Birth Control and Hormone Testing

Should I consider hormone testing?
Do you experience fatigue, headaches and/or weight gain? These qualify as potential hormone problems, as well as hot flashes, night sweats, mood swings, PMS/PMDD, low sex drive, vaginal dryness, insomnia, abnormal or irregular periods, menstrual headaches, cyclical migraines, breast tenderness and postpartum depression.

Do I have to come off birth control prior to hormone testing?
If you are on hormonal birth control (birth control pills, Depo Provera shot, birth control patch, birth control ring/Nuvaring, Implanon implant or Mirena IUD), it is recommended that you come off your hormonal birth control to properly assess your hormones.

What do I do if I’m not ready to come off birth control?
If you are not yet ready to come off of your hormonal birth control, then come in for the initial consultation and you & Dr. Poppy can decide together on the timing of your hormone test. If you are on birth control pills, the patch or ring you can stop those, have a period (a withdrawal bleed from the hormones), then wait to have your period on your own (usually 4 weeks). Day 1 of your own period is day 1 of your cycle. Please complete the saliva test on Day 20.

If you are sexually active and you do not want to become pregnant, please take precautions and either use condoms or abstain while you are coming off of your hormonal birth control and having your hormones tested. If you do not start your period when anticipated, and you are not pregnant, call the office to find out the timing of your saliva test. If you are using condoms, diaphragm, Natural Family Planning/Fertility Awareness, Copper IUD (Paragard), vaginal film/foam, or withdrawal and having regular cycles, you can do the saliva test ahead of time.

Periods and Hormone Testing

My periods are irregular, how do I know when I should try hormone testing? Most of these patients will need to have an initial consultation before doing their saliva test, check with Dr. Poppy for specific instructions. I’m over 50 with regular periods, but not on birth control. I have had a tubal or vasectomy or I am not sexually active. When should I take the saliva test? You can take the saliva test ahead of your visit on Day 20 of your cycle. I’m over 50 and not having periods (or periods are irregular), when can I take the saliva test? If your last period was more than 6 months ago, go ahead and do saliva test. If your last period was less than 6 months, check with Dr. Poppy on the timing of your saliva test. I’ve had a hysterectomy, when can I take the saliva test? If you’ve had a hysterectomy, you can do saliva test anytime. If you are less than 50, and you have had a hysterectomy with ovarian conservation, try to time your saliva test to when you are having the most hormonal symptoms.

Prescription Hormones and Hormone Testing

I am on a topical hormone cream (or hormone patch or vaginal hormone cream or vaginal suppositories.) What type of test will I need to do? You will need to do a ZRT Saliva Test. The cost is $200. If you are on pellet hormone therapy you will also need ZRT, but you will need to check with Dr. Poppy on the timing of your test. I am on sublingual hormones, what type of testing do I require? You will need to do a ZRT Combo Kit, Bloodspot for Hormones and Saliva for Cortisol. The cost is $200. I am taking oral hormones, what type of test do I require? You can take a ZRT Saliva Test. The cost is $200. Why type of hormones does Dr. Poppy prescribe? Dr. Poppy prescribes a wide range of Bioidentical Hormones in many different forms. The phrase, “Bioidentical Hormone” means the same chemical structure as what the body makes naturally. These hormones still have to be made in a lab. Dr. Poppy prescribes many compounded hormones, which means hormones that are made for you by a pharmacy, in a customized prescription. These are prescribed for you, based on your saliva test results. She occasionally will prescribe synthetic birth control for a patient, depending on the situation. However, she is focused on bringing about hormone balance using Bioidentical Hormones. Many compounded hormones are not paid for by insurance. Cost issues of hormones are between the patient and the pharmacy. Prices do vary between pharmacies, so patients have the option to shop around for the best prices. We do not have the ability to find the best price for you. However, please recognize that compounding helps patients take multiple hormones at the same time that are not available combined on the retail market. There are some Bioidentical Hormones on the retail market, like estrogen patches, oral progesterone pills, etc. that Dr. Poppy will prescribe. Many patients feel the additional cost of a customized hormone prescription is worth it for proper hormone balance. What is Dr. Poppy’s experience with Bioidendical Hormone Therapy? Dr. Poppy has been prescribing Bioidentical hormone therapy since 2003. It is often hard to find a provider with a lot of experience with this specialized type of of hormone therapy. People drive from many distances, including other states, for help with an experienced hormone practitioner.

Saliva Tests

How much is a saliva test? If you are on hormones, you need to tell the staff what types of hormones you're on, so we can tell you which test to take. The cost of a ZRT test is $200, which is paid to us. If you are on hormonal birth control we prefer you to have an appointment prior to testing. How do I collect a saliva test? If you are having a regular cycle, then day 1 of your period, is day 1 of your cycle. You will collect your saliva sample on day 20 of your cycle. If you are not having cycles or you are a man, you can collect the saliva test on any day. Preferably you should do the saliva test on a day that you don’t have too much going on, because it does take time to collect the saliva samples. You will collect 4 tubes throughout the day. You will begin the test first thing in the morning (fasting), one at noon, one between 4 and 5pm and one right before bed. Be sure to fill each tube about 3/4 of the way with saliva. It helps to be well hydrated the day before. The day of the test, if you buy a lemon and cut it open and sniff it during collection, it will increase your saliva production. Each tube must be labeled with your name, and the time of collection. Please read all the directions and fill out the information. Each kit includes a pre-paid mailing label, through UPS, so you can drop it off at a UPS Store, drop box or call UPS to come pick it up. How long does it take to receive saliva test results? We will automatically receive your results. It usually takes between 7-10 business days, after you mail it. We will then contact you to schedule your appointment and review your results. Please specify if you’d prefer to be contacted by phone, text or email. How do I get my saliva test? I live locally in Springfield (or in the surrounding towns). Can I pick up my test? You can come to the office and pick up a saliva test, which must be paid for when picked up. I don’t live locally, how can I get my saliva test? If you need your saliva test mailed, there is a $5 shipping and handling fee. Do you offer any other types of tests? Dr. Poppy offers routine, screening and targeted blood work testing, including comprehensive thyroid and vitamin testing, MTHFR/homocysteine, which can be drawn in our office.

Pap Tests and/or Pelvic Exams

Do I need a Pap or Pelvic Exam. Can we do that at the time of consultation?
We can do a pap and pelvic exam at the time of consultation. However, please let us know so we can include that in your appointment. If it has been more than three years since your last exam, Dr. Poppy will likely recommend one, although it does not have to occur at the same visit if you want to wait. If you are unsure if you need one, you can discuss this with Dr. Poppy at the time of your initial consultation.

Blood Work

I have had blood work done, can the results be sent to you? Yes! Do you have copies of it, or can the results be printed off the internet through a hospital portal? The results can be faxed or emailed to us ahead of time ,or brought in with you at the time of the visit for review. If you’ve had blood work done, but do not have access to it, you can call the office where your blood work was completed and ask for a copy (there is sometimes a fee for that). You can also sign a release with us to fax to the doctor’s office to obtain your blood work results (or pap or mammogram/bone density reports etc). We can fax, email or mail a release to them ahead of time. I haven’t had any blood work done, but I do have insurance. What do I do? If you haven’t had any blood work done, but you do have insurance, then you can have lab work done ahead of time. We can fax an order to a local lab, that your insurance covers, or we can submit it through insurance (Quest, note: some insurances specify Lab Corp for blood draws).DISCLAIMER: If you choose to submit blood work, or pap testing through your insurance, please know that we do not have the ability to know if it will be covered or not. Patients with insurance can call their insurance company ahead of time to check whether lab work/paps/biopsies will be covered, and if so, you need to ask if it needs to be drawn at a specific location. It is your responsibility to know your insurance coverage, not ours. If lab work will not be covered, or you have a high deductible and assume that it won’t, you have the option of paying out-of-pocket. I haven’t had any blood work done, but I do NOT have insurance. What do I do? If you do not have insurance, or have a high deductible and wish to pay out-of-pocket for blood work, you can have blood work done at our office. We have very low prices, however we do charge a $5 blood draw fee. You can complete this ahead of time, or at the time of visit. Please check with our staff to see if you need to be fasting or not. Can you send my pap or biopsies through my insurance? Yes, we can. We just need a copy of your insurance card to do so. Can you order tests at outside facilities that I need done (like mammograms, DEXA scans, colonoscopies, etc)? Yes, as long as you don’t have Medicaid. These patients can opt to pay out of pocket for services as long as they understand that they can choose to go to a Medicare or Medicaid provider to have tests done through their government insurance. We cannot use Medicaid to pay for blood work, but patients can pay out of pocket for tests they wish to have run with us.

What does a visit with Dr. Poppy cost?

  • Wellness Appt with no hormonal concerns, with or without Pap, $250
  • Initial hormone evaluation, 1 hour visit (specific hormonal or health issues that need to be addressed) without saliva results: $300
  • Initial hormone evaluation, 1 hour visit with saliva results: $350
  • 3-6-9 month follow-up appts, $125
  • Annual Hormone Appts for Existing Appts, $200.
  • Extras: Lab fees (blood work, pap smears, biopsies) are extra and can be billed to your insurance if you have it. If you have hormonal problems, and do not have hormonal testing before your initial visit, you will most likely be asked to complete hormone testing, which will require a follow-up visit to go over the results. The cost: $125-150.
Do you accept insurance? No, we do not accept insurance. We are a fee-for-service office. In other words, we charge a specific fee for a specific service.

Initial Prices

  • Initial Hormone Consultation without Saliva Results: $300 for one hour consultation
  • Initial Hormone Consultation with Saliva Results: $350 for one hour consultation
  • Follow-up Appointment for Saliva Results: $125 for half hour
  • Follow-up Appointment for Exam/Pap/Biopsy/IUD Removal/Diaphragm Fitting (if within 3-6 months of last appointment): $125 for half hour
  • Follow-up Appointment for Saliva and Blood Work Results: $150 for one hour
  • 3-9 month visits/phone consults $125
  • 10-12 month follow up/Annual Hormone Appt $200
  • Annual Hormone and Wellness: $150 for one hour
  • Buddy Package: Two people who make the appointment together each get $50 off their regular price.
  • Urinalysis/Pregnancy Test $10
This seems like a lot of money to see Dr. Poppy. Why does she charge so much? Compared to most specialty clinics, and anti-aging doctors who specialize in Bioidential Hormones and Wellness, Dr. Poppy’s prices are very reasonable. We invite you to research and compare. Most people come to Dr. Poppy because they want an in-depth approach toward healing. They desire expert help problem solving their hormonal and medical issues. They also want someone who will take the time to listen and preform detailed testing and evaluation. In this age of managed care and Obamacare, doctors are under more and more pressure to see more and more patients, for less and less time. Many patients have complex issues that require time and effort to sort out. When Dr. Poppy took insurance she felt that same pressure to see more patients, because insurance companies would not reimburse her for her time. She chose to step away from the insurance model, because she wanted to spend more time with her patients, and help them get to the root causes of their issues. Many people are happy and willing to pay for someone to partner with them in their healthcare, and choose to make an investment in their health and wellbeing. How do I pay for my visit? We accept cash, checks, credit cards, debit cards, Health Savings Account Cards and Flex Spend Cards. Do you accept payment plans? Yes we do. We require at least $100 at the time of the appointment. Approval for an automatic recurring monthly payment (until your bill is paid) from your check, savings, credit or debit card must be set up at the time of your visit. A follow-up appointment can’t be made until the initial visit is paid off. Can I get reimbursed from my insurance or cost-sharing organization? We are happy to provide you with an itemized bill and receipt for your insurance or cost-sharing organization. Due to the increasing complexity and time required to navigate ICD-10, we are no longer providing HICFA insurance reimbursement forms. We will provide diagnoses for cost-sharing organizations if requested.

Supplements and Thyroid Conditions

Will Dr. Poppy tell me what supplements I should take? She will generally make supplement recommendations, after a full review of your history, as well as you saliva and blood work results. Does Dr. Poppy deal with thyroid problems? Yes. She is very comfortable treating most common thyroid conditions. She uses specialized iodine and thyroid testing, as well as a variety of thyroid medications.

Miscellaneous Questions

Does Dr. Poppy do phone consultations? Dr. Poppy can do phone consultations for patients that live at a distance, or in another state. If a patient lives in a state where Dr. Poppy does not have a medical license, the patient has to come to see her face-to-face for a consultation, the patient has to come see her in person for a face-to-face visit at least once a year. Dr. Poppy can do a phone consultation for a patient that lives out of state, however she can not prescribe medications unless the patient comes for a face-to-face visit. Dr. Poppy does have many patients that travel from out of state to see her. Can Dr. Poppy be my primary care doctor? Dr. Poppy is an Obstetrician/Gynecologist and a Hormone Specialist. We do offer a direct primary care option. Please see the direct primary care tab for more information. Can you refer me to another specialist if I need one? Of course! Does Dr. Poppy see men? Yes. She sees men for hormonal conditions, as long as they have a primary care provider for their other medical needs. Does Dr. Poppy see kids? Not usually. She will see girls, as long as they are having a period, or unless they have a specific hormonal or gynecological issue. How do I find out more about Dr. Poppy? You can follow Dr. Poppy on Facebook at Dr. Poppy and on Twitter, Instagram, Pinterest @drpoppybhrt. Dr Poppy also has a weekly radio show, every Sunday between 5-6pm CST on www.KSGF.com. You can listen locally at 104.1 FM in Springfield or live-streaming on the internet or via the KSGF App. You can also download the podcasts of the show. Dr. Poppy’s past shows are archived at www.KSGF.com.