Comprehensive evaluation should include complete thyroid panel (not just TSH), fasting insulin and HOMA-IR for insulin resistance assessment, cortisol testing for adrenal dysfunction, sex hormone panel (testosterone, estrogen, progesterone), sleep study if sleep apnea is suspected, medication review for weight-promoting drugs, and psychological evaluation for eating disorders or food addiction
and cases where insurance coverage exists or out-of-pocket costs are financially manageable
Off-label denials (Ozempic for weight loss in a non-diabetic) carry a 20 to 30% internal appeal success rate, jumping to 40 to 50% on external review
What if there was an approach that could profoundly impact sexual health at the neurological level, requiring minimal effort, and often proving more targeted and effective for women facing these challenges, while being cost-effective in the long term