[],"text":"Furthermore, PCOS is associated with a broader adverse cardiometabolic profile that extends beyond hyperandrogenism and insulin resistance."},{"_key":"19b98ea5f53b","_type":"span","marks":["em"],"text":"12"},{"_key":"a37b7fdb2633","_type":"span","marks":[],"text":" Chronic inflammation, dyslipidemia, and hypertension are common comorbidities that independently contribute to accelerated cognitive aging and adverse brain health outcomes."},{"_key":"e0ac5472a9da","_type":"span","marks":["em"],"text":"11"},{"_key":"bdc4b25fb3fd","_type":"span","marks":[],"text":" For example, hypertension can lead to vascular dementia by reducing blood flow to the brain."},{"_key":"f2aa5d37aff4","_type":"span","marks":["em"],"text":"13"},{"_key":"4622814c2c08","_type":"span","marks":[],"text":" The cumulative burden of these interconnected metabolic and inflammatory factors likely contributes significantly to the observed cognitive deficits and white matter integrity changes in PCOS."},{"_key":"4af2ed9d3671","_type":"span","marks":["em"],"text":"11"}],"markDefs":[],"style":"normal"},{"_key":"b1db49b6aff0","_type":"block","children":[{"_key":"5b888a11a8ae0","_type":"span","marks":[],"text":"The altered hormonal milieu in PCOS, involving not only elevated androgens but also potentially altered estrogen dynamics and often low progesterone levels, further contributes to observed cognitive and structural brain changes. While the primary focus is often on androgen excess, the neuroprotective effects of progesterone may be diminished when its levels are too low, as is common in PCOS."},{"_key":"b89b97853f32","_type":"span","marks":["em"],"text":"16"},{"_key":"7c36b5fc2a46","_type":"span","marks":[],"text":" The overall hormonal imbalance, coupled with the pervasive metabolic dysfunction (insulin resistance) and chronic inflammation, creates a neurobiological environment conducive to cognitive impairment and structural brain changes, such as reduced white matter integrity."},{"_key":"69be844f05c0","_type":"span","marks":["em"],"text":"11"},{"_key":"97981e0dabd9","_type":"span","marks":[],"text":" This complex interplay suggests a multi-hit hypothesis where various PCOS-related factors synergistically contribute to brain health compromise. While hyperandrogenism is a key feature of PCOS, the cognitive impact is likely not solely due to excess androgens but also the imbalance of other hormones, particularly the potential deficiency of neuroprotective progesterone. This suggests that a holistic view of the hormonal milieu, rather than focusing on a single hormone, is crucial for understanding and addressing PCOS-related brain health issues."}],"markDefs":[],"style":"normal"},{"_key":"fea46fca9a87","_type":"sectionHeader","headerLevel":"h2","title":"Broader Relevance: Estrogen's Enduring Impact on Brain Health Across the Lifespan"},{"_key":"9260eb38f85e","_type":"block","children":[{"_key":"8edc39a2b62b0","_type":"span","marks":[],"text":"The study of PCOS and its impact on cognitive function provides valuable insights into the broader influence of sex hormones on brain health. Sex differences in cognitive functioning have been reported in both healthy individuals and those with disease, and these differences may be partly attributed to the modulating effects of sex hormones."},{"_key":"bca13bbb75e3","_type":"span","marks":["em"],"text":"20"},{"_key":"0b653116f606","_type":"span","marks":[],"text":" While systematic advantages in overall executive function between sexes are not strongly supported by current evidence, individual components of executive functions can be modulated differently, often depending on the modality of testing."},{"_key":"e861f7a1ff22","_type":"span","marks":["em"],"text":"23"},{"_key":"3e791b2dccf6","_type":"span","marks":[],"text":" These differences extend to the vulnerability and manifestation of several psychiatric and neurological diseases, such as Alzheimer's disease (AD) and schizophrenia, highlighting the profound influence of sex hormones on brain health trajectories across the lifespan."},{"_key":"9b50c289e8e7","_type":"span","marks":["em"],"text":"4"}],"markDefs":[],"style":"normal"},{"_key":"1606f8c223cb","_type":"block","children":[{"_key":"c0105707a9b00","_type":"span","marks":[],"text":"As individuals age, circulating sex hormone levels naturally decrease, with a more rapid decline observed at menopause in women and a slower, more gradual reduction in men."},{"_key":"8d6920bcd8b2","_type":"span","marks":["em"],"text":"4"},{"_key":"e9e7ad3cea0e","_type":"span","marks":[],"text":" The rapid decline of 17β-estradiol (E2) during the menopausal transition is associated with a number of changes in the brain, including cognitive alterations such as reduced verbal memory and processing speed, as well as effects on sleep and mood disturbances."},{"_key":"12f4f0d0aa55","_type":"span","marks":["em"],"text":"17"},{"_key":"bf28284055b8","_type":"span","marks":[],"text":" This significant drop in estrogen levels entails a reduction in neuroprotection and resilience within the aging brain."},{"_key":"e194df7ce851","_type":"span","marks":["em"],"text":"4"},{"_key":"f3e1066c5915","_type":"span","marks":[],"text":" Estrogen interactions have been implicated in the pathogenesis of various neuropsychiatric disorders, including AD, Parkinson's disease (PD), schizophrenia, and depression."},{"_key":"418c90e736b6","_type":"span","marks":["em"],"text":"4"},{"_key":"c353319e04c5","_type":"span","marks":[],"text":" The neuroprotective properties of E2, mediated through its diverse receptors, are essential for maintaining brain health, and their decline with aging contributes to age-related cognitive vulnerability and the observed sex differences in neurodegenerative disease incidence and progression."},{"_key":"2407f5bf36c3","_type":"span","marks":["em"],"text":"4"}],"markDefs":[],"style":"normal"},{"_key":"b359f4e306a2","_type":"block","children":[{"_key":"633a42cae3fa0","_type":"span","marks":[],"text":"Recent research has introduced the compelling concept of \"reproductive longevity,\" which posits a direct link between the duration of a woman's reproductive years—defined as the time between menarche (first menstruation) and menopause—and long-term cognitive health."},{"_key":"3909ea8e911e","_type":"span","marks":["em"],"text":"18"},{"_key":"82fe7f15ae7d","_type":"span","marks":[],"text":" Studies indicate that women who experience earlier menarche, later menopause, or a prolonged reproductive window exhibit signs indicative of slower brain aging."},{"_key":"359b48d1d147","_type":"span","marks":["em"],"text":"18"},{"_key":"c7e59e8a5e7a","_type":"span","marks":[],"text":" This discovery positions estradiol as a potential neuroprotective agent, with sustained elevated concentrations throughout the reproductive years appearing to play a crucial role in maintaining brain health and cognitive resilience."},{"_key":"5a52e367f499","_type":"span","marks":["em"],"text":"18"},{"_key":"ef3eb4f7a9cf","_type":"span","marks":[],"text":" This concept underscores the cumulative neuroprotective benefits of endogenous estrogen exposure over a lifetime. The idea that the duration of physiological estrogen exposure over a woman's lifetime is intricately linked to long-term brain health and slower cognitive aging suggests that conditions like PCOS, which involve chronic hormonal dysregulation, or early menopause, might disrupt this protective trajectory, leading to an increased vulnerability to cognitive decline later in life."}],"markDefs":[],"style":"normal"},{"_key":"a7c29866d629","_type":"block","children":[{"_key":"e2cb3a73db620","_type":"span","marks":[],"text":"Given the established neuroprotective roles of estrogen, the potential for hormonal therapies to combat neurodegeneration and preserve cognitive function is a significant area of ongoing research."},{"_key":"de82f817c88e","_type":"span","marks":["em"],"text":"4"},{"_key":"dba184822ac1","_type":"span","marks":[],"text":" Observational studies have pointed towards a decreased risk of AD and PD in women taking menopausal estrogenic replacement therapy (ERT), although results have varied, and the use of hormone therapy (HT) has been controversial due to concerns about breast cancer, thromboembolism, and stroke."},{"_key":"a1e44e423b2e","_type":"span","marks":["em"],"text":"8"},{"_key":"51690cfc5e98","_type":"span","marks":[],"text":" However, a re-evaluation of older studies and the emergence of new data suggest that the benefits of HT can outweigh these risks, particularly when initiated early after menopause."},{"_key":"6b6c9408103a","_type":"span","marks":["em"],"text":"8"},{"_key":"29d4171212bf","_type":"span","marks":[],"text":" Furthermore, certain formulations, such as ERT without progestins, may even be associated with a lower risk of breast cancer."},{"_key":"cf1eefa6dced","_type":"span","marks":["em"],"text":"8"},{"_key":"994ba49576a0","_type":"span","marks":[],"text":" The differential expression of estrogen receptor subtypes offers a promising avenue for more targeted therapeutic interventions. Specifically, ERβ is predominantly expressed in the brain, intestine, and gonads, making it a promising therapeutic target for neuroprotection while potentially avoiding the systemic side effects associated with widespread ERα activation."},{"_key":"a2778faded07","_type":"span","marks":["em"],"text":"8"},{"_key":"a6c8419cdbb0","_type":"span","marks":[],"text":" This understanding moves beyond broad hormonal replacement to a precision medicine approach, aiming to maximize brain benefits while minimizing systemic side effects. This paves the way for personalized or precision medicine approaches, where a better understanding of which individuals may particularly benefit from such treatment is critical for preventing or treating cognitive disturbances during aging."},{"_key":"cb7a9fecbe7a","_type":"span","marks":["em"],"text":"4"}],"markDefs":[],"style":"normal"},{"_key":"888591ed552b","_type":"sectionHeader","headerLevel":"h2","title":"Conclusion and Future Directions"},{"_key":"da4be8d4ca76","_type":"block","children":[{"_key":"62cd4a51a7980","_type":"span","marks":[],"text":"Polycystic Ovary Syndrome is not merely a reproductive disorder but a complex neuroendocrine condition with significant implications for brain health and cognitive function. The evidence consistently demonstrates that hyperandrogenism and insulin resistance, central features of PCOS, are strongly associated with specific cognitive deficits, particularly in executive functions, and structural brain changes like reduced white matter integrity, even from young adulthood."},{"_key":"dd7e322bf7f7","_type":"span","marks":["em"],"text":"1"},{"_key":"139c4582643f","_type":"span","marks":[],"text":" These impacts are mediated by the multifaceted actions of sex hormones like estrogen and androgens, which act as neurosteroids influencing neurogenesis, synaptic plasticity, neurotransmitter systems, and neuroinflammation through both genomic and non-genomic pathways."},{"_key":"0dd81bed6b21","_type":"span","marks":["em"],"text":"2"},{"_key":"6d978010fb06","_type":"span","marks":[],"text":" The broader context reveals that lifetime estrogen exposure contributes significantly to cognitive longevity, and its decline with aging can increase vulnerability to neurodegenerative diseases."},{"_key":"fb13b28c40c5","_type":"span","marks":["em"],"text":"18"},{"_key":"ad924ab5b921","_type":"span","marks":[],"text":" The insights gained from studying PCOS, a condition characterized by chronic hormonal and metabolic dysregulation, serve as a valuable model for understanding the broader impact of sex hormones on brain health, aging, and vulnerability to neurodegenerative diseases. The findings from PCOS can inform research and interventions for other conditions involving hormonal imbalances or metabolic dysfunction."}],"markDefs":[],"style":"normal"},{"_key":"6b9be49ddca7","_type":"block","children":[{"_key":"3d6e804854b40","_type":"span","marks":[],"text":"Despite significant progress, there remains a critical need for additional research to confirm these findings in larger, more diverse cohorts and to further investigate the precise mechanistic pathways linking PCOS to cognitive outcomes."},{"_key":"7d48d7f30dc1","_type":"span","marks":["em"],"text":"1"},{"_key":"d2d93806e93c","_type":"span","marks":[],"text":" Future studies should focus on:"}],"markDefs":[],"style":"normal"},{"_key":"a988dd75747c","_type":"block","children":[{"_key":"7b5ae1e7fa5a0","_type":"span","marks":["strong"],"text":"Detailed Mechanistic Investigations:"},{"_key":"7b5ae1e7fa5a1","_type":"span","marks":[],"text":" Elucidating the specific molecular and cellular mechanisms by which altered androgen and insulin signaling, as well as chronic inflammation, translate into neuronal dysfunction and structural brain changes in PCOS. This includes exploring the reversal of normal brain microstructure-hormone relationships observed in PCOS."},{"_key":"5b992fbff8c2","_type":"span","marks":["em"],"text":"15"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e3ba3af958d8","_type":"block","children":[{"_key":"531db211d14b0","_type":"span","marks":["strong"],"text":"Longitudinal Studies:"},{"_key":"531db211d14b1","_type":"span","marks":[],"text":" Continuing to track cognitive trajectories and brain changes in PCOS populations over extended periods, from adolescence through post-menopause, to better understand the progression and long-term consequences of the condition."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"53c0189aef5d","_type":"block","children":[{"_key":"8e9d6ef34fa70","_type":"span","marks":["strong"],"text":"Identification of Modifiable Factors:"},{"_key":"8e9d6ef34fa71","_type":"span","marks":[],"text":" Pinpointing specific modifiable factors within the complex PCOS phenotype that, when targeted, can most effectively mitigate cognitive decline."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3babbbe6637b","_type":"block","children":[{"_key":"2d6e99052c3b0","_type":"span","marks":["strong"],"text":"Hormone Quantification and Biomarkers:"},{"_key":"2d6e99052c3b1","_type":"span","marks":[],"text":" Future research should incorporate precise hormone quantification and biomarkers of inflammation, neurodegeneration, and vascular health to refine understanding of estradiol's specific contribution and its interplay with other physiological systems affecting brain health."},{"_key":"5e658826a539","_type":"span","marks":["em"],"text":"18"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2efc9a234bde","_type":"block","children":[{"_key":"87f0c178415d0","_type":"span","marks":["strong"],"text":"Neurodevelopmental Impacts:"},{"_key":"87f0c178415d1","_type":"span","marks":[],"text":" Further investigating the potential intergenerational effects of PCOS, particularly the impact of in utero androgen exposure on offspring neurodevelopmental outcomes like autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD)."},{"_key":"ee118cd02c89","_type":"span","marks":["em"],"text":"19"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2fd4ba1fe172","_type":"block","children":[{"_key":"3f7839d994020","_type":"span","marks":[],"text":"The strong links between PCOS, insulin resistance, and cognitive decline highlight the importance of early and sustained management of metabolic health for preserving brain function."},{"_key":"39a3f6341b41","_type":"span","marks":["em"],"text":"13"},{"_key":"12a1bb7a141c","_type":"span","marks":[],"text":" The multi-faceted nature of PCOS's impact on the brain, involving hormonal, metabolic, inflammatory, and even mental health components, necessitates a holistic and personalized approach to patient management. This goes beyond addressing individual symptoms to targeting the underlying systemic dysregulations to preserve long-term cognitive health."}],"markDefs":[],"style":"normal"},{"_key":"d5ae40b75bd6","_type":"block","children":[{"_key":"d4c75a64e9510","_type":"span","marks":[],"text":"Potential therapeutic and lifestyle interventions for improving cognitive outcomes in PCOS and broader brain health include:"}],"markDefs":[],"style":"normal"},{"_key":"6fb37b99dbfc","_type":"block","children":[{"_key":"6740d505126b0","_type":"span","marks":["strong"],"text":"Lifestyle Interventions:"},{"_key":"6740d505126b1","_type":"span","marks":[],"text":" Weight management, adopting a nutrient-rich diet (e.g., fiber-filled diets to reduce insulin resistance), and engaging in regular exercise are crucial first-line interventions."},{"_key":"d073c83ac0d4","_type":"span","marks":["em"],"text":"13"},{"_key":"60dbc110108a","_type":"span","marks":[],"text":" These strategies can significantly improve insulin sensitivity, enhance blood flow to the brain, and positively impact mental health (e.g., reducing depression), thereby mitigating cognitive risks."},{"_key":"1cda3104e10c","_type":"span","marks":["em"],"text":"13"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0241300a4eac","_type":"block","children":[{"_key":"5bcf4b4865bf0","_type":"span","marks":["strong"],"text":"Pharmacological Approaches:"},{"_key":"5bcf4b4865bf1","_type":"span","marks":[],"text":" While conventional treatments for PCOS often include metformin for insulin resistance and oral contraceptives for hormonal regulation "},{"_key":"89c81e8a6908","_type":"span","marks":["em"],"text":"22"},{"_key":"f84c11413907","_type":"span","marks":[],"text":", future therapeutic strategies might involve more targeted approaches, such as selective estrogen receptor modulators (SERMs) that specifically activate neuroprotective pathways without broad systemic effects."},{"_key":"30f72b9597de","_type":"span","marks":["em"],"text":"8"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"829ebce97c02","_type":"block","children":[{"_key":"d3cddfca2f970","_type":"span","marks":["strong"],"text":"Cognitive Enrichment:"},{"_key":"d3cddfca2f971","_type":"span","marks":[],"text":" Promoting cognitive enrichment activities, such as reading, engaging in mentally stimulating games, and memory training, can also contribute to preserving mental function and overall brain health in individuals with PCOS."},{"_key":"bc568dd5cc90","_type":"span","marks":["em"],"text":"16"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"b5be01a37d25","_type":"block","children":[{"_key":"8f96543e90420","_type":"span","marks":[],"text":"These integrated strategies underscore the evolving understanding of PCOS as a condition requiring comprehensive management that extends beyond reproductive health to encompass long-term neurological and cognitive well-being."}],"markDefs":[],"style":"normal"},{"_key":"c3ce0d9a2b88","_type":"sectionHeader","headerLevel":"h2","title":"Sources"},{"_key":"f37f8e5d0230","_type":"block","children":[{"_key":"61cbdd3b01180","_type":"span","marks":[],"text":"(PDF) OR15-5 Cognitive Function in Reproductive Aged Individuals ..., accessed June 5, 2025, "},{"_key":"2806d554783c","_type":"span","marks":["3fb85d2a70ea"],"text":"https://www.researchgate.net/publication/365040683_OR15-5_Cognitive_Function_in_Reproductive_Aged_Individuals_with_Polycystic_Ovary_Syndrome"},{"_key":"78a4d1c3dc6f","_type":"span","marks":[],"text":" "}],"level":1,"listItem":"number","markDefs":[{"_key":"3fb85d2a70ea","_type":"externalLink","linkType":"text","url":"https://www.researchgate.net/publication/365040683_OR15-5_Cognitive_Function_in_Reproductive_Aged_Individuals_with_Polycystic_Ovary_Syndrome"}],"style":"small"},{"_key":"21cae2ad2b18","_type":"block","children":[{"_key":"d5b1e7801b9a0","_type":"span","marks":[],"text":"Brain-derived estrogen and neural function - 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Our physical environment today shares little with the environment in which we first evolved, yet our biological systems are 99% the same."}],"markDefs":[{"_key":"bfc73a3705fa","_type":"externalLink","url":"http://publichealthintelligence.org/content/life-expectancy-progress-1990-2013"}],"style":"normal"},{"_key":"cc2a81d1a24e","_type":"block","children":[{"_key":"7e64443e7e3c","_type":"span","marks":[],"text":"The foundations of our modern healthcare system arose around 170 years ago. When we first evolved our healthcare system, life expectancy was 38 years. The most common ways to die were tuberculosis, dysentery, cholera, malaria, typhoid fever, pneumonia, diphtheria, or scarlet fever. Meaning, acute infections. This list is substantially different today. While the average life expectancy for someone born in 1990 is 75 years old, the most common causes of death are heart disease, cancer, accidents, chronic lower respiratory infections (includes asthma), stroke, Alzheimer's, and diabetes. We’ve all but stricken acute infections from the "},{"_key":"73d55e0e9170","_type":"span","marks":["bfc73a3705fa"],"text":"leading causes of death"},{"_key":"e55d214c6a34","_type":"span","marks":[],"text":"."}],"markDefs":[{"_key":"bfc73a3705fa","_type":"externalLink","url":"http://publichealthintelligence.org/content/life-expectancy-progress-1990-2013"}],"style":"normal"},{"_key":"20dca69ee876","_type":"block","children":[{"_key":"a4cc686fdb7b0","_type":"span","marks":[],"text":"In 1850, when our modern medical system really started to take shape, we were focused on solving these acute diseases. We developed a medical system to eradicate these diseases, and the tools were blunt (read: leg amputations, full lobotomies, annexation of thyroids). Surgical interventions are popularized as one of the most effective tools to stop the spread of infection and disease throughout the body. "}],"markDefs":[],"style":"normal"},{"_key":"c329b164127e","_type":"block","children":[{"_key":"8e7b8535f9730","_type":"span","marks":[],"text":"As we have consistently eradicated acute infections, we’ve failed to update our healthcare system’s focus, and really evolve our tactics to ensure longevity and fight disease. The most prevalent, deadly, and costly diseases of today are not typically (aside from Covid) infections, they are autoimmune-based. They’re diseases of physical degradation and of aging (eg. diabetes, heart disease, Alzheimer's, IBS & Crohns, depression/anxiety, rheumatoid arthritis). "}],"markDefs":[],"style":"normal"},{"_key":"d218f986808a","_type":"editorialImageCarousel","items":[{"_key":"272ff46131f3","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-3befb81a4f5ff48ef2f211e03c427dae0c39b293-2103x973-png","_type":"reference"}}}}]},{"_key":"3dbbab87c0e8","_type":"block","children":[{"_key":"4cabefe502bb0","_type":"span","marks":[],"text":"The aging process is, in the most simplistic manner, triggered by oxidative or chronic stress. Enduring periods of stress distract our bodies from critical periods of repair, and without these periods of repair, we start to age or lose optimal performance in our body, typically due to failures in our DNA to properly copy itself. Unlike the lifestyles we are adapted to experience (with short-lived acute stressors) we lead lives that consistently levy psychological burden upon us. Our bodies don’t recognize this manner of stress differently than stress due to starvation or intertribal genocide. So, our bodies start to exhibit features of a chronic stress state, that would make sense evolutionarily but do not benefit us given how we are living today."}],"markDefs":[],"style":"normal"},{"_key":"e9fd85a28ed1","_type":"block","children":[{"_key":"4cdbcf883bc70","_type":"span","marks":[],"text":"At Tia we are fixated on this topic of chronic stress, longevity medicine is another term for it. We believe that this is the equivalent of the realm of antibiotics over a ½ century ago. Our approach to medicine through this lens is what will enable us to unlock the antidotes to the new cadre of disease that humanity is facing: the internally born disease promulgated by us literally eating ourselves from the inside out."}],"markDefs":[],"style":"normal"},{"_key":"a61dfb540b0f","_type":"block","children":[{"_key":"d4bb7982a3480","_type":"span","marks":[],"text":"Our focus is on how to modulate the stress response, or even, at times reverse the implications of aging. While there are certain areas of research in this arena that are showing medical interventions can be useful (metformin, resveratrol, stem cell therapy, NAD+ /NMN), what is fascinating and truly uplifting is that the most effective research in this field shows that lifestyle adjustments are just as, if not more, effective than many of the leading medical interventions on the market."}],"markDefs":[],"style":"normal"},{"_key":"cd677b60a313","_type":"block","children":[{"_key":"0e9d4072e8230","_type":"span","marks":[],"text":"Tia is not an “integrative medicine practice,” meaning our mission is not to combine alternative and “traditional” modalities. First, we aren’t even sure what qualifies as “traditional.” For example, ashwagandha, an Indian herb, has been used in medical practices for centuries. Is it an alternative? What is the purpose of these distinctions, and more importantly, what is the purpose of putting these methods into arbitrarily (in)distinct little boxes? While we certainly are interested in many of the same interventions these practices use, our purpose for using them is perhaps different."}],"markDefs":[],"style":"normal"},{"_key":"f9655996a42b","_type":"editorialImageCarousel","items":[{"_key":"beecaf27b165","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-6ac7878fe69f031d7ca86dedda09feb78f852687-2103x973-png","_type":"reference"}}}}]},{"_key":"bb9819277362","_type":"block","children":[{"_key":"c215833c634f0","_type":"span","marks":[],"text":"Somatically, performance degradation is imputed through symptoms: PMS, migraines, PCOS, anxiety. From our perspective, all of these issues come down to a single root: an overactive stress response, which could likely be wreaking havoc on proper cell functioning, and that could ultimately lead to multifactorial disease promotion. Our mission is to say: what could be off-kilter in your proper functioning? Is it the lack of carbs in your diet? Is it a lifelong attenuated stress pathway due to premature birth? Is it that your grandmother experienced periods of famine, and this was passed down through her and your mother’s epigenome?"}],"markDefs":[],"style":"normal"},{"_key":"254f48924f11","_type":"block","children":[{"_key":"e2d1b46530a0","_type":"span","marks":[],"text":"This approach does require a “precision medicine” approach, as each and every person, due to their genetic composition and epigenetic display, is different. It is far more complex than administering an antibiotic for tuberculosis. While we, over time, hope to consistently layer in more and more data resources that can help us methodologically and empirically assess your cellular age, we are starting with one of the most reliable and important sources for this information: the health record. While ours is long (over 250 questions, in fact) — it asks questions that get to the core of your personal vulnerabilities."}],"markDefs":[],"style":"normal"},{"_key":"b563a30bd67c","_type":"block","children":[{"_key":"3e979e81f182","_type":"span","marks":[],"text":"The annual well-woman has historically been a preventive exam that women (should) get every year. Preventive is an interesting phrase in this case; while yes, the exam & screens are intended to detect diseases preventively (eg. cervical cancer via Pap smears, breast exams/mammograms for breast cancer), the typical well-woman does not revolve around a provider digging into your biology to understand how you tick. Nor is it the norm for your provider to assess the ways in which you may already be, or are predisposed to be, rendered “off-kilter.\" In this way, the typical well-woman operates in the world of “old medicine.” It’s focused on detecting infections and disease *after* onset. It does not assess your vulnerability to developing a disease in the first place. To exemplify the difference here, consider this: cervical cancer is highly correlated with bacterial vaginosis (BV). BV is typically a chronic condition of a dysbiotic vaginal microbiome. Detecting a dysbiotic vaginal microbiome is actually relatively simple, and only requires a swab test, yet we must understand the baseline in each woman to detect abnormalities (and each woman’s vaginal microbiome is different). Sequencing a woman’s vaginal microbiome regularly could enable us to detect aberrations. Most providers do not consider sampling a woman’s vaginal microbiome to assess for general health, nor do they consider counseling patients who have a high sugar/alcohol intake that this could put their vaginal microbiome more at risk. This is what we mean by preventative. Assessing and considering lifestyle factors that could put a patient more at risk."}],"markDefs":[],"style":"normal"},{"_key":"bbe9712514e5","_type":"editorialImageCarousel","items":[{"_key":"e7d3130637bc","_type":"editorialImageAndText","imageCaption":{"_type":"imageCaption","image":{"_type":"image","asset":{"_ref":"image-9e2e2c14040750ba7dfc97b3b1a6ec82d8f7b3d2-2103x621-png","_type":"reference"}}}}]},{"_key":"8174fdf301a3","_type":"block","children":[{"_key":"06529bc95370","_type":"span","marks":[],"text":"Tia’s annual Whole Health Exam is anchored on the goal of extending patients' lifespans, mitigating the effects of our chronically stressed environments, and promoting longevity in our cellular function. Tia’s approach is anchored on ensuring truly optimal health. While of course, we will treat disease, we take the view that if we’re treating a patient's disease, we’ve failed. We should’ve set her up for better success from square one."}],"markDefs":[],"style":"normal"},{"_key":"a8d1c9b9c301","_type":"block","children":[{"_key":"846d9ba6a6e50","_type":"span","marks":[],"text":"At Tia, in your "},{"_key":"73f0693a7db1","_type":"span","marks":["da0a885b854a"],"text":"Whole Health Exam"},{"_key":"5c7e2c8c3d2d","_type":"span","marks":[],"text":", we will assess your vulnerabilities (lifestyle, genetic, current condition-based, world views), and craft a Care Plan with you. This Care Plan will not be a “one and done.” This Care Plan will include daily, weekly and monthly activities to promote your health. And, as a part of your Care Plan, your care team will meet with you frequently to assess your progress and ongoing needs."}],"markDefs":[{"_key":"da0a885b854a","_type":"externalLink","linkType":"text","url":"https://asktia.com/whole-health-exam"}],"style":"normal"},{"_key":"436efc9307b4","_type":"block","children":[{"_key":"57dcaa2f8aaf","_type":"span","marks":["strong"],"text":"Sources:"}],"markDefs":[],"style":"normal"},{"_key":"0014244bec89","_type":"block","children":[{"_key":"0d10d302914a","_type":"span","marks":[],"text":"Infoplease. (n.d.). Life Expectancy by Age, 1850?2011. Infoplease. https://www.infoplease.com/us/health-statistics/life-expectancy-age-1850-2011."}],"markDefs":[],"style":"normal"},{"_key":"371a1e490fcb","_type":"block","children":[{"_key":"b828d1c06bf60","_type":"span","marks":[],"text":"Life Expectancy: progress from 1990 to 2013. Life Expectancy: progress from 1990 to 2013 | Health Intelligence. (n.d.). http://publichealthintelligence.org/content/life-expectancy-progress-1990-2013."}],"markDefs":[],"style":"normal"},{"_key":"ed79f3a9dde9","_type":"block","children":[{"_key":"b035bc710e9b0","_type":"span","marks":[],"text":"Oshinsky, D. M. (2017). Bellevue: three centuries of medicine and mayhem at America's most storied hospital. Anchor Books."}],"markDefs":[],"style":"normal"},{"_key":"81df2bf7ccef","_type":"block","children":[{"_key":"07a2cf811a70","_type":"span","marks":[],"text":"Sinclair, D., & LaPlante, M. D. (2021). Lifespan: why we age and why we don't have to. 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The care, thoughtfulness, and deep listening my provider offered was immediately reassuring. I left with a comprehensive plan that I could start that day. She demonstrated a complete understanding of what I was and was not open to trying, and never pressured me into a direction that wasn't right for me.","Title":"Tia Mental Health Patient","_key":"ff9cd991386e","_type":"inline"}]},{"_key":"bcc5dcd62927","_type":"spacer","backgroundColor":"bcoat","spacing":"pym"},{"_key":"c04bca89581b","_type":"faqModule","cta":"See full FAQ","faqs":[{"_id":"1a2e4a13-208f-4639-a373-caf6b82bc5cf","_type":"faq","_createdAt":"2025-12-01T21:07:14Z","_rev":"2RaIhATCtSK8GqmYnWgw89","_updatedAt":"2025-12-01T21:07:30Z","answer":[{"_key":"9fc10f2efa5f","_type":"block","children":[{"_key":"092c5f8fb8ec0","_type":"span","marks":[],"text":"Yes, our specialty trained primary care providers and psychiatric providers offer evaluation and management of medication, along with non-medication options. 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If individual, couples, or family therapy is part of your plan, we will refer you to our trusted partner."}],"markDefs":[],"style":"normal"}],"question":"Does Tia offer therapy?","id":"e6165e18-b02e-523e-8599-782de04303ad","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"76d22105ab2923b22b6a5ea830a78ba2","counter":2361,"owner":"gatsby-source-sanity"}},{"_id":"319073df-c6a4-4ade-a60a-a0c6286b824e","_type":"faq","_createdAt":"2025-12-01T21:08:02Z","_rev":"Ji4XR0mhHma5OwzDdCoKdl","_updatedAt":"2025-12-01T21:08:10Z","answer":[{"_key":"9da2539a7eb1","_type":"block","children":[{"_key":"9350bca1eef10","_type":"span","marks":[],"text":"We do provide treatment for people with ADHD but we do not prescribe stimulant medications. However, there are many other medications and modalities that are very effective and our team will work to find the right solution for you. 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We are in network with a select number of insurance billers in our LA + SF and are cash only in our NY and AZ markets. Tia does not accept Anthem, Blue Shield, or insurance plans that use American Specialty Health (ASH) for acupuncture benefits. Please head here for specific details and some questions to support you when calling your insurance for details: Ask Tia (https://asktia.com/acupuncture-benefits/)We can always offer superbills at your request to be submitted to your insurance for possible reimbursement following your visit."}],"markDefs":[],"style":"normal"},{"_key":"6fb7fe49a499","_type":"block","children":[{"_key":"bb1e3ac908460","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"d4c0e2013a28","_type":"block","children":[{"_key":"823e97966e9c0","_type":"span","marks":[],"text":"Please head "},{"_key":"e095dafb30ec","_type":"span","marks":["4c176d023cce"],"text":"here"},{"_key":"7413f24c71d2","_type":"span","marks":[],"text":" for more specific details around benefits. You can view the out-of-pocket (cash) cost for acupuncture appointments "},{"_key":"a52d3837d499","_type":"span","marks":["96d80e65db83"],"text":"here"},{"_key":"44606047fd94","_type":"span","marks":[],"text":". "}],"markDefs":[{"_key":"4c176d023cce","_type":"externalLink","linkType":"text","url":"https://asktia.com/acupuncture-benefits/"},{"_key":"96d80e65db83","_type":"externalLink","linkType":"text","url":"https://asktia.com/tia-service-list/"}],"style":"normal"},{"_key":"1f90f20c19ca","_type":"block","children":[{"_key":"f58f43e6668b","_type":"span","marks":[],"text":"For more information about billing processes, please visit our "},{"_key":"823e97966e9c3","_type":"span","marks":["underline","7d1e3e64e037"],"text":"patient billing FAQ"},{"_key":"9492e3a02d87","_type":"span","marks":[],"text":"."}],"markDefs":[{"_key":"7d1e3e64e037","_type":"externalLink","linkType":"text","url":"https://asktia.com/patient-billing-faq/"}],"style":"normal"},{"_key":"94dbd7301147","_type":"block","children":[{"_key":"479a8282111c0","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"}],"question":"Do you take insurance for acupuncture?","id":"dfc9e811-f808-5690-afcc-79681115fb16","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"56ab1b8d06c149de39593adc65cf1632","counter":2726,"owner":"gatsby-source-sanity"}},{"_id":"aeade810-1e5b-4b51-b9e2-ecfc10f1f278","_type":"faq","_createdAt":"2020-08-17T20:52:21Z","_rev":"6Z1vQzRSgX0uhFrP8HuG65","_updatedAt":"2022-09-29T21:54:52Z","answer":[{"_key":"b25ab28eb776","_type":"block","children":[{"_key":"d78cb96bff03","_type":"span","marks":[],"text":"If you are using insurance for services, the cost or “patient responsibility” will vary depending on your plan and specified service. Our Tia Care Coordinators can help you assess you patient responsibility by running an eligibility check ahead of your appointment. You can view our full cash price list "},{"_key":"b4e7dcb8ae74","_type":"span","marks":["1e0102bd19ba"],"text":"here"},{"_key":"4ee300e71f67","_type":"span","marks":[],"text":". "}],"markDefs":[{"_key":"1e0102bd19ba","_type":"internalLink","linkType":"text","reference":{"_ref":"e4a75667-0564-4b01-9e24-0c8d6c146821","_type":"reference"}}],"style":"normal"}],"question":"How much will my appointment cost?","id":"adbf8e11-0faa-58b1-8de6-fbf6be9b36ab","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"da6465bf04d08b24b95bc443bc0dcfd0","counter":2722,"owner":"gatsby-source-sanity"}},{"_id":"5240c60b-cc47-41d5-a25a-f970265146b4","_type":"faq","_createdAt":"2023-07-18T14:30:32Z","_rev":"rz9drFwQxbJxsNtaFgI9DH","_updatedAt":"2023-07-18T14:30:32Z","answer":[{"_key":"4ae5ea3e0f35","_type":"block","children":[{"_key":"bd327153252b0","_type":"span","marks":[],"text":"Yes! Acupuncture is safe and actually quite beneficial throughout all stages of pregnancy to help support you in feeling your best. Acupuncture has been known to help reduce morning sickness + nausea, support healthy energy levels, regulate digestion and help to reduce pain (back, low back, sciatic, hip, etc.) associated with pregnancy."}],"markDefs":[],"style":"normal"}],"question":"Can I get acupuncture if I'm pregnant?","id":"e02c4050-0952-56c8-9270-73d4291a76dd","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"12197735a6ccd748afe5ab59f62d7ed2","counter":2568,"owner":"gatsby-source-sanity"}},{"_id":"ad11951a-155b-45db-b50d-aae797f631b5","_type":"faq","_createdAt":"2023-07-18T14:30:52Z","_rev":"rz9drFwQxbJxsNtaFgI9rm","_updatedAt":"2023-07-18T14:30:52Z","answer":[{"_key":"0a5635047aca","_type":"block","children":[{"_key":"6c62ce4a0a020","_type":"span","marks":[],"text":"Yes! Acupuncture can be used to support your body during the preconception phase (as well as throughout pregnancy!) through helping to regulate your menstrual cycle, support healthy blood flow to your reproductive organs, balancing hormones and reducing stress levels. There have been many studies showing how acupuncture has helped to increase odds of conception."}],"markDefs":[],"style":"normal"}],"question":"Can acupuncture help with fertility? 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Rejuvenation"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3817c5fd1d21","_type":"block","children":[{"_key":"0fcaaed9213f0","_type":"span","marks":[],"text":"Smoking cessation"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"}],"question":"What else can acupuncture treat?","id":"e13fed01-0179-5f64-9354-2ef342e6025c","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"eb9fa26f47f5921fb9ad8744d5c53d49","counter":282,"owner":"gatsby-source-sanity"}},{"_id":"22ebfa27-06b5-4ca2-90c3-da4d634935be","_type":"faq","_createdAt":"2022-09-30T17:17:29Z","_rev":"MwYN9pIE2c0i8Ti7nkGkQQ","_updatedAt":"2022-09-30T17:17:29Z","answer":[{"_key":"5b3f086af04a","_type":"block","children":[{"_key":"a8b7d3e651f10","_type":"span","marks":[],"text":"Here are some pro tips from our provider team: make sure to eat at least two hours before your session, stay hydrated, and wear loose-fitting, comfortable clothing."}],"markDefs":[],"style":"normal"}],"question":"What should I do before coming in for acupuncture?","id":"26ef5e7f-a59b-5d89-ba9a-b3981ccf1979","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"43ba98f95a57ea6d702652bf21257a79","counter":2515,"owner":"gatsby-source-sanity"}},{"_id":"1c4c7fb8-68f6-41ef-b40b-9eaeb63dd38b","_type":"faq","_createdAt":"2022-09-29T23:30:53Z","_rev":"fLfRNBK5SBSu1C06WlSmPB","_updatedAt":"2022-10-12T15:25:52Z","answer":[{"_key":"c13c749c857a","_type":"block","children":[{"_key":"b6e4586cacf70","_type":"span","marks":[],"text":"The most simple answer to this question is usually not! Depending on the thickness of the skin on the areas of the body we are working on, you may feel the needles go in, but there should be no sharp or painful sensations. Once the needles are in, people describe feelings of warmth, tingling or heaviness where the needles have been inserted; these are all signs that blood flow is circulating. Believe it or not, most people actually fall asleep during their treatment."}],"markDefs":[],"style":"normal"}],"question":"Does acupuncture hurt?","id":"a8bd0a0d-266d-54d3-a2f0-376ef4b333a4","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"e511aecc58551c2b74fb06db43460d14","counter":2505,"owner":"gatsby-source-sanity"}},{"_id":"e48e8bb6-41f4-4988-b255-2eac3fb7aff3","_type":"faq","_createdAt":"2022-09-30T17:18:15Z","_rev":"azxXIEqyWHJx9Llaz2ddKM","_updatedAt":"2023-07-18T14:37:49Z","answer":[{"_key":"aa4244b42fc0","_type":"block","children":[{"_key":"46d112d249d10","_type":"span","marks":[],"text":"After your session, allow your body time to restore. Make sure to drink plenty of water, avoid strenuous physical activity, and listen to your body! Take time to adjust back into your day. It can be normal to feel a little faint or signs of a headache. These sensations after your treatment, especially if you didn’t eat or drink anything before your acupuncture can be normal. We recommend drinking extra water and eating a protein rich snack after your appointment."}],"markDefs":[],"style":"normal"},{"_key":"e8218dfd91e3","_type":"block","children":[{"_key":"7a1d766dbbbb0","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"}],"question":"What should I do after my acupuncture treatment?","id":"0548ac67-e19d-5ec4-8e82-b129c6e32fc7","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"c3d932b351111c04168da53436d8ee1f","counter":2815,"owner":"gatsby-source-sanity"}},{"_id":"3357041b-fe91-4c66-827b-8766c1e88df2","_type":"faq","_createdAt":"2022-09-29T23:29:05Z","_rev":"B6HiadhD20MvAeFsSVZr3o","_updatedAt":"2022-09-29T23:29:05Z","answer":[{"_key":"1e9e9ffe6232","_type":"block","children":[{"_key":"8f222e766b0d","_type":"span","marks":[],"text":"We've gotten used to quick fixes, but acupuncture is about balance. While every patient is different, the benefits and longer-term improvements from acupuncture take time (we see it often takes up to 6 treatments within 3-month window). You and your acupuncturist can design a treatment plan that is right for you and your goals. "}],"markDefs":[],"style":"normal"}],"question":"How many sessions does it take to see benefits from acupuncture?","id":"8b9610c4-3675-5f92-93d2-40ef3ea2b7c8","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"700f6d1ec6d5f4c6f70d1bc280e12bc7","counter":2537,"owner":"gatsby-source-sanity"}},{"_id":"234acf9a-ddb0-4587-a451-337cd1acbfb7","_type":"faq","_createdAt":"2023-07-18T14:28:59Z","_rev":"3IuUNQ99MCPbEPhGN4gl2X","_updatedAt":"2023-07-18T14:29:32Z","answer":[{"_key":"e767039dc73a","_type":"block","children":[{"_key":"f693154e4c020","_type":"span","marks":[],"text":"We generally recommend waiting at least 1 hour or so before jumping into a workout after acupuncture, especially if it’s high intensity. If you do, make sure to drink extra water and make sure you’re well fed."}],"markDefs":[],"style":"normal"}],"question":"Can I workout after acupuncture session?","id":"8d265146-b484-5821-9ea7-8f4a0f29a849","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"bc45c45a94e277c6db327f8788b07c64","counter":254,"owner":"gatsby-source-sanity"}},{"_id":"1ccd11e1-2604-4ff8-8b1d-dbae841370a7","_type":"faq","_createdAt":"2023-07-18T14:40:30Z","_rev":"rz9drFwQxbJxsNtaFgJ0mH","_updatedAt":"2023-07-18T14:40:30Z","answer":[{"_key":"d07b473767ac","_type":"block","children":[{"_key":"554c6fa70aa8","_type":"span","marks":[],"text":"Your acupuncturist will include your custom recommendation on your care plan, but for most, we recommend following up within the first week of your first session and continuing weekly sessions for 4-6 weeks."}],"markDefs":[],"style":"normal"},{"_key":"dd7d0d6bf73f","_type":"block","children":[{"_key":"fde76c422366","_type":"span","marks":[],"text":"With more acute concerns, like pain above a 5/10 pain scale or high anxiety, it may be recommended to come in 2 times a week until those initial concerns subside."}],"markDefs":[],"style":"normal"},{"_key":"7800d6ae6299","_type":"block","children":[{"_key":"eb81a4f92e64","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"6aee9f4ca9f5","_type":"block","children":[{"_key":"25a2131919eb","_type":"span","marks":[],"text":"\n\n"}],"markDefs":[],"style":"normal"}],"question":"How often should I come back for Acupuncture?","id":"8c3b4777-3361-5b4c-904a-6fc93b46991e","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"0ced60e8328d198635dba4ed5ba59d78","counter":2507,"owner":"gatsby-source-sanity"}}],"title":"Acupuncture 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have an integrative approach to health and believe acupuncture should be core to your care. 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It has to be removed by your provider.  <br><br><b>Effectiveness:</b> >99%","<b>Pros:</b> Good for five years.  You may not have a period at all. <br><br><b>Cons:</b>It is possible to bleed for longer than desired amounts of time and the bleeding can be unpredictable. "]},{"_key":"bf56f9e7-e0c8-46f6-b620-6845b8dfd1fd","_type":"tableRow","cells":["<b>IUD</b> (Paragard, Mirena, Kyleena, Skyla)","Must be placed in the uterus by your provider. Your provider also needs to remove it. <br><br><b>Effectiveness:</b> >99%","<b>Pros:</b> Effective for up to 12 years depending on which IUD you choose. Hormonal IUDs can decrease or stop bleeding. The copper IUD does not have any hormones. <br><br><b>Cons:</b> You need an appt to get the IUD inserted and removed. Paragard, the 12-year IUD, can increase bleeding."]},{"_key":"38f292c1-be54-4930-9fe5-cb93057844be","_type":"tableRow","cells":["<b>The Patch</b> (Xulane, Twirla)","Apply a new patch once a week for three weeks. 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For too long, women have been pressured into fertility decisions or dismissed with a casual \"you're fine\" after childbirth when they know they're not. That stops here. We're building a new standard of care, one where you are heard, you are trusted, and you are treated as a whole person. This is a partnership, and you're in the driver's seat.\""}],"style":"normal"},{"_key":"f8f14ae276ba","_type":"block","children":[{"_key":"fb5240d9b704","_type":"span","text":"Courtney Domingo, NP"}],"style":"large"}],"textAboveMedia":false,"videoDisplay":"container"},{"_key":"990d70c7d612255028685709080e4609","_type":"spacer","backgroundColor":"bccream","spacing":"pys"},{"_key":"6c2789e0ad66","_type":"shape","backgroundColor":"secondary-2","shapeColor":"secondary-1","shapeType":"shape-3"},{"_key":"7fea6839fc68","_type":"spacer","backgroundColor":"bcoat","spacing":"pys"},{"_key":"464a6254f976","_type":"standardText","backgroundColor":"bcoat","text":[{"_key":"8bfd1c13dc44","_type":"block","children":[{"_key":"174c1345875b","_type":"span","text":"What is Tia's approach to your fertility journey?"}],"style":"h2"},{"_key":"949476f3a8df","_type":"block","children":[{"_key":"87862874ef48","_type":"span","text":"At Tia, we believe your health is interconnected and your care should be, too. 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Together, we explore your cycle patterns, fertility goals, pregnancy history, postpartum recovery, and everything in between."}],"style":"normal"}]},{"_key":"e12f077ea09d","_type":"featureCard","text":[{"_key":"02f185f16781","_type":"block","children":[{"_key":"cd3b7d3cac61","_type":"span","marks":["strong"],"text":"Evidence-Based Care"}],"style":"h4"},{"_key":"5712f1c67553","_type":"divider","dividerType":"squiggle-black"},{"_key":"553e8dfaba3e","_type":"block","children":[{"_key":"d4fe345dcd0b","_type":"span","text":"Our care is grounded in science, not trends or pressure. Whether it’s support for conception or recovery after birth, we focus on treatments and guidance proven to help you feel well and stay well. 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Characterized by a constellation of symptoms, including irregular or absent ovulation, PCOS is a global public health concern that affects 5-15% of women and people assigned female at birth (AFAB). Strikingly, according to the best available estimates, "},{"_key":"f96b9a2f61a0","_type":"span","marks":["8e44c4895ec1"],"text":"50-70% of women with PCOS remain undiagnosed"},{"_key":"253e05122a72","_type":"span","marks":[],"text":"—and suffer unnecessarily because of it."}],"markDefs":[{"_key":"8e44c4895ec1","_type":"internalLink","linkType":"text","reference":{"_ref":"208f4e01-a92e-4bb2-ae88-84672bdb6462","_type":"reference"}}],"style":"normal"},{"_key":"d23211baca78","_type":"block","children":[{"_key":"15706c9514440","_type":"span","marks":[],"text":"Hopefully these numbers get your attention. Many people are struggling with PCOS—including struggling to get pregnant and get answers—and the social stigma its diagnosis often carries. But if you learn one thing from this article, let it be this: while PCOS is one of the leading causes of infertility and isn’t curable, it "},{"_key":"15706c9514441","_type":"span","marks":["em"],"text":"is"},{"_key":"15706c9514442","_type":"span","marks":[],"text":" manageable and treatable. You "},{"_key":"15706c9514443","_type":"span","marks":["em"],"text":"can"},{"_key":"15706c9514444","_type":"span","marks":[],"text":" get pregnant if you have PCOS. You "},{"_key":"15706c9514445","_type":"span","marks":["em"],"text":"can"},{"_key":"15706c9514446","_type":"span","marks":[],"text":" have a healthy pregnancy. And you "},{"_key":"15706c9514447","_type":"span","marks":["em"],"text":"can "},{"_key":"15706c9514448","_type":"span","marks":[],"text":"deliver a healthy baby."}],"markDefs":[],"style":"normal"},{"_key":"2b795be056ec","_type":"block","children":[{"_key":"8f653e8d1fa20","_type":"span","marks":[],"text":"At "},{"_key":"88306046d38f","_type":"span","marks":["7f1072c0b983"],"text":"Tia"},{"_key":"0b90bef1f740","_type":"span","marks":[],"text":", our team of collaborative care experts understands the unique needs of people with PCOS and the importance of personalized care that empowers women to navigate their fertility journeys on their terms and without pressure, fear, or judgment. Keep reading to learn more about PCOS and Tia’s holistic, personalized approach to this notoriously complicated condition."}],"markDefs":[{"_key":"7f1072c0b983","_type":"internalLink","linkType":"text","reference":{"_ref":"8a7e7b1e-7485-4a22-be24-9a2005998452","_type":"reference"}}],"style":"normal"},{"_key":"6e29aeacc171","_type":"sectionHeader","title":"Understanding PCOS and its effects on pregnancy"},{"_key":"8522c6947d50","_type":"block","children":[{"_key":"58d19ceefae40","_type":"span","marks":[],"text":"PCOS is a common endocrine disorder that disrupts the delicate balance of hormones involved in ovulation and menstruation, and it manifests with a combination of symptoms related to these hormonal imbalances. PCOS is characterized by irregular or absent menstrual cycles, elevated androgen levels (a male sex hormone present in small amounts in women), and the presence of numerous small cysts on the ovaries. Despite its name, not all women with PCOS develop ovarian cysts. And, confusingly, some women with ovarian cysts don’t meet the diagnostic criteria for PCOS."}],"markDefs":[],"style":"normal"},{"_key":"e65e2b940cc9","_type":"block","children":[{"_key":"4bc005979ff30","_type":"span","marks":[],"text":"While the exact cause of PCOS remains unclear, it likely involves a combination of genetic and environmental factors, including insulin resistance and inflammation. Importantly, women with a family history of PCOS or type 2 diabetes seem to be at a higher risk for developing PCOS."}],"markDefs":[],"style":"normal"},{"_key":"171cf764c3b4","_type":"block","children":[{"_key":"cacb7114afd90","_type":"span","marks":[],"text":"One hallmark feature of PCOS is its significant impact on fertility. The hormonal imbalances seen in PCOS often disrupt the normal ovulatory process, which leads to irregular or absent ovulation. Since ovulation is the process that releases a mature egg from the ovaries and makes it available for fertilization by sperm, it’s easy to understand why unpredictable or absent ovulation makes pregnancy difficult, if not impossible, to achieve without proper counseling and treatment."}],"markDefs":[],"style":"normal"},{"_key":"f32040cf2bf3","_type":"block","children":[{"_key":"85ee0f1c2f450","_type":"span","marks":[],"text":"Besides infertility, PCOS can present with several other symptoms:"}],"markDefs":[],"style":"normal"},{"_key":"47883781c3a5","_type":"block","children":[{"_key":"b37364542d361","_type":"span","marks":["strong"],"text":"Irregular menstrual cycles"},{"_key":"b37364542d362","_type":"span","marks":[],"text":". Women with PCOS might have missed, unpredictable, or absent periods—though it’s not uncommon for them to experience heavy and long periods as well."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"70827416aa84","_type":"block","children":[{"_key":"84b7a888bb2c1","_type":"span","marks":["strong"],"text":"Hirsutism"},{"_key":"84b7a888bb2c2","_type":"span","marks":[],"text":". Excessive hair on the face, chin, chest, back, or parts of the body where men usually have hair is often seen in people with PCOS."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"789cf0937b7a","_type":"block","children":[{"_key":"e803add0e5a71","_type":"span","marks":["strong"],"text":"Acne and/or male-pattern baldness."},{"_key":"e803add0e5a72","_type":"span","marks":[],"text":" Hirsutism, acne, and male-pattern baldness are most likely due to excess androgen levels that often accompany PCOS."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"25525f64cf37","_type":"block","children":[{"_key":"db29d43d983c1","_type":"span","marks":["strong"],"text":"Weight gain, "},{"_key":"db29d43d983c2","_type":"span","marks":[],"text":"especially around the belly."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"70e672ccdd2a","_type":"block","children":[{"_key":"f20ce967ce571","_type":"span","marks":["strong"],"text":"Polycystic ovaries"},{"_key":"f20ce967ce572","_type":"span","marks":[],"text":" that might feel large on exam or appear large on imaging."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"d29e5a724323","_type":"block","children":[{"_key":"1aeaf16deeca1","_type":"span","marks":["strong"],"text":"Skin tags "},{"_key":"1aeaf16deeca2","_type":"span","marks":[],"text":"or small pieces of excess skin on the neck or armpits."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a33f49ca91ea","_type":"block","children":[{"_key":"a398dbc4e75c1","_type":"span","marks":["strong"],"text":"Dark or thick patches of skin "},{"_key":"a398dbc4e75c2","_type":"span","marks":[],"text":"particularly along neck creases,"},{"_key":"a398dbc4e75c3","_type":"span","marks":["strong"],"text":" "},{"_key":"a398dbc4e75c4","_type":"span","marks":[],"text":"in the groin area, in the armpits, or underneath the breasts."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"db9ca07aea28","_type":"cta","backgroundColor":"bccream","text":[{"_key":"6d3ce20c0c37","_type":"block","children":[{"_key":"9baa1781269e","_type":"span","marks":[],"text":"Experiencing PCOS symptoms? Sign up for Tia's membership and schedule an appointment today."}],"markDefs":[],"style":"normal"},{"_key":"6555ebcbee74","_type":"buttonBlock","items":[{"_key":"c85229a11925","_type":"singleButton","linkCta":"Join Tia","linkType":"button","reference":{"_ref":"6b861435-f6fe-4c96-893c-77732c7ab389","_type":"reference"}}]}]},{"_key":"cf4fcb84c985","_type":"block","children":[{"_key":"bf18708fd1560","_type":"span","marks":[],"text":"With appropriate medical management aimed at reducing symptoms and"},{"_key":"bf18708fd1561","_type":"span","marks":["strong"],"text":" "},{"_key":"bf18708fd1562","_type":"span","marks":[],"text":"improving ovulation, women with PCOS "},{"_key":"bf18708fd1563","_type":"span","marks":["em"],"text":"can"},{"_key":"bf18708fd1564","_type":"span","marks":[],"text":" get pregnant—but they may face certain challenges during pregnancy that require careful monitoring and possible medical intervention. "}],"markDefs":[],"style":"normal"},{"_key":"fd687ceb6979","_type":"block","children":[{"_key":"67adbd52d5ef","_type":"span","marks":[],"text":"Some of the potential complications associated with pregnancy in women with PCOS:"}],"markDefs":[],"style":"normal"},{"_key":"0cee0e27af29","_type":"block","children":[{"_key":"13344b8fa7c61","_type":"span","marks":["strong"],"text":"Gestational diabetes."},{"_key":"13344b8fa7c62","_type":"span","marks":[],"text":" People with PCOS have an increased risk of developing gestational diabetes. While poorly understood, researchers postulate that fluctuating hormones caused by pregnancy make it more difficult for the body to process blood sugar effectively."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2e77834e3a67","_type":"block","children":[{"_key":"5df12f7a04411","_type":"span","marks":["strong"],"text":"Preeclampisa"},{"_key":"5df12f7a04412","_type":"span","marks":[],"text":". There’s a strong association between PCOS and preeclampsia, a potentially dangerous condition characterized by high blood pressure and proteins in the urine, which can cause organ damage. Regular prenatal visits and routine monitoring are crucial to protect both the parent and baby and prevent preeclampsia from developing into a life-threatening condition called eclampsia."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"61cf02261ff7","_type":"block","children":[{"_key":"7341416083da0","_type":"span","marks":["strong"],"text":"Preterm birth."},{"_key":"7341416083da1","_type":"span","marks":[],"text":" There is an increased risk of preterm birth in women with PCOS."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"1c7d09526ad1","_type":"block","children":[{"_key":"81b9c486c2f81","_type":"span","marks":["strong"],"text":"Miscarriage."},{"_key":"81b9c486c2f82","_type":"span","marks":[],"text":" People with PCOS have a slightly higher risk of miscarriage compared to those without the condition."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"26d58d0c71ab","_type":"block","children":[{"_key":"ee166fcf53ca1","_type":"span","marks":["strong"],"text":"Increased C-section rates."},{"_key":"ee166fcf53ca2","_type":"span","marks":[],"text":" Those diagnosed with PCOS have a higher likelihood of delivering via Cesarean section, often due to complications related to gestational diabetes, preeclampsia, and fetal distress."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"ebdf13b2c5ad","_type":"block","children":[{"_key":"f0c435176e151","_type":"span","marks":["strong"],"text":"Neonatal complications."},{"_key":"f0c435176e152","_type":"span","marks":[],"text":" Babies whose parents have PCOS often experience complications, like respiratory distress syndrome, that necessitate admission to the neonatal intensive care unit."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"7e172fccc510","_type":"block","children":[{"_key":"5bb9440e9d7b1","_type":"span","marks":["strong"],"text":"Long-term health implications."},{"_key":"5bb9440e9d7b2","_type":"span","marks":[],"text":" Children born to parents with PCOS have a higher risk of developing certain chronic health conditions later in life, such as obesity and diabetes."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"fc745211df6d","_type":"sectionHeader","title":"Optimizing fertility with PCOS"},{"_key":"6800b8880323","_type":"block","children":[{"_key":"18b801be027f0","_type":"span","marks":[],"text":"Not everyone with PCOS will experience these complications, and it’s worth repeating that many women with PCOS have successful, healthy pregnancies. Thankfully, there are several commonsense and effective strategies, including lifestyle modifications and medications, that can greatly increase the likelihood of ovulating and becoming pregnant if you suffer from PCOS."}],"markDefs":[],"style":"normal"},{"_key":"93e4c88a1390","_type":"block","children":[{"_key":"01a075f712df0","_type":"span","marks":[],"text":"Lifestyle modifications almost always begin with getting regular exercise and eating a healthy diet, generally full of protein-rich, low-carbohydrate foods; high-fiber fruits and vegetables; whole grains; and healthy fats and oils. Cutting out caffeine, nicotine, and alcohol are also common recommendations. Weight management through exercise and dietary changes can vastly improve insulin sensitivity and hormonal imbalances, stabilize blood sugar levels, and make fertility easier to achieve, often without additional intervention."}],"markDefs":[],"style":"normal"},{"_key":"9b1d2a881152","_type":"block","children":[{"_key":"9bb1cf7213a30","_type":"span","marks":[],"text":"When lifestyle changes alone don’t lead to pregnancy, healthcare providers often recommend medication to improve fertility and promote ovulation, including metformin and/or clomiphene citrate (Clomid) alone or in combination. Metformin, an insulin-lowering drug and mainstay in type 2 diabetes management, has been shown to improve fertility and ovulation, and reverse endocrine abnormalities in women with PCOS. .Metformin is also a drug-of-choice for women with PCOS because it also has positive effects on other PCOS symptoms, including menstrual irregularities, anovulation (lack of ovulation), hirsutism, and obesity. And during pregnancy, metformin might also be protective against insulin resistance, gestational diabetes, and a first trimester pregnancy loss. Clomiphene citrate (Clomid) is an important ovulation induction agent that works by stimulating hormones necessary for follicle development. Letrozole, another medication that induces ovulation, is sometimes used when clomiphene citrate is ineffective."}],"markDefs":[],"style":"normal"},{"_key":"54ee4325c67a","_type":"sectionHeader","title":"Seeking preconception care"},{"_key":"70cf3c25d58e","_type":"block","children":[{"_key":"7629956b4c1b0","_type":"span","marks":[],"text":"As always, it’s important for people with PCOS to consult with an experienced and trustworthy healthcare provider before trying to conceive. Your provider can help assess your fertility status, manage PCOS symptoms, and address underlying health conditions to improve your chances of getting pregnant, staying pregnant, and having a healthy pregnancy. And since PCOS is associated with other long-term health risks, like type 2 diabetes, endometrial cancer, and cardiovascular disease, it’s even more critical for these people to share their fertility journeys and health histories with their provider before conception so they can make the best and most informed decisions about their health and care."}],"markDefs":[],"style":"normal"},{"_key":"d7520205e4e6","_type":"sectionHeader","title":"Pregnancy care for people with PCOS"},{"_key":"679be8a1efeb","_type":"block","children":[{"_key":"8f6fdbd145670","_type":"span","marks":[],"text":"Close collaboration with a healthcare provider, strict adherence to prenatal care, lifestyle management, and taking a prenatal vitamin that offers folic acid are key components of ensuring a healthy pregnancy for women with PCOS. Since women with PCOS who become pregnant are more vulnerable to certain pregnancy-related complications, like gestational diabetes and preeclampsia, regular prenatal office visits and routine screenings are essential for recognizing the earliest signs of these conditions. Your care team will closely monitor your blood pressure, blood glucose levels, and weight gain, measure the progression of your pregnancy, and address any issues that might contribute to miscarriage or preterm labor."}],"markDefs":[],"style":"normal"},{"_key":"7a49e008bc32","_type":"sectionHeader","title":"Next steps for PCOS treatment"},{"_key":"b6eb1bcd8a2f","_type":"block","children":[{"_key":"215a43a920990","_type":"span","marks":[],"text":"PCOS is a complex and prevalent condition that requires a comprehensive and personalized approach. The impact of PCOS extends beyond the bounds of reproductive health, it impacts metabolic and cardiovascular health too. Some symptoms, like infertility, obesity, and unwanted hair growth, can lead to social stigma and even cause anxiety and depression. Consultation with a healthcare provider or fertility specialist is essential for a thorough evaluation, diagnosis, and a personalized treatment plan aimed at restoring hormonal balance, managing symptoms, and regulating ovulation."}],"markDefs":[],"style":"normal"},{"_key":"e8059e98ad70","_type":"block","children":[{"_key":"6f001f1b66580","_type":"span","marks":[],"text":"So, whether you’re already pregnant, trying, undecided, or not planning to have kids, your journey matters—and so does your story. "}],"markDefs":[],"style":"normal"},{"_key":"87323364518a","_type":"cta","backgroundColor":"bccream","text":[{"_key":"f559b1448cc3","_type":"block","children":[{"_key":"af8a0517f650","_type":"span","marks":[],"text":"Experiencing PCOS symptoms? Sign up for Tia's membership and schedule an appointment today."}],"markDefs":[],"style":"normal"},{"_key":"cf4b3627b65a","_type":"buttonBlock","items":[{"_key":"b99fe2b5f01b","_type":"singleButton","linkCta":"Join Tia","linkType":"button","reference":{"_ref":"6b861435-f6fe-4c96-893c-77732c7ab389","_type":"reference"}}]}]}],"image":{"_type":"image","asset":{"_ref":"image-be386cb6359763e79730a31e029a20ffb481d4f1-14000x8000-png","_type":"reference"}},"publishedAt":"2023-11-29T01:36:00.000Z","slug":{"_type":"slug","current":"pcos-pregnancy"},"status":"production","title":"PCOS and Pregnancy: Embracing the Unique Path to Motherhood","topics":[{"_key":"2f4fd95ae57b","_ref":"8620b4dd-9ad9-4abc-96fb-b7bffc848982","_type":"reference"}]},"metaInformation":{"_type":"metaCard","metaDescription":"Unlock the journey of navigating pregnancy with PCOS. 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How common is it? "},{"_key":"1b208505da0e","_type":"span","marks":["1e18418d59b6"],"text":"Endometriosis impacts"},{"_key":"ae4825680582","_type":"span","marks":[],"text":" the lives of roughly 10% (190 million) of women during their reproductive years."}],"markDefs":[{"_key":"1e18418d59b6","_type":"externalLink","linkType":"text","url":"https://www.who.int/news-room/fact-sheets/detail/endometriosis"}],"style":"normal"},{"_key":"e1351338a303","_type":"block","children":[{"_key":"e7dcf38bc6890","_type":"span","marks":[],"text":"Endometriosis is a chronic disease that can cause a constellation of uncomfortable symptoms, including pain during periods, sex, and bowel movements, irregular bleeding, abdominal bloating, nausea, fatigue, anxiety, and depression. It is characterized by tissue similar to the lining of the uterus growing outside of it and implanting on other reproductive organs (fallopian tubes, ovaries, uterine ligaments),"}],"markDefs":[],"style":"normal"},{"_key":"2bc4214e3a10","_type":"block","children":[{"_key":"2110b69ee6040","_type":"span","marks":[],"text":"Endometriosis can also "},{"_key":"75481a7102f3","_type":"span","marks":["62b0519eefd4"],"text":"cause infertility"},{"_key":"c0f84023082f","_type":"span","marks":[],"text":" in 30-50% of people suffering from this condition. If you’re living with endometriosis and dreaming about starting or growing a family, you’re probably wondering how endometriosis might affect your pregnancy journey. If so, there’s good news ahead. Even if there is no absolute cure for endometriosis, there are many proven treatments aimed at controlling its symptoms, and many people with the condition become pregnant and have healthy pregnancies and babies."}],"markDefs":[{"_key":"62b0519eefd4","_type":"externalLink","linkType":"text","url":"https://www.massgeneral.org/condition/endometriosis"}],"style":"normal"},{"_key":"a0b49699b9ec","_type":"block","children":[{"_key":"be30685fcc930","_type":"span","marks":[],"text":"How Endometriosis Impacts Fertility"}],"markDefs":[],"style":"h1"},{"_key":"0b8b340470a0","_type":"block","children":[{"_key":"1d4fb53903ef0","_type":"span","marks":[],"text":"Although the medical community has been conducting research and making educated guesses for years, there’s still a lot it doesn’t know about endometriosis, including its exact cause. But there’s something the medical community "},{"_key":"1d4fb53903ef1","_type":"span","marks":["em"],"text":"does"},{"_key":"1d4fb53903ef2","_type":"span","marks":[],"text":" know about the condition: people with endometriosis often have a more challenging time getting pregnant. "}],"markDefs":[],"style":"normal"},{"_key":"3a5c300e7aa7","_type":"block","children":[{"_key":"29bf77c6bf6d","_type":"span","marks":[],"text":"But at Tia, our team of women’s health experts is committed to helping our members manage their endometriosis with a comprehensive approach that ensures their whole health is taken into account."}],"markDefs":[],"style":"normal"},{"_key":"ec67762b1b28","_type":"cta","backgroundColor":"bcoat","text":[{"_key":"ae1643d0ac9f","_type":"block","children":[{"_key":"f5e379d38bdd0","_type":"span","marks":[],"text":"Struggling with fertility? 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They can offer guidance and treatments tailored to your specific situation, which might include managing endometriosis symptoms (NSAIDs, hormonal birth control methods, GnRH agonists), assessing fertility, and exploring fertility treatments."}],"markDefs":[],"style":"normal"},{"_key":"88dc1e07fbd6","_type":"block","children":[{"_key":"5a999eb5ca4b0","_type":"span","marks":[],"text":"In the early stages of endometriosis, you might be able to get pregnant without any medical intervention. Oftentimes, at this stage, controlling symptoms is enough to get past the hurdle of endometriosis."}],"markDefs":[],"style":"normal"},{"_key":"7d3b18080cd4","_type":"block","children":[{"_key":"09543ca512850","_type":"span","marks":[],"text":"If you’re finding it more difficult to conceive, your doctor might recommend a laparoscopy to surgically remove endometriosis. During this simple procedure, a medical professional inserts a camera through a small incision in the abdomen to assess your endometriosis lesions and remove as many as possible."}],"markDefs":[],"style":"normal"},{"_key":"051f75d5d268","_type":"block","children":[{"_key":"47eaed31fba60","_type":"span","marks":[],"text":"For people who are 35 + or diagnosed with a more advanced form of the condition, your doctor might recommend the fertility medication to help trigger ovulation. "}],"markDefs":[],"style":"normal"},{"_key":"a2409610a499","_type":"block","children":[{"_key":"871149f8399a","_type":"span","marks":[],"text":"Additionally, your provider may suggest intrauterine insemination (IUI) instead of surgery. 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Recently, there has been an uptick in attention to chronic conditions like endometriosis and the global toll these conditions can take."}],"markDefs":[],"style":"normal"},{"_key":"5f3732ab75b9","_type":"block","children":[{"_key":"d5f50936e12e0","_type":"span","marks":[],"text":"Advances in treatments and a better understanding of endometriosis have made pregnancy a reality for many people who once thought it might be out of reach. Keeping an open dialogue with your doctor, staying up-to-date and informed, and leaning on your support network is paramount. But with patience, preparation, and proper care you, too, can likely navigate these challenges and start or grow your family with success."}],"markDefs":[],"style":"normal"},{"_key":"56866bebf70a","_type":"block","children":[{"_key":"cfc8b72546270","_type":"span","marks":[],"text":"If you’re experiencing symptoms of endometriosis and struggling to get a diagnosis and treatment plan, Tia is a good place to start. 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Your provider will educate you on the benefits and limitations of each option, empowering you to make the best choice for your health."}],"markDefs":[],"style":"normal"}],"question":"Do you do fertility and hormonal testing?","id":"348c2627-d336-5e5e-9766-bac7160eb3ef","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"0db619d5083705eff5dbab34d4afdedb","counter":1439,"owner":"gatsby-source-sanity"}},{"_id":"bceba89b-b7cf-4103-ab57-cd3d684daebd","_type":"faq","_createdAt":"2025-10-08T15:55:10Z","_rev":"ZKXhZ2Mdtd1ZHYRRWwE6Pk","_updatedAt":"2025-10-08T15:55:35Z","answer":[{"_key":"938030fb87ac","_type":"block","children":[{"_key":"19ef39bf71f90","_type":"span","marks":[],"text":"Tia does not offer IVF, egg freezing, or other fertility-related procedures, but we are happy to refer you to a trusted partner."}],"markDefs":[],"style":"normal"}],"question":"Does Tia do egg freezing or IVF?","id":"aaac3c44-a330-5cbc-8d73-7acb75ccdadf","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"ade0442ae9aee7e3e9701bdc719d933f","counter":1440,"owner":"gatsby-source-sanity"}},{"_id":"a8d70ed9-610b-4ee7-ad2d-39c5481184c2","_type":"faq","_createdAt":"2025-10-08T15:55:47Z","_rev":"ZKXhZ2Mdtd1ZHYRRWwEBoC","_updatedAt":"2025-10-08T15:55:55Z","answer":[{"_key":"6103c31c6e87","_type":"block","children":[{"_key":"5cc88f094bec0","_type":"span","marks":[],"text":"Yes, we provide proactive, long-term care to help you avoid the “postpartum cliff.” Re-establishing care after giving birth is a critical step in managing any lingering pregnancy-related health concerns, such as high blood pressure or gestational diabetes. 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Because insurance plans require these visits to be strictly preventive, any specific concern (a UTI, new pain, or fatigue) is best handled at a separate Sick Visit. 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This is called "},{"_key":"78cb3e53cfa6","_type":"span","marks":["strong"],"text":"cost-sharing"},{"_key":"c5e9b2ca608d","_type":"span","text":"."}],"style":"normal"}]},{"_key":"439ede3168fd","_type":"tableModule","backgroundColor":"bccream","spacing":"pys","subTable":{"_type":"table","rows":[{"_key":"b134b05bb6c2","_type":"tableRow","cells":[" Term","What It Is","How it Works"]}]},"table":{"_type":"table","rows":[{"_key":"572e93d9f7ac","_type":"tableRow","cells":["<b>Deductible</b>","The <b>total amount you must pay</b> for covered services <b>before</b> your insurance company starts to pay for anything other than preventive care.","Example: If your deductible is <b>$2,500</b>, you pay the first $2,500 in medical bills for the year. Once you hit that number, the insurance \"kicks in\" and starts paying a share. Your deductible resets every year."]},{"_key":"0be67eab42b0","_type":"tableRow","cells":["<b>Copayment (Copay)</b>","A <b>fixed, flat fee</b> you pay for certain services. 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new capped invoicing system that ensures that no matter the total amount you owe, you will only ever be billed $250 per month until your balance is paid off. Depending on the care you receive, this could look like: the total amount owed for care might be $500, but the total due this month is $250. This method offers a clear, manageable way to handle medical expenses, allowing you to focus on what truly matters—your health."}],"markDefs":[],"style":"normal"}],"textAboveMedia":false,"videoDisplay":"container"},{"_key":"1eaa1d5efd4f","_type":"standardText","backgroundColor":"bccream","spacing":"pys","text":[{"_key":"1177301216b6","_type":"block","children":[{"_key":"560e7e8612fd","_type":"span","text":"Benefits of Predictable Payments:"}],"style":"h3"},{"_key":"4405ed31e402","_type":"columnText","items":[{"_key":"6bc3e3e01263","_type":"plainText","text":[{"_key":"2648b9147137","_type":"block","children":[{"_key":"734ea0029e80","_type":"span","marks":[],"text":"1. $250 Capped Invoices"}],"markDefs":[],"style":"h4"},{"_key":"da8fee1a7b4f","_type":"block","children":[{"_key":"a9b4bb678414","_type":"span","marks":[],"text":"One of the biggest benefits of this payment method is predictability. With a consistent $250 cap, you can budget with confidence and avoid fluctuating or surprising bills. We know that some months you may need more time to pay, and that’s ok. Our goal is to remove financial stress so you never delay the care you need."}],"markDefs":[],"style":"normal"}]},{"_key":"62f372e57485","_type":"plainText","text":[{"_key":"bd954e81fe00","_type":"block","children":[{"_key":"64ea8b43befd","_type":"span","text":"2. One Invoice, One Time a Month"}],"style":"h4"},{"_key":"aa39c7628804","_type":"block","children":[{"_key":"bbace43f0410","_type":"span","text":"The healthcare billing process can be complicated and confusing. Our new method simplifies this by providing clear, straightforward billing. 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We’re here with the essential steps and insights you need to make the best decision for the year ahead."}],"markDefs":[],"style":"normal"},{"_key":"020f183409bb","_type":"block","children":[{"_key":"1de8a6186eb10","_type":"span","marks":[],"text":"Healthcare is confusing. Between the need-to-Google terminology and the ever-changing rules, it can be a headache to understand—but it’s also crucial to know how your plan works. Knowing your coverage makes it easier to choose the right plan "},{"_key":"1de8a6186eb11","_type":"span","marks":["em"],"text":"and"},{"_key":"1de8a6186eb12","_type":"span","marks":[],"text":" take full advantage of your current benefits. (You’re paying for them, after all.)"}],"markDefs":[],"style":"normal"},{"_key":"19932b31458f","_type":"block","children":[{"_key":"bd6d0ddc49b90","_type":"span","marks":[],"text":"To ensure you get the healthcare you need without surprises, we recommend carving out time during the Open Enrollment window to call your insurance provider, ask some important questions, and truly get to know your plan options."}],"markDefs":[],"style":"normal"},{"_key":"704cbde1f918","_type":"sectionHeader","headerLevel":"h2","title":"Step 1: Get Prepared to Research Your Options"},{"_key":"9fe04bd86b02","_type":"block","children":[{"_key":"d5a5bf2426f80","_type":"span","marks":[],"text":"Before getting on the phone with your insurance provider or logging into your benefits portal, take a few minutes to get ready."}],"markDefs":[],"style":"normal"},{"_key":"425536d66bfd","_type":"block","children":[{"_key":"d96072412853","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"3d6dad85682a","_type":"block","children":[{"_key":"8735d7e7e651","_type":"span","marks":["strong"],"text":"Gather Your Plan Documents"}],"markDefs":[],"style":"normal"},{"_key":"f42ce66d14ee","_type":"block","children":[{"_key":"71ae0696c6dc0","_type":"span","marks":[],"text":"Have the following documents from your current or potential plans handy:"}],"markDefs":[],"style":"normal"},{"_key":"2883f5fbd2ee","_type":"block","children":[{"_key":"71a2ad85c8020","_type":"span","marks":[],"text":"Your current insurance card."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"707f7a34c6bf","_type":"block","children":[{"_key":"487221ec374f0","_type":"span","marks":[],"text":"A copy of the plan’s "},{"_key":"487221ec374f1","_type":"span","marks":["strong"],"text":"Summary of Benefits and Coverage (SBC)"},{"_key":"487221ec374f2","_type":"span","marks":[],"text":"."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8bc5996ade97","_type":"block","children":[{"_key":"c291fb0f1b140","_type":"span","marks":[],"text":"Recent "},{"_key":"c291fb0f1b141","_type":"span","marks":["strong"],"text":"Explanation of Benefits (EOB)"},{"_key":"c291fb0f1b142","_type":"span","marks":[],"text":" statements, if applicable."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"c595998f1ddc","_type":"block","children":[{"_key":"97a12ca8ec6b0","_type":"span","marks":[],"text":"A list of past and upcoming medical appointments or treatments, including any ongoing prescriptions."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f2d832669a8d","_type":"block","children":[{"_key":"782b3c8a7944","_type":"span","marks":["strong"],"text":""}],"markDefs":[],"style":"normal"},{"_key":"ff74e7276320","_type":"block","children":[{"_key":"d089cfcf2d910","_type":"span","marks":["strong"],"text":"Review Your Medical History and Think About the Year Ahead"}],"markDefs":[],"style":"normal"},{"_key":"661e2ee51c41","_type":"block","children":[{"_key":"b837818b814a0","_type":"span","marks":[],"text":"Make a list of any ongoing health conditions (e.g., fertility treatments, chronic illness management) and medical needs for the upcoming year (e.g., planned surgeries, mental health support, family planning). Determine how your coverage needs might change based on lifestyle shifts, like starting a family or taking a new medication."}],"markDefs":[],"style":"normal"},{"_key":"77170071513a","_type":"sectionHeader","headerLevel":"h2","title":"Step 2: Key Questions to Ask When Comparing Plans"},{"_key":"89a062dc79ae","_type":"block","children":[{"_key":"174fabad576e0","_type":"span","marks":[],"text":"Getting a thorough understanding of your coverage involves asking some nitty-gritty questions. Use this list as a guide when speaking with an insurance representative or reviewing the "},{"_key":"174fabad576e1","_type":"span","marks":["strong"],"text":"Summary of Benefits and Coverage (SBC)"},{"_key":"174fabad576e2","_type":"span","marks":[],"text":" for a potential plan."}],"markDefs":[],"style":"normal"},{"_key":"a6c7e5b1b7d4","_type":"sectionHeader","headerLevel":"h3","title":"Coverage & Network Questions"},{"_key":"54c25e68f126","_type":"block","children":[{"_key":"2b83a9d1500c0","_type":"span","marks":[],"text":"Getting these answers will help you learn how your benefits work and how to make the most of them."}],"markDefs":[],"style":"normal"},{"_key":"cca49e88d4da","_type":"tableModule","subTable":{"rows":[{"_key":"8974759c-bd5f-4cdb-91fa-69e83157b11c","_type":"tableRow","cells":["Category","Key Questions to Ask"]}]},"table":{"rows":[{"_key":"fb8a0faf-e838-451f-9ca7-6ba5a496d023","_type":"tableRow","cells":["<b>General Coverage</b>","What is my <b>deductible</b>? How much do I pay before my plan starts covering care? What are my <b>out-of-pocket maximums</b>? Does my maximum include copays? Is there a <b>co-insurance</b> rate after my deductible is met? Do I have to select a <b>primary care provider (PCP)</b>?"]},{"_key":"0e841ae7-66e0-4a97-bcc4-2a7f27252f15","_type":"tableRow","cells":["<b>Network & Providers</b>","Is my current doctor or specialist <b>in-network</b>? Do I need a <b>referral</b> to see specialists (e.g., dermatologists, mental health professionals)? What are the rules for <b>out-of-network</b> providers?"]},{"_key":"bc5bc4d4-fb20-4ab5-8680-5247f966b8c4","_type":"tableRow","cells":["<b>Prescription Coverage</b>","Are my <b>prescription medications</b> covered? Is there a <b>formulary</b> I should review? What are the <b>co-pay amounts</b> for different types of prescriptions (generics vs. brand-name)?"]}]}},{"_key":"fa89de229fb2","_type":"sectionHeader","headerLevel":"h3","title":"Services & Treatments Questions"},{"_key":"c8f2f3313e4b","_type":"block","children":[{"_key":"3c398564997f0","_type":"span","marks":[],"text":"These questions help you dive deeper into what types of services are covered by your plan."}],"markDefs":[],"style":"normal"},{"_key":"10a821ede3cd","_type":"tableModule","subTable":{"rows":[{"_key":"bfc91828-2ef1-48db-ae07-c28de2f93885","_type":"tableRow","cells":["Category","Key Questions to Ask"]}]},"table":{"rows":[{"_key":"eb435882-6852-414f-8275-c180b8b0ae25","_type":"tableRow","cells":["<b>Preventive Care</b>","What preventive services are fully covered (annual physicals, vaccines, screenings)? Are annual preventive visits and counseling covered at 100% by insurance or will I have a cost share?"]},{"_key":"9d5d1431-d326-46de-a088-20377ad06ba2","_type":"tableRow","cells":["<b>Specialty Services</b>","Are mental health services covered, and if so, what types of care (e.g., therapy, psychiatry)? What alternative treatments are covered (e.g., acupuncture, chiropractic care)? Are there limitations on when these services will be covered?"]},{"_key":"805076de-f38a-4726-83fc-141c530ebbff","_type":"tableRow","cells":["<b>Chronic Conditions & Needs</b>","Does the plan cover care for chronic conditions (e.g., diabetes, asthma)? What fertility treatments are covered (e.g., IVF, egg freezing)? Are maternity services fully covered?"]}]}},{"_key":"5f3b6b44681d","_type":"sectionHeader","headerLevel":"h2","title":"Step 3: Finding Your Perfect Fit: Case Studies in Plan Selection"},{"_key":"3fdba81a79f5","_type":"block","children":[{"_key":"dd69b75bcaeb0","_type":"span","marks":[],"text":"The answers to the questions above will help you weigh the costs and benefits of each plan option. \n\nTo illustrate the choices, meet "},{"_key":"1e1656ed3ec1","_type":"span","marks":["strong"],"text":"Carly, Bea, and Alice"},{"_key":"8d0300c470c2","_type":"span","marks":[],"text":". Their scenarios will reference three different types of Insurance plans: the Gold PPO 2000, the Gold PPO 1000, and the HDHP 5000."}],"markDefs":[],"style":"normal"},{"_key":"e7c194e890c8","_type":"tableModule","subTable":{"rows":[{"_key":"89aef08e-1ab0-486c-898d-710ff82e2a88","_type":"tableRow","cells":["Plan","Premium / Deductible","Best For"]}]},"table":{"rows":[{"_key":"a9047c96-988f-47b6-8b0c-cfecf59444e3","_type":"tableRow","cells":["<b>HDHP 5000</b>","$50/month (Lowest) <b>/</b> $5,000 (Highest)","Healthy individuals who only anticipate needing routine preventive services and want a low-cost plan."]},{"_key":"4c8e3cf8-639d-4097-9cf0-e364013807e0","_type":"tableRow","cells":["<b>Gold PPO 2000</b>","$100/month (Low) <b>/</b> $2,000 (Mid)","Those who need specific covered services (like acupuncture) but don't expect frequent visits."]},{"_key":"18160790-6ce3-46a9-a366-a858b0344c17","_type":"tableRow","cells":["<b>Gold PPO 1000</b>","$200/month (Highest) <b>/</b> $1,000 (Lowest)","Those expecting frequent doctor’s appointments who need predictable costs (copays)."]}]}},{"_key":"681ea84f74d8","_type":"cta","backgroundColor":"bcb","text":[{"_key":"735495fa5daa","_type":"block","children":[{"_key":"e974c6801c320","_type":"span","marks":["strong"],"text":"Open Enrollment Alert: Government Uncertainty and Your Premiums"}],"markDefs":[],"style":"h3"},{"_key":"f74fd11119a4","_type":"block","children":[{"_key":"7b2e38e780320","_type":"span","marks":[],"text":"As you approach your Open Enrollment decision, be aware that the current government funding debate may have a significant and immediate impact on your costs."}],"markDefs":[],"style":"normal"},{"_key":"932f70b20278","_type":"block","children":[{"_key":"cfaf2acf9b860","_type":"span","marks":[],"text":"A key point of dispute causing the current federal government shutdown is the potential expiration of the "},{"_key":"cfaf2acf9b861","_type":"span","marks":["strong"],"text":"Affordable Care Act (ACA) enhanced premium tax credits (subsidies)"},{"_key":"cfaf2acf9b862","_type":"span","marks":[],"text":" at the end of the year."}],"markDefs":[],"style":"normal"},{"_key":"78819ea20967","_type":"block","children":[{"_key":"1df3dccc523d0","_type":"span","marks":["strong"],"text":"What This Means for You:"}],"markDefs":[],"style":"normal"},{"_key":"34c894a9b4dd","_type":"block","children":[{"_key":"8d72b6ee200e0","_type":"span","marks":[],"text":"If these enhanced subsidies are "},{"_key":"8d72b6ee200e1","_type":"span","marks":["strong"],"text":"not extended"},{"_key":"8d72b6ee200e2","_type":"span","marks":[],"text":" by Congress, millions of Americans who purchase their coverage on the ACA Marketplace could face a dramatic increase in their monthly premium payments—in some cases, seeing costs more than double."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"ac14b4874d79","_type":"block","children":[{"_key":"ee157d77c15e0","_type":"span","marks":["strong"],"text":"Actionable Step:"},{"_key":"ee157d77c15e1","_type":"span","marks":[],"text":" The rates you see quoted during Open Enrollment may reflect the loss of these subsidies. It is vital to ask your Marketplace or insurer how the ongoing debate will affect your final, out-of-pocket premium. Check for communications from your state or the federal marketplace regarding rate changes and the subsidy status."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"}]},{"_key":"1540bcefad74","_type":"sectionHeader","headerLevel":"h2","title":"Case Study 1: Carly's Open Enrollment Choice - Prioritizing Low Premiums"},{"_key":"d22643ea975e","_type":"block","children":[{"_key":"60db67098b930","_type":"span","marks":["strong"],"text":"Healthcare needs:"},{"_key":"60db67098b931","_type":"span","marks":[],"text":" Carly is rarely sick and doesn’t expect to need frequent medical care, but wants to stay prepared in case of emergencies. She’s also focused on maintaining her health through preventive care."}],"markDefs":[],"style":"normal"},{"_key":"9ae989fccd04","_type":"block","children":[{"_key":"de856952decf0","_type":"span","marks":["strong"],"text":"Plan chosen: HDHP 5000"}],"markDefs":[],"style":"normal"},{"_key":"5d3af1ba0eb4","_type":"block","children":[{"_key":"b1fc8ae120dc0","_type":"span","marks":["strong"],"text":"Carly’s reasoning:"}],"markDefs":[],"style":"normal"},{"_key":"fc5161a18576","_type":"block","children":[{"_key":"d16ff68525870","_type":"span","marks":[],"text":"Carly isn’t expecting many doctor visits but wants to make sure her "},{"_key":"d16ff68525871","_type":"span","marks":["strong"],"text":"preventive care is covered"},{"_key":"d16ff68525872","_type":"span","marks":[],"text":", which the HDHP 5000 plan offers."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"391815456397","_type":"block","children":[{"_key":"7901db7b5d2c0","_type":"span","marks":[],"text":"The "},{"_key":"7901db7b5d2c1","_type":"span","marks":["strong"],"text":"lower premium of $50/month"},{"_key":"7901db7b5d2c2","_type":"span","marks":[],"text":" works well with Carly’s budget, and she’s comfortable with the higher $5,000 deductible since she rarely needs medical attention."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"9f4b6e55267c","_type":"block","children":[{"_key":"a429f408bf5a0","_type":"span","marks":[],"text":"Carly’s focus for the Open Enrollment decision is on saving money while still ensuring she’s protected in case of emergencies."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"caae50dd8494","_type":"block","children":[{"_key":"ce482af51d820","_type":"span","marks":["strong"],"text":"Plan benefits for Carly:"}],"markDefs":[],"style":"normal"},{"_key":"8fd070c475a9","_type":"block","children":[{"_key":"ba66164643950","_type":"span","marks":[],"text":"Full coverage for preventive services without needing to meet the deductible."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2dd981077207","_type":"block","children":[{"_key":"7b24ea5ee9380","_type":"span","marks":[],"text":"Lower monthly premiums that allow her to save more."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"b6a611e078dd","_type":"block","children":[{"_key":"5f7d304060890","_type":"span","marks":[],"text":"Out-of-pocket costs are manageable because Carly doesn’t foresee major medical expenses in the coming year."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"1b371ab44b73","_type":"sectionHeader","headerLevel":"h2","title":"Case Study 2: Bea's Open Enrollment Choice - Managing Ongoing Care"},{"_key":"5dd2dab3091a","_type":"block","children":[{"_key":"ab5c06eb37cf0","_type":"span","marks":["strong"],"text":"Healthcare needs:"},{"_key":"ab5c06eb37cf1","_type":"span","marks":[],"text":" Bea was recently diagnosed with PCOS and needs regular doctor visits, lab work, and fertility consultations. She expects to have more frequent healthcare needs throughout the year."}],"markDefs":[],"style":"normal"},{"_key":"f7a57c819598","_type":"block","children":[{"_key":"75f1ca97fdf20","_type":"span","marks":["strong"],"text":"Plan Chosen: Gold PPO 1000."}],"markDefs":[],"style":"normal"},{"_key":"e79671c970c1","_type":"block","children":[{"_key":"004a58dfc6110","_type":"span","marks":["strong"],"text":"Bea’s reasoning:"}],"markDefs":[],"style":"normal"},{"_key":"35143371dc32","_type":"block","children":[{"_key":"2570aaaba50f0","_type":"span","marks":[],"text":"The "},{"_key":"2570aaaba50f1","_type":"span","marks":["strong"],"text":"$1,000 deductible is manageable"},{"_key":"2570aaaba50f2","_type":"span","marks":[],"text":", and she likes having fixed "},{"_key":"2570aaaba50f3","_type":"span","marks":["strong"],"text":"copays for office visits"},{"_key":"2570aaaba50f4","_type":"span","marks":[],"text":" ($50 for primary care, $75 for specialists), which helps her budget for more frequent appointments."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"b5f2fb17e344","_type":"block","children":[{"_key":"d356481e1bcb0","_type":"span","marks":[],"text":"She anticipates needing frequent lab work, office visits, and fertility consultations, and the Gold PPO 1000 plan covers more of these costs than the other options."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"ec172fe32af7","_type":"block","children":[{"_key":"253f33ebbc1f0","_type":"span","marks":[],"text":"Although the monthly premium is higher ($200/month), Bea values knowing her office visits will be affordable when she needs them, providing financial predictability for the year ahead."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"143be1f9d615","_type":"block","children":[{"_key":"c7be35afcf050","_type":"span","marks":["strong"],"text":"Plan benefits for Bea:"}],"markDefs":[],"style":"normal"},{"_key":"a9a65c738c97","_type":"block","children":[{"_key":"cbf8110a30eb0","_type":"span","marks":[],"text":"Lower out-of-pocket costs for office visits and specialist appointments."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"61700b63841b","_type":"block","children":[{"_key":"2d6e8b03707f0","_type":"span","marks":[],"text":"Greater financial predictability for ongoing healthcare and lab work."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"2d62f53410c6","_type":"block","children":[{"_key":"18602947a8850","_type":"span","marks":[],"text":"Peace of mind knowing her PCOS treatments will be more easily covered."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"cbd36fcd58f5","_type":"sectionHeader","headerLevel":"h2","title":"Case Study 3: Alice's Open Enrollment Choice - Needing Alternative Therapies"},{"_key":"0908b8fafa28","_type":"block","children":[{"_key":"250610b6ae570","_type":"span","marks":["strong"],"text":"Healthcare needs:"},{"_key":"250610b6ae571","_type":"span","marks":[],"text":" Alice has lingering back pain from a car accident and is exploring alternative treatments like acupuncture. She’s not often sick, but she wants coverage for complementary therapies."}],"markDefs":[],"style":"normal"},{"_key":"306cd4a20a11","_type":"block","children":[{"_key":"afb59ea1de0b0","_type":"span","marks":["strong"],"text":"Plan Chosen: Gold PPO 2000."}],"markDefs":[],"style":"normal"},{"_key":"638019a3c167","_type":"block","children":[{"_key":"23c79c567acb0","_type":"span","marks":["strong"],"text":"Alice’s reasoning:"}],"markDefs":[],"style":"normal"},{"_key":"fe5eb6ba150d","_type":"block","children":[{"_key":"b2113ed676050","_type":"span","marks":[],"text":"The "},{"_key":"b2113ed676051","_type":"span","marks":["strong"],"text":"$100/month premium is a middle ground"},{"_key":"b2113ed676052","_type":"span","marks":[],"text":" for her budget, and while she’s okay with a higher "},{"_key":"b2113ed676053","_type":"span","marks":["strong"],"text":"deductible of $2,000"},{"_key":"b2113ed676054","_type":"span","marks":[],"text":", she prioritizes coverage for acupuncture, which isn’t offered under the HDHP 5000."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a9f8df721597","_type":"block","children":[{"_key":"3f6e0b4bc2960","_type":"span","marks":[],"text":"She doesn’t need frequent medical visits, but when she does, she wants the flexibility to access specialists like acupuncturists without breaking the bank."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"bc78fe5867dc","_type":"block","children":[{"_key":"96692cc468260","_type":"span","marks":[],"text":"The plan strikes a balance between affordability and access to the specific treatments she needs most, like acupuncture."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8182eb12b84b","_type":"block","children":[{"_key":"3b9317c78b590","_type":"span","marks":["strong"],"text":"Plan benefits for Alice:"}],"markDefs":[],"style":"normal"},{"_key":"a29e9cd3d528","_type":"block","children":[{"_key":"a9ebe96af9ab0","_type":"span","marks":[],"text":"Lower monthly premiums while still offering access to acupuncture services."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8493a45819a9","_type":"block","children":[{"_key":"32336a9c21f10","_type":"span","marks":[],"text":"Flexibility to meet her back pain management needs without frequent doctor visits."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"fc2bc5b78579","_type":"block","children":[{"_key":"31fde5adc2700","_type":"span","marks":[],"text":"The higher deductible works for Alice since she doesn’t expect to meet it often, but she’s comfortable with paying out of pocket for more expensive visits when needed."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"489b13bb21a5","_type":"cta","backgroundColor":"bccream","text":[{"_key":"32742315f962","_type":"block","children":[{"_key":"dcfa106ebeae0","_type":"span","marks":["strong"],"text":"Not sure which insurance plan is right for you?"}],"markDefs":[],"style":"h3"},{"_key":"2a0a325dba4a","_type":"block","children":[{"_key":"99899ebee549","_type":"span","marks":[],"text":"Answer some simple questions about your priorities and walk away with answers and actionable next steps so you can take care of your whole health—in open enrollment season and beyond."}],"markDefs":[],"style":"normal"},{"_key":"20ca78e14507","_type":"buttonBlock","items":[{"_key":"a172445c86b9","_type":"singleButton","addWidgetCopy":false,"backgroundColor":"bctran","linkCta":"Take quiz now!","linkType":"button","url":"https://learn.asktia.com/insurancequiz/?utm_medium=organic-search&utm_source=blog"}],"onlyStackButtons":false}]},{"_key":"55b9d677f767","_type":"sectionHeader","headerLevel":"h2","title":"Step 4: Making the Final Decision and Next Steps"},{"_key":"5a06628ca910","_type":"block","children":[{"_key":"ce1e4c8d32a40","_type":"span","marks":[],"text":"As Carly, Alice, and Bea showed, there’s no one-size-fits-all solution: you need insurance that works for your specific financial and healthcare needs."}],"markDefs":[],"style":"normal"},{"_key":"56136f7e88fb","_type":"block","children":[{"_key":"02dcc6289934","_type":"span","marks":["strong"],"text":""}],"markDefs":[],"style":"normal"},{"_key":"b3b6c57bf226","_type":"block","children":[{"_key":"8243b1fcaef90","_type":"span","marks":["strong"],"text":"Document Your Conversation"}],"markDefs":[],"style":"normal"},{"_key":"b1aa3cb48e39","_type":"block","children":[{"_key":"c7fc923b324c0","_type":"span","marks":[],"text":"Once you’ve finished speaking with your insurance representative:"}],"markDefs":[],"style":"normal"},{"_key":"cb6589855ac3","_type":"block","children":[{"_key":"6c48892e95490","_type":"span","marks":[],"text":"Ask for a confirmation number or a reference to your call."}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"d919cc4eba8f","_type":"block","children":[{"_key":"4e6c38d12bde0","_type":"span","marks":[],"text":"Request an email follow-up that outlines any agreements or complex coverage details."}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"810853ffbee8","_type":"block","children":[{"_key":"bb8a3d8789e90","_type":"span","marks":[],"text":"Keep detailed notes, including the name of the representative you spoke 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These changes have led to confusion and concern, particularly among women and marginalized groups."}],"markDefs":[],"style":"normal"},{"_key":"40127e758853","_type":"block","children":[{"_key":"d95f012a7e180","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"afc8a53f6d0d","_type":"block","children":[{"_key":"352b80ef0d0a0","_type":"span","marks":[],"text":"At Tia, our mission is to be a trusted healthcare advisor for women, providing clear, factual information to help you make informed decisions. Below, we outline the key policy changes and their potential impacts, along with practical steps you can take to protect your health and coverage."}],"markDefs":[],"style":"normal"},{"_key":"05e16b4053f1","_type":"sectionHeader","headerLevel":"h2","title":"Care Access"},{"_key":"6dd11a4a1f92","_type":"block","children":[{"_key":"475a460b3f29","_type":"span","marks":[],"text":"Access to abortion care:"}],"markDefs":[],"style":"h3"},{"_key":"87da617d11b4","_type":"block","children":[{"_key":"1c47379b41230","_type":"span","marks":[],"text":"In 2022, the United States Supreme Court decided a landmark case, Dobbs v. Jackson Women's Health Organization. While this case effectively removed the "},{"_key":"1aede4d15cc8","_type":"span","marks":["em"],"text":"federal constitutional right"},{"_key":"d93c09b3bc27","_type":"span","marks":[],"text":" to bodily autonomy for pregnant women, it did not ban abortions nationwide. Rather, the court’s decision gave individual states (not the federal government) increased rights to determine abortion laws in their respective states. Certain states used this decision as a basis to limit or even outlaw abortions, but other states have remained steadfast in their protection of abortion rights. California, New York, or Arizona (states in which Tia currently provides service) continue to protect abortion rights through state constitutions and statutes. Thus far, the Trump administration has not indicated plans to alter this state-level authority."}],"markDefs":[],"style":"normal"},{"_key":"9ae8c09301bd","_type":"block","children":[{"_key":"9550297a9cd90","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"bcf41f81c502","_type":"block","children":[{"_key":"473e3173d5320","_type":"span","marks":[],"text":"In California, Governor Gavin Newsom signed legislation in September 2025 to enhance access to contraception, including over-the-counter options, and to strengthen patient confidentiality protections. In March 2025, a Superior Court judge in Arizona permanently blocked the state's 15-week abortion ban, ruling it unconstitutional in light of the new constitutional amendment."}],"markDefs":[],"style":"normal"},{"_key":"ab5f19d7a5bb","_type":"cta","backgroundColor":"bccream","text":[{"_key":"1f2183fcae1d","_type":"block","children":[{"_key":"bc62bdc7cd11","_type":"span","marks":["strong","em"],"text":"Simplified: Reproductive rights are controlled by the states, not the federal government, since the overturning of Dobbs in 2022. The Trump administration has not indicated a plan to change this. Abortions are legal in CA, NY, and AZ."}],"markDefs":[],"style":"normal"}]},{"_key":"3df7fb2a7a0c","_type":"sectionHeader","headerLevel":"h2","title":"Care for LGBTQIA and individuals subjected to gender-based violence"},{"_key":"ceadae6041c4","_type":"block","children":[{"_key":"e1f0673b9bea0","_type":"span","marks":[],"text":"The new administration has scrubbed government and federal agency websites of content that protects the LGBTQIA community. These actions follow executive orders ending federal funding for gender-affirming care, which would include terminating government-sponsored healthcare for gender affirming programs under Medicaid and Medicare. On June 25, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a final rule prohibiting health insurers from providing coverage for \"sex-trait modification procedures\" as an essential health benefit under the Affordable Care Act's health insurance exchanges. While private/commercial payors have not yet announced similar policies, historically, we have seen commercial payors (eg Aetna, Cigna, United Healthcare, Blue Cross, Anthem etc) follow the same coverage guidelines used by Medicare & Medicaid Services."}],"markDefs":[],"style":"normal"},{"_key":"2d771981e64d","_type":"block","children":[{"_key":"82a600ebfa28","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"6168b74865cf","_type":"cta","backgroundColor":"bccream","text":[{"_key":"3d1d2a8ddba6","_type":"block","children":[{"_key":"9c260f69410d0","_type":"span","marks":["strong","em"],"text":"Simplified: the rights for LGBTQIA people to access gender affirming care no longer broadly exists in this country, and we are watching changes to private/commercial coverage decisions closely."}],"markDefs":[],"style":"normal"}]},{"_key":"2034add44f75","_type":"block","children":[{"_key":"b75739cb68e70","_type":"span","marks":[],"text":"Numerous lawsuits have been filed challenging these federal and state-level restrictions. Some federal judges have issued injunctions blocking the enforcement of certain provisions, such as withholding federal funds from hospitals providing gender-affirming care to minors. However, the legal landscape remains fluid, with ongoing litigation that may impact the implementation of these policies."}],"markDefs":[],"style":"normal"},{"_key":"bc5127ec4dfc","_type":"sectionHeader","headerLevel":"h2","title":"Coverage under the Affordable Care Act (ACA)"},{"_key":"87abe920d7a5","_type":"block","children":[{"_key":"ca77dda8fb7c0","_type":"span","marks":[],"text":"The Affordable Care Act (ACA)(5) is an Obama-era policy that instituted enhanced access and coverage for key healthcare services. The ACA is known most significantly for federally mandating that individuals obtain healthcare coverage, and instituting the exchange (marketplace) for individuals to buy insurance policies."}],"markDefs":[],"style":"normal"},{"_key":"d4ccd2f2b59c","_type":"block","children":[{"_key":"cf3cd6f986640","_type":"span","marks":[],"text":"Healthcare exchange or marketplace plans (terms used interchangeably) are services available in every state that help individuals, families, and small businesses shop for, and enroll in, affordable medical insurance that meet ACA guidelines."}],"markDefs":[],"style":"normal"},{"_key":"e68a2ad5f3d6","_type":"block","children":[{"_key":"e688cb9636690","_type":"span","marks":[],"text":"In most states, the federal government runs the Marketplace or exchange plans available at HealthCare.gov, although some states run their own Marketplaces at different websites. These plans are also accessible through call centers and in-person assistance. If you have an individual plan *not* purchased for you by your employer, you likely have a marketplace plan."}],"markDefs":[],"style":"normal"},{"_key":"c2b4cf3b8676","_type":"block","children":[{"_key":"00a8302fbd8c0","_type":"span","marks":[],"text":"The prior Trump administration rolled back the federal mandate (requiring all in the US to obtain healthcare coverage) in 2017, as part of Tax Cuts and Jobs Act (6). Now, only certain states (Massachusetts, New Jersey, Rhode Island, Vermont, and Washington, D.C) have individual coverage mandates."}],"markDefs":[],"style":"normal"},{"_key":"e9b9c7b9f72c","_type":"sectionHeader","headerLevel":"h2","title":"Policies that impact ACA access"},{"_key":"774cd73cf836","_type":"block","children":[{"_key":"201b62ed99b90","_type":"span","marks":[],"text":"In addition to Trump administration policies that may shift coverage options in the coming years, the administration reduced funding for ACA “navigator” programs — which help people understand their ACA options and enroll — by about 90%. This reduction means many areas will have fewer or no navigators to help low-income or first-time enrollees. Specifically, the new administration has taken measures to:"}],"markDefs":[],"style":"normal"},{"_key":"05db2a07b18e","_type":"block","children":[{"_key":"4ea5754ffc710","_type":"span","marks":[],"text":"Compress the open enrollment window (Nov. 1 - Dec. 15) for federal exchanges"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"35b0ef6b4339","_type":"block","children":[{"_key":"90e634294fab0","_type":"span","marks":[],"text":"Institute stricter measures for pre-enrollment verification and documentation;"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"365b52cfb936","_type":"block","children":[{"_key":"7821c6cb6a360","_type":"span","marks":[],"text":"Rescind Biden-era policies aimed at increasing coverage and access for individuals. The policies facing roll-back include mid-year enrollment and affordability of coverage or financial assistance for coverage."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"1c14d0acdaa4","_type":"block","children":[{"_key":"c98fd44f8e470","_type":"span","marks":[],"text":"Healthcare policy analysts have pointed out that as individual access to ACA marketplace options decreases, demand for employer sponsored plans will increase – resulting in higher costs to employers and employees in these plans who have commercial insurance."}],"markDefs":[],"style":"normal"},{"_key":"81395b532380","_type":"block","children":[{"_key":"f9d559befd33","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"5252cbee1205","_type":"cta","backgroundColor":"bccream","text":[{"_key":"1da8de3bfc1d","_type":"block","children":[{"_key":"00915ba7c2860","_type":"span","marks":["strong","em"],"text":"Simplified: for those who access plans through the exchange, it is likely that the administrative burden to get individual coverage will increase and it is likely that most of us on commercial insurance will see plan premiums rise."}],"markDefs":[],"style":"normal"}]},{"_key":"0d0e0a9f3066","_type":"block","children":[{"_key":"a1894a75d317","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"372d32a08aaa","_type":"sectionHeader","headerLevel":"h2","title":"What should I do?"},{"_key":"f9899555ceac","_type":"block","children":[{"_key":"324329eea90d0","_type":"span","marks":[],"text":"Understandably, if you are covered under an ACA marketplace plan or through employer-sponsored coverage, you may be wondering how these upcoming changes could affect you."}],"markDefs":[],"style":"normal"},{"_key":"ac89f49bb805","_type":"block","children":[{"_key":"82303d56c6990","_type":"span","marks":[],"text":"First – note these changes have not yet happened. So, it is critical to continue to watch. We don’t know if / when these proposals will be finalized; however, it is likely that the Administration will strive to put them into effect by Nov 2025, when enrollment for 2026 starts."}],"markDefs":[],"style":"normal"},{"_key":"a09be8c4fc86","_type":"block","children":[{"_key":"f70daf875ea60","_type":"span","marks":[],"text":"Second – even though we don’t have full information, you can start planning now. Here are a few ways for you to stay proactive to protect your coverage and care options through Tia:"}],"markDefs":[],"style":"normal"},{"_key":"d2dcbd32f5ce","_type":"block","children":[{"_key":"13bbcbbc5d480","_type":"span","marks":[],"text":"Budget for higher premiums"}],"markDefs":[],"style":"h4"},{"_key":"66c358469ccf","_type":"block","children":[{"_key":"3438fc980c410","_type":"span","marks":[],"text":"Although the solution of “spend more money” is not ideal, the reality is that premiums under marketplace and employer-sponsored plans will likely increase. As you are choosing a (new) plan, it is important to carefully consider what features of a particular plan are most important to you and where you may be able to decrease coverage in certain areas to increase affordability. While exchange-based plans are most at risk for rising costs, as noted above, employer-based plan premiums could also rise. Again – not that it is not likely these changes will “hit” ahead of the next open enrollment cycle (especially if you are already enrolled in an annual plan), which starts in November 2025."}],"markDefs":[],"style":"normal"},{"_key":"72803d69e047","_type":"block","children":[{"_key":"b2766b39afb20","_type":"span","marks":[],"text":"Research employer-sponsored options"}],"markDefs":[],"style":"h4"},{"_key":"6c746e131df8","_type":"block","children":[{"_key":"57ae361b50470","_type":"span","marks":[],"text":"If you are not currently covered under your employer or eligible partner’s employer-sponsored plan, we recommend that you research coverage options available through those plans. If you get coverage through your employer, your Human Resources team may start to learn about adjusted costs as soon as Q2 – so you could reach out to them to start to understand coverage shifts and changes. Oftentimes, employers are able to negotiate more favorable rates and premiums due to a volume based model. Many employers offer a multitude of plans and we suggest that you carefully consider the components of each plan to ensure that you are optimizing the coverage options vs. the premiums and out of pocket costs based on your individual circumstances."}],"markDefs":[],"style":"normal"},{"_key":"d68367bc0cf0","_type":"block","children":[{"_key":"87c10ed73a910","_type":"span","marks":[],"text":"Tia’s commitment"}],"markDefs":[],"style":"h4"},{"_key":"479e25accbfc","_type":"block","children":[{"_key":"ca48151dbfbd0","_type":"span","marks":[],"text":"Tia has an unwavering commitment to providing women with the high-quality care they deserve. Full stop. We remain steadfast in our efforts to provide safe, compassionate, and comprehensive care, no matter what, including creating a safe space that enables you to show up exactly as you are. Whether in our clinics, through virtual care, or in our community, Tia is here to ensure you are seen, heard, and supported."}],"markDefs":[],"style":"normal"},{"_key":"e1ae021f9dda","_type":"block","children":[{"_key":"242ef44e01780","_type":"span","marks":[],"text":"Despite this commitment, there are realities we must accept and that we strive to build around, including:"}],"markDefs":[],"style":"normal"},{"_key":"2bd73fdda5ea","_type":"block","children":[{"_key":"953aed2c60720","_type":"span","marks":[],"text":"The noise is real and can be overwhelming, especially during uncertain and volatile times. We are committed to being a source of clarity and truth during these times and always. We hope you feel you can turn to us as you need."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"7f33b468905e","_type":"block","children":[{"_key":"88d3c375a92b0","_type":"span","marks":[],"text":"Care is not always covered, or fully covered, and the insurance landscape is confusing and hard to navigate (one may think this is on purpose). We strive to provide support navigating insurance coverage with our care team, and when certain visits or procedures are not covered, cost transparency."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"245226bbda0a","_type":"block","children":[{"_key":"55ce29fd02190","_type":"span","marks":[],"text":"Cost is a limiting agent to many seeking healthcare, and the lack of clarity about how much something will cost or when it will “hit” is nerve wracking. We have launched a "},{"_key":"9fbd697788aa","_type":"span","marks":["202034c79d6d"],"text":"predictable payments"},{"_key":"ceaf111407f7","_type":"span","marks":[],"text":" product to assuage these concerns."}],"level":1,"listItem":"bullet","markDefs":[{"_key":"202034c79d6d","_type":"internalLink","linkType":"text","reference":{"_ref":"b242f2b8-a163-4b20-b47a-df2db3f5bdfa","_type":"reference"}}],"style":"normal"},{"_key":"5438101f4f6a","_type":"block","children":[{"_key":"e7bea813e7d90","_type":"span","marks":[],"text":"Thank you for your trust in Tia. We are committed to doing all we can to support our patients and our larger community through times of uncertainty - now more than ever. Please find us in clinic, virtually or through chat - if we can help you navigate any specific concerns."}],"markDefs":[],"style":"normal"},{"_key":"41a24ef406dd","_type":"cta","backgroundColor":"bccream","text":[{"_key":"c17fcaf8345d","_type":"block","children":[{"_key":"14aa515a3e7e0","_type":"span","marks":[],"text":"There is so much change for women and healthcare right now. We see this, and invite you to come as you are to receive our care. "}],"markDefs":[],"style":"large"},{"_key":"4884857c3e64","_type":"block","children":[{"_key":"f686dbc3e28d","_type":"span","marks":["em","d4a2595fa037"],"text":"Located in New York, Phoenix, San Francisco, and Los Angeles."},{"_key":"7a67758c2875","_type":"span","marks":["d4a2595fa037"],"text":" "}],"markDefs":[{"_key":"d4a2595fa037","_type":"internalLink","linkType":"text","reference":{"_ref":"9b061bf7-f926-43be-8614-aa477d9eed59","_type":"reference"}}],"style":"normal"},{"_key":"ce85f0c00405","_type":"buttonBlock","items":[{"_key":"57030f15d667","_type":"singleButton","backgroundColor":"bcpoppy","linkCta":"Get Care","linkType":"join-scroll-shape"},{"_key":"149c2ce28b5e","_type":"singleButton","backgroundColor":"bctran","linkCta":"Member Portal","linkType":"button","url":"https://member.asktia.com"}],"onlyStackButtons":false}]},{"_key":"2aea48424bb9","_type":"block","children":[{"_key":"524f99c76984","_type":"span","marks":[],"text":"\n————"}],"markDefs":[],"style":"normal"},{"_key":"79fb70e85796","_type":"block","children":[{"_key":"ae93d7e6ceef","_type":"span","marks":[],"text":"1 - Dobbs v. Jackson Women's Health Organization, 597 U.S. 215 (2022)\n2- CAL. HEALTH & SAFETY CODE § 123468, CAL. HEALTH & SAFETY CODE § 123462, CAL. HEALTH & SAFETY CODE § 123466, CAL. HEALTH & SAFETY CODE § 123462;"}],"markDefs":[],"style":"normal"},{"_key":"1f7339a1d0eb","_type":"block","children":[{"_key":"aa81264b71c40","_type":"span","marks":[],"text":"CAL. CONST. Art. I, § 1 (Added 1974); Comm. to Defend Reprod. Rights v. Myers, 625 P.2d 779 (Cal. 1981) (striking down limits on Medicaid coverage for abortions, finding that all women possess a fundamental constitutional right to choose abortion under the California constitutional privacy provision); Am. Acad. of Pediatrics v. Lungren, 940 P.2d 797 (Cal. 1997) (invalidating parental-consent requirement)."}],"markDefs":[],"style":"normal"},{"_key":"d1c5b5bd94cd","_type":"block","children":[{"_key":"e3d94781f7160","_type":"span","marks":[],"text":"A res. to propose to the people of the State of Cal. an amend. to the Const. of the State, by adding Section 1.1 to Article I thereof, relating to fundamental rights, Sen. Const. Amend. No. 10, 2022, https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SCA10. NYTimes, California Proposition 1 Election Results: Constitutional Right to Reproductive Freedom, https://www.nytimes.com/interactive/2022/11/08/us/elections/results-california-proposition-1-constitutional-right-to-reproductive-freedom.html (Last accessed Nov. 9, 2022)."}],"markDefs":[],"style":"normal"},{"_key":"bf0846f84105","_type":"block","children":[{"_key":"77f75e4cea550","_type":"span","marks":[],"text":"3- NY Pub Health L § 2599-BB (2023)"}],"markDefs":[],"style":"normal"},{"_key":"044f9497b277","_type":"block","children":[{"_key":"039f4e31f8be","_type":"span","marks":[],"text":"4- On November 5, 2024, Arizona voters approved Proposition 139, the “Arizona Abortion Access Act.”"}],"markDefs":[],"style":"normal"},{"_key":"b2b034ccc602","_type":"block","children":[{"_key":"988b6b2e701f","_type":"span","marks":[],"text":"5- Public Law 111–148, 124 Stat. 119 (2010)."}],"markDefs":[],"style":"normal"},{"_key":"6dbcff0d98f9","_type":"block","children":[{"_key":"ffb940770d6a","_type":"span","marks":[],"text":"6- Public Law 115-97 (2017)"}],"markDefs":[],"style":"normal"}],"image":{"_type":"image","asset":{"_ref":"image-b0f58597b49d7573dd469bee3ae9ae12b7e9bd32-2800x800-png","_type":"reference"}},"publishedAt":"2025-02-18T23:24:00.000Z","slug":{"_type":"slug","current":"understanding-healthcare-policy-changes-how-to-stay-informed-and-protected"},"status":"production","title":"Healthcare Policy Changes: A Guide to Staying Informed & Protecting Your Coverage","topics":[{"_key":"1fb1602a686e","_ref":"e73216c3-62ac-4d28-a1a2-78bb60a208be","_type":"reference"}],"updatedAt":"2025-10-14T02:19:00.000Z"},"metaInformation":{"_type":"metaCard","metaDescription":"Don't get caught off guard by new laws. 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Preventive care is designed to catch problems early—before they grow into something more serious or costly. Services like wellness visits, vaccinations, and screenings are vital for long-term health, and in many cases, insurance plans cover them completely."}],"markDefs":[],"style":"normal"},{"_key":"9421e6a4fa93","_type":"block","children":[{"_key":"fc925e710a640","_type":"span","marks":[],"text":"Sometimes, though, insurance rules can make things tricky. Preventive visits—like your annual wellness exam—are generally covered at no cost to you. But there are certain factors, such as the time since your last visit, your specific insurance benefits, or your healthcare provider network status that can impact this coverage."},{"_key":"369050dd894e","_type":"span","marks":["strong"],"text":" This isn’t unique to Tia; it’s how insurance companies define and process care."}],"markDefs":[],"style":"normal"},{"_key":"6a9cbf97e8b6","_type":"block","children":[{"_key":"37c16672b36f0","_type":"span","marks":[],"text":"At Tia, we’re here to bridge the gap between preventive care and the complex world of insurance, making it easier for you to access the care you need while keeping costs transparent and manageable. In this guide, we’ll explore what preventive care entails and how it’s covered by insurance. By the end, you’ll feel confident in planning your next visit, asking the right questions, and making informed decisions about your health."}],"markDefs":[],"style":"normal"},{"_key":"42827489e417","_type":"block","children":[{"_key":"e4caba382f500","_type":"span","marks":[],"text":"What Is Preventive Care?"}],"markDefs":[],"style":"h2"},{"_key":"6d58ae359d64","_type":"block","children":[{"_key":"cf4766b935f00","_type":"span","marks":[],"text":"Preventive care is the foundation of a healthy lifestyle. It focuses on catching potential health issues early through proactive measures, helping you avoid serious conditions and costly treatments. Key components of preventive care include:"}],"markDefs":[],"style":"normal"},{"_key":"d1b404756ad1","_type":"block","children":[{"_key":"2c5e6b906e4c0","_type":"span","marks":["strong"],"text":"Screenings:"},{"_key":"eac4c6437748","_type":"span","marks":[],"text":" Tests for conditions like high blood pressure, cholesterol, diabetes, and certain cancers."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"e8ba8d841910","_type":"block","children":[{"_key":"153c857a49fd0","_type":"span","marks":["strong"],"text":"Vaccinations: "},{"_key":"387dbc3949f5","_type":"span","marks":[],"text":"Immunizations to protect against infectious diseases, such as flu shots and childhood vaccines."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"c6060c8bd48b","_type":"block","children":[{"_key":"77479df26bd80","_type":"span","marks":["strong"],"text":"Wellness Visits:"},{"_key":"0f7069fa1aed","_type":"span","marks":[],"text":" Routine check-ups where your provider assesses your overall health, offers counseling, and discusses lifestyle factors."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"53a7b649780f","_type":"block","children":[{"_key":"e2a90206b2440","_type":"span","marks":[],"text":"The benefits of preventive care are clear—it improves outcomes, reduces the risk of chronic illnesses, and saves money by addressing issues early."}],"markDefs":[],"style":"normal"},{"_key":"3e1d75706e82","_type":"block","children":[{"_key":"aefebec9fc780","_type":"span","marks":[],"text":"What’s Covered by Insurance? "}],"markDefs":[],"style":"h3"},{"_key":"442e62276a45","_type":"block","children":[{"_key":"aefebec9fc781","_type":"span","marks":[],"text":"Most in-network insurance plans cover many preventive services at 100%, including:"}],"markDefs":[],"style":"normal"},{"_key":"36c63c1fe66c","_type":"block","children":[{"_key":"b6566482fb7d0","_type":"span","marks":[],"text":"Annual well-woman exams"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"3c437a75b62a","_type":"block","children":[{"_key":"0a3a65d884270","_type":"span","marks":[],"text":"Cervical cancer screenings (pap smears)"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"ffe47ecccf38","_type":"block","children":[{"_key":"0d65ca4beb3b0","_type":"span","marks":[],"text":"Blood pressure, diabetes, and cholesterol tests"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"51d2f4be85a6","_type":"block","children":[{"_key":"3a68197deb7e0","_type":"span","marks":[],"text":"STI screenings"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"fd4b53afec4f","_type":"block","children":[{"_key":"d99d94ceb0ff0","_type":"span","marks":[],"text":"Immunizations"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"9d7095e4c996","_type":"block","children":[{"_key":"b544eb84beed0","_type":"span","marks":[],"text":"However, not all plans are created equal. For example, some may cover Vitamin D testing or nutritional counseling as preventive, while others do not. To avoid surprises, it’s important to confirm your coverage directly with your insurance provider."}],"markDefs":[],"style":"normal"},{"_key":"c54572480f28","_type":"block","children":[{"_key":"c4f2fae4696a0","_type":"span","marks":[],"text":"Where Things Can Get Complicated…"}],"markDefs":[],"style":"h2"},{"_key":"aeba902323fe","_type":"block","children":[{"_key":"e723f37d5d0d0","_type":"span","marks":[],"text":"The line between preventive and diagnostic care can be blurry. Preventive visits are routine check-ups aimed at maintaining health, while diagnostic visits focus on addressing specific symptoms or concerns. Just because you are receiving care for preventive purposes unfortunately doesn’t mean your insurance will consider the visit to be preventive. Understanding this distinction is crucial to avoid unexpected bills."}],"markDefs":[],"style":"normal"},{"_key":"5bb00bf5be4c","_type":"block","children":[{"_key":"1defced9d7ec0","_type":"span","marks":[],"text":"Diagnostic Scenario:"}],"markDefs":[],"style":"h3"},{"_key":"7c5618d86cbb","_type":"block","children":[{"_key":"f7a16ef0e82e0","_type":"span","marks":[],"text":"You schedule a preventive wellness visit, which is fully covered by your insurance."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"b5872aaf750d","_type":"block","children":[{"_key":"36af64e53dd40","_type":"span","marks":[],"text":"During the visit, you mention experiencing frequent migraines."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"4ff732ef7a4e","_type":"block","children":[{"_key":"0c6da19aafe90","_type":"span","marks":[],"text":"Your provider evaluates the migraines, possibly prescribes medication, and orders tests."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"59e471d63afe","_type":"block","children":[{"_key":"cc0a064d1b9f0","_type":"span","marks":[],"text":"In this case, the visit shifts from preventive to diagnostic, meaning you could be responsible for a copay or coinsurance, depending on your plan."}],"markDefs":[],"style":"normal"},{"_key":"01cddea41e0d","_type":"block","children":[{"_key":"140ab4ebbff60","_type":"span","marks":[],"text":"“Not Preventive” Scenario:"}],"markDefs":[],"style":"h3"},{"_key":"7974e3a6682d","_type":"block","children":[{"_key":"908c60616d870","_type":"span","marks":[],"text":"You schedule a preventive wellness visit, which is fully covered by your insurance."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"68491a0a69e7","_type":"block","children":[{"_key":"342646a7334a0","_type":"span","marks":[],"text":"During the visit, your provider states they want to order an ultrasound for your PCOS to confirm your current health status."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f0fc0ef02fb7","_type":"block","children":[{"_key":"d1f2caaa609f0","_type":"span","marks":[],"text":"In this case, while the ultrasound was done for preventive reasons, insurance does not consider this service to be preventive based on criteria from the Affordable Care Act."}],"markDefs":[],"style":"normal"},{"_key":"59291f8c8966","_type":"block","children":[{"_key":"1ffa7f9aec220","_type":"span","marks":[],"text":"Timing Issue Scenario:"}],"markDefs":[],"style":"h3"},{"_key":"e9690be2c8ff","_type":"block","children":[{"_key":"00718c3d9a9b0","_type":"span","marks":[],"text":"You schedule a preventive wellness visit for January 15, 2025, but your last preventive exam was February 28, 2024"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"9da0f3032b3f","_type":"block","children":[{"_key":"2ba270a8ae4e0","_type":"span","marks":[],"text":"Your visit is fully preventive with your regular annual physical checkup and screenings."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"a398f42bafa5","_type":"block","children":[{"_key":"dc7ba7584fcb0","_type":"span","marks":[],"text":"In this case, while your visit was truly preventive with no diagnostic issues and you only had “preventive” services completed, your insurance denied your appointment because it hadn’t been 365 days since your last annual preventive exam, resulting in a bill."}],"markDefs":[],"style":"normal"},{"_key":"986ba5e631f4","_type":"block","children":[{"_key":"b5fc383bba8f0","_type":"span","marks":[],"text":"Actionable Tips for Maximizing Your Benefits"}],"markDefs":[],"style":"h2"},{"_key":"6a6efcea64f7","_type":"block","children":[{"_key":"e5a27aab50830","_type":"span","marks":[],"text":"Before your next visit, take these steps to ensure a smooth experience:"}],"markDefs":[],"style":"normal"},{"_key":"15adee66eab4","_type":"block","children":[{"_key":"c0774f8142420","_type":"span","marks":["strong"],"text":"Call Your Insurance Provider"},{"_key":"c0774f8142421","_type":"span","marks":[],"text":": Ask what preventive services are covered, how often, and if there are any restrictions."}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"68d1f024f2f2","_type":"block","children":[{"_key":"abe0820dc9630","_type":"span","marks":["strong"],"text":"Prepare for Your Appointment"},{"_key":"abe0820dc9631","_type":"span","marks":[],"text":": Use Tia’s "},{"_key":"abe0820dc9632","_type":"span","marks":["strong"],"text":"Preventive Insurance Checklist"},{"_key":"abe0820dc9633","_type":"span","marks":[],"text":" to guide your conversation with your insurer."}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"5f5f041ead06","_type":"block","children":[{"_key":"cc6f617ba1cd0","_type":"span","marks":["strong"],"text":"Understand Billing Scenarios"},{"_key":"cc6f617ba1cd1","_type":"span","marks":[],"text":": Know what might trigger a shift from preventive to diagnostic care."}],"level":1,"listItem":"number","markDefs":[],"style":"normal"},{"_key":"46579155e1a8","_type":"block","children":[{"_key":"845ac7ec9b530","_type":"span","marks":[],"text":"Preventive Insurance Checklist:"}],"markDefs":[],"style":"h3"},{"_key":"23ceea76df29","_type":"block","children":[{"_key":"b8d75439b9ea0","_type":"span","marks":[],"text":"Does my insurance plan cover preventive care at 100%?"}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"5b3677187647","_type":"block","children":[{"_key":"521e61c4c97d0","_type":"span","marks":[],"text":"What preventive services are covered under my 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Care"}],"markDefs":[],"style":"h2"},{"_key":"788744b69045","_type":"block","children":[{"_key":"5ce59bb7ae8d0","_type":"span","marks":[],"text":"Preventive care is about more than avoiding illness—it’s an investment in your overall well-being. At Tia, we’re here to support you with personalized care, transparent costs, and guidance to help you navigate the complexities of insurance."}],"markDefs":[],"style":"normal"},{"_key":"860e6b9a0094","_type":"block","children":[{"_key":"f5acae0e05ee0","_type":"span","marks":[],"text":"Take charge of your health today by scheduling your next preventive visit. If you have questions about your benefits or costs, reach out to Tia’s care team—we’re here to help every step of the way."}],"markDefs":[],"style":"normal"},{"_key":"aced0b748c89","_type":"cta","backgroundColor":"bcoat","text":[{"_key":"c85e3504a604","_type":"block","children":[{"_key":"d9c764ed3de7","_type":"span","marks":[],"text":"Ready to engage in preventive care? Join Tia and schedule an appointment to get started at the clinic nearest you!"}],"markDefs":[],"style":"large"},{"_key":"b45fc719a66a","_type":"block","children":[{"_key":"07df7136844b","_type":"span","marks":["em","2d17c67529f2"],"text":"Located in New York, Phoenix, San Francisco, and Los Angeles."},{"_key":"b7024b12af6d","_type":"span","marks":["2d17c67529f2"],"text":" "}],"markDefs":[{"_key":"2d17c67529f2","_type":"internalLink","linkType":"text","reference":{"_ref":"9b061bf7-f926-43be-8614-aa477d9eed59","_type":"reference"}}],"style":"normal"},{"_key":"6b40478a96f9","_type":"buttonBlock","items":[{"_key":"b71e5a190a2f","_type":"singleButton","linkCta":"Book appointment","linkType":"button","reference":{"_ref":"05c3c462-1aee-4ec5-b586-eb1c603f1444","_type":"reference"}}],"onlyStackButtons":false}]}],"image":{"_type":"image","asset":{"_ref":"image-d7960e8f9cae23512333b5aaa63b589052c52e28-4200x2400-png","_type":"reference"}},"publishedAt":"2025-02-20T20:41:00.000Z","slug":{"_type":"slug","current":"your-guide-to-preventive-care-and-insurance-costs"},"status":"production","title":"Your Guide to Preventive Care and Insurance Costs at Tia: How to Stay Healthy Without Breaking the Bank","topics":[{"_key":"82b5f5cf7967","_ref":"52909ed4-6c00-4b08-bfee-cee50984c63b","_type":"reference"}]},"metaInformation":{"_type":"metaCard","noIndex":false,"openImage":{"_type":"image","asset":{"_ref":"image-d7960e8f9cae23512333b5aaa63b589052c52e28-4200x2400-png","_type":"reference"}},"title":"Your Guide to Preventive Care and Insurance Costs at Tia: How to Stay Healthy Without Breaking the Bank","twitterImage":{"_type":"image","asset":{"_ref":"image-d7960e8f9cae23512333b5aaa63b589052c52e28-4200x2400-png","_type":"reference"}},"twitterTitle":"Your Guide to Preventive Care and Insurance Costs at Tia: How to Stay Healthy Without Breaking the Bank"}},"id":"68286162-cbb1-55e5-8794-9648d73e3d16","parent":null,"children":[],"internal":{"type":"SanityEditorial","contentDigest":"a8bca28ac527c420332e9ec8d397ca30","counter":10003,"owner":"gatsby-source-sanity"}}],"backgroundColor":"bcb","spacing":"pys","title":"Helpful Resources Related to Insurance"},{"_key":"5d355767e258","_type":"shape","backgroundColor":"secondary-1","shapeColor":"tertiary-3","shapeType":"shape-1"},{"_key":"a18627e098ce","_type":"spacer","backgroundColor":"bccream","spacing":"pys"},{"_key":"122fc5fb9661","_type":"faqModule","faqs":[{"_id":"0d664388-a42d-4f20-8e60-3911c6a8c79b","_type":"faq","_createdAt":"2020-08-30T03:43:46Z","_rev":"MirE1BP5LZnAEHAHShJ0Ds","_system":{"base":{"id":"0d664388-a42d-4f20-8e60-3911c6a8c79b","rev":"RdixGn6lpDGH89K9LFGi20"}},"_updatedAt":"2025-09-04T00:38:39Z","answer":[{"_key":"5b220ee24edc","_type":"block","children":[{"_key":"5b220ee24edc0","_type":"span","marks":[],"text":"To check if your plan works with Tia, go to our "},{"_key":"e561747950dc","_type":"span","marks":["c6d34487e212"],"text":"Join Page"},{"_key":"296d10295564","_type":"span","marks":[],"text":". Once you enter your information on in Step 1, you’ll be able to check if Tia takes your plan in Step 2. Don’t worry, this will not commit you to a membership (that happens in the later steps). "}],"markDefs":[{"_key":"c6d34487e212","_type":"internalLink","linkType":"text","reference":{"_ref":"6b861435-f6fe-4c96-893c-77732c7ab389","_type":"reference"}}],"style":"normal"}],"question":"How do I know if you take my insurance plan?","id":"1894de72-42a3-5558-a08e-fe67b0b9304a","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"0fb781771083bbb9442b7e819900b4e0","counter":2486,"owner":"gatsby-source-sanity"}},{"_id":"98fab06a-1a72-409e-8b4d-4e2aef838df1","_type":"faq","_createdAt":"2020-08-20T17:29:09Z","_rev":"S1ICLYYXLL04VHpWAZR7gv","_system":{"base":{"id":"98fab06a-1a72-409e-8b4d-4e2aef838df1","rev":"uBZyzL1oEJWqYeY7paHABE"}},"_updatedAt":"2025-09-24T17:01:39Z","answer":[{"_key":"162907c09157","_type":"block","children":[{"_key":"162907c091570","_type":"span","marks":[],"text":"Yes! You can join Tia with or without insurance. If you do not have insurance, you can pay cash for services. However, we cannot accept members with Medicaid or Medicaid managed plans as we are not in-network with Medicaid. 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Because insurance plans require these visits to be strictly preventive, any specific concern (a UTI, new pain, or fatigue) is best handled at a separate Sick Visit. 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Depending on the care you receive, this could look like: the total amount owed for care might be $500, but the total due this month is $250. This method offers a clear, manageable way to handle medical expenses, allowing you to focus on what truly matters—your health."}],"markDefs":[],"style":"normal"}],"textAboveMedia":false,"videoDisplay":"container"},{"_key":"1eaa1d5efd4f","_type":"standardText","backgroundColor":"bccream","spacing":"pys","text":[{"_key":"1177301216b6","_type":"block","children":[{"_key":"560e7e8612fd","_type":"span","text":"Benefits of Predictable Payments:"}],"style":"h3"},{"_key":"4405ed31e402","_type":"columnText","items":[{"_key":"6bc3e3e01263","_type":"plainText","text":[{"_key":"2648b9147137","_type":"block","children":[{"_key":"734ea0029e80","_type":"span","marks":[],"text":"1. $250 Capped Invoices"}],"markDefs":[],"style":"h4"},{"_key":"da8fee1a7b4f","_type":"block","children":[{"_key":"a9b4bb678414","_type":"span","marks":[],"text":"One of the biggest benefits of this payment method is predictability. With a consistent $250 cap, you can budget with confidence and avoid fluctuating or surprising bills. We know that some months you may need more time to pay, and that’s ok. Our goal is to remove financial stress so you never delay the care you need."}],"markDefs":[],"style":"normal"}]},{"_key":"62f372e57485","_type":"plainText","text":[{"_key":"bd954e81fe00","_type":"block","children":[{"_key":"64ea8b43befd","_type":"span","text":"2. One Invoice, One Time a Month"}],"style":"h4"},{"_key":"aa39c7628804","_type":"block","children":[{"_key":"bbace43f0410","_type":"span","text":"The healthcare billing process can be complicated and confusing. Our new method simplifies this by providing clear, straightforward billing. 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At Tia, our providers are trained to connect the dots across your physical, mental, and emotional health. We believe in taking the time to listen your unique story because we know your health isn't a series of disconnected issues—it's a whole picture. 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All of the questions and information gathered when I first signed up helped to create both a comprehensive medical history as well as a snapshot of my current conditions. But the best part? Whether my visit is virtual or in-person, I never, ever feel rushed. My physician and nurse practitioners are empathetic and understanding. If you want holistic healthcare, try Tia. You won’t be disappointed.","Title":"Natalie D., Tia Patient","_key":"995b939291ee","_type":"inline"}]},{"_key":"b3b130bcb8f3","_type":"editorialText","editorialText":[{"_key":"88a360f65dc9","_type":"cta","text":[{"_key":"089cc2bcc445","_type":"block","children":[{"_key":"d3ada71a90d4","_type":"span","marks":[],"text":"Book a Weight & Metabolic Health visit"}],"markDefs":[],"style":"h2"},{"_key":"08dc1094385d","_type":"block","children":[{"_key":"474383e77aec","_type":"span","marks":[],"text":"Weight and metabolic health can shape everything from your energy and mood to hormones and long-term wellness. 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Because insurance plans require these visits to be strictly preventive, any specific concern (a UTI, new pain, or fatigue) is best handled at a separate Sick Visit. 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Depending on the care you receive, this could look like: the total amount owed for care might be $500, but the total due this month is $250. 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With a consistent $250 cap, you can budget with confidence and avoid fluctuating or surprising bills. We know that some months you may need more time to pay, and that’s ok. Our goal is to remove financial stress so you never delay the care you need."}],"markDefs":[],"style":"normal"}]},{"_key":"62f372e57485","_type":"plainText","text":[{"_key":"bd954e81fe00","_type":"block","children":[{"_key":"64ea8b43befd","_type":"span","text":"2. One Invoice, One Time a Month"}],"style":"h4"},{"_key":"aa39c7628804","_type":"block","children":[{"_key":"bbace43f0410","_type":"span","text":"The healthcare billing process can be complicated and confusing. Our new method simplifies this by providing clear, straightforward billing. 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Because insurance plans require these visits to be strictly preventive, any specific concern (a UTI, new pain, or fatigue) is best handled at a separate Sick Visit. 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With a consistent $250 cap, you can budget with confidence and avoid fluctuating or surprising bills. We know that some months you may need more time to pay, and that’s ok. Our goal is to remove financial stress so you never delay the care you need."}],"markDefs":[],"style":"normal"}]},{"_key":"62f372e57485","_type":"plainText","text":[{"_key":"bd954e81fe00","_type":"block","children":[{"_key":"64ea8b43befd","_type":"span","text":"2. One Invoice, One Time a Month"}],"style":"h4"},{"_key":"aa39c7628804","_type":"block","children":[{"_key":"bbace43f0410","_type":"span","text":"The healthcare billing process can be complicated and confusing. Our new method simplifies this by providing clear, straightforward billing. 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Because insurance plans require these visits to be strictly preventive, any specific concern (a UTI, new pain, or fatigue) is best handled at a separate Sick Visit. 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Depending on the care you receive, this could look like: the total amount owed for care might be $500, but the total due this month is $250. 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With a consistent $250 cap, you can budget with confidence and avoid fluctuating or surprising bills. We know that some months you may need more time to pay, and that’s ok. Our goal is to remove financial stress so you never delay the care you need."}],"markDefs":[],"style":"normal"}]},{"_key":"62f372e57485","_type":"plainText","text":[{"_key":"bd954e81fe00","_type":"block","children":[{"_key":"64ea8b43befd","_type":"span","text":"2. One Invoice, One Time a Month"}],"style":"h4"},{"_key":"aa39c7628804","_type":"block","children":[{"_key":"bbace43f0410","_type":"span","text":"The healthcare billing process can be complicated and confusing. Our new method simplifies this by providing clear, straightforward billing. 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