What mental health conditions do you treat?

We treat adults 18 and over for anxiety, depression, ADHD, OCD, perimenopausal and postpartum mood changes, trauma-related symptoms, sleep issues, and burnout.

Do you offer therapy or just medication management?

We offer medication management and supportive therapy strategies, and we collaborate with therapists when needed.

Do you prescribe stimulants for ADHD?

Yes. Stimulants may be prescribed after a comprehensive evaluation, required testing and screening, and with mandatory safety monitoring.

What insurance do you accept for mental health care?

We accept insurance for mental health visits for Nebraska patients. We are in-network with Aetna, Blue Cross Blue Shield, UnitedHealthcare (including UMR), Midlands Choice, and Nebraska Total Care (Medicaid). Self-pay is $300 initial visit, $150 follow-up. Coverage varies by plan and participation can change; being listed does not guarantee payment.

How soon can I get an appointment?

Most new patients are scheduled within 1 to 2 weeks. Appointments are offered in-person in Papillion or via secure telehealth anywhere in Nebraska.

Do you offer telehealth mental health care outside Nebraska?

Mental health services are currently licensed in Nebraska only. Our other services (medical weight loss, hormone therapy, and online prescriptions) are available via telehealth across 16 states.

Do you continue benzodiazepine prescriptions from other providers?

For patient safety, we do not continue or assume daily benzodiazepine prescriptions initiated elsewhere. Benzodiazepines may be considered short-term when clinically appropriate, while working toward safer long-term options.

Can we address weight loss or hormones during my visit?

Yes, we care about your whole health. During a mental health visit, we may discuss hormones, weight, sleep, or metabolic health if they affect your mood, focus, or well-being. However, medical treatment, prescriptions, or dose changes for weight loss or hormone therapy must be handled through a separate self-pay medical visit, as insurance does not allow those services to be billed under mental health coverage.

Vaginal Estrogen Cream

Local estrogen therapy for menopausal vaginal wellness.

Topical vaginal estrogen minimizes systemic absorption while directly treating dryness, discomfort, and urinary symptoms. FDA-approved estradiol or compounded estriol/DHEA options.

Low Cost

$50

service fee · pharmacy
cost separate

Quick

1–2

business days
clinician review

Easy

appointments
online intake

How It Works

$50 service fee · Insurance may cover estradiol · 16 states · Adults 18+

12-Month Annual Prescription

Pay once for the year. 11 refills included.

$50 one-time clinical fee. Your prescription includes 11 refills for 12 months of treatment. Fill at your preferred pharmacy (medication ~$13/month) — pharmacy cost is separate and paid directly to the pharmacy.

For Comparison

Alloy, Winona, and comparable menopause telehealth services charge $40–$90 per month on recurring subscriptions, totaling $480–$1,000+ per year. Patients commonly save $270–$800/year with us.

Pricing verified against major DTC telehealth providers as of 2026.

What It Treats

Genitourinary syndrome of menopause.

As estrogen levels drop, the vaginal and urinary tissues thin and lose elasticity. Local estrogen therapy restores those tissues directly, with minimal systemic absorption. It addresses symptoms that oral HRT often does not fully resolve.

Vaginal Dryness. The most common menopausal complaint. Local estrogen restores moisture and elasticity within 2–4 weeks.

Painful Intercourse (Dyspareunia). Vaginal thinning makes sex uncomfortable or painful. Local estrogen restores tissue comfort.

Recurrent UTIs. Menopausal urinary changes increase UTI risk. Local estrogen reduces recurrence significantly.

Urinary Urgency & Frequency. The urethra is also estrogen-sensitive. Local therapy often improves urinary symptoms.

Formulations Available

Two proven options.

💧

Estradiol Cream 0.01%

FDA-approved estradiol vaginal cream. 30g tube with three refills. Most insurance plans cover this option with a copay. The standard first-line choice for most patients.

$10–$100/mo with insurance
$13.21/mo cash (Cost Plus)

🌿

Estriol/DHEA Compounded

Custom-compounded estriol 0.5mg + DHEA 5mg/ml cream. Estriol is a gentler, weaker estrogen. DHEA provides local hormonal support with minimal systemic effect. 30g with three refills.

$115 via compounding pharmacy
Not FDA-approved (compounded)

How to Get Your Prescription

Async intake. Clinician review. Prescription sent.

Online Intake

Secure questionnaire covering medical history, menopausal status, medications, and any history of breast cancer or thromboembolic disease. 5–10 minutes.

Clinician Review

Licensed clinician reviews for safety and selects the appropriate formulation. Typically 1–2 business days.

Prescription Sent

Sent to your chosen pharmacy (estradiol) or compounding pharmacy (estriol/DHEA).

Safety & Contraindications

Local vaginal estrogen has minimal systemic absorption and is considered safer than oral estrogen for most patients. However, we do not prescribe if you have a current or recent history of breast cancer, estrogen-sensitive cancer, active thromboembolic disease, or undiagnosed vaginal bleeding without OB-GYN clearance first.

The compounded estriol/DHEA option is not FDA-approved and is prepared by a licensed compounding pharmacy based on individual prescription. Please disclose your full medical history during intake so we can recommend the safest option for you.

Important Safety Information

Before starting vaginal estrogen, please read.

Pregnancy and breastfeeding. Vaginal estrogen therapy is generally not used during pregnancy or breastfeeding. Tell us before starting if you are pregnant, could be pregnant, trying to conceive, or breastfeeding.
Personal and family history. Tell us about any personal history of breast cancer, endometrial cancer, undiagnosed vaginal bleeding, active thromboembolic disorders, liver disease, or known hypersensitivity. We will review whether vaginal estrogen is appropriate for you.
FDA-approved vs. compounded. We offer commercially available, FDA-approved vaginal estradiol formulations (creams, tablets, rings) where clinically appropriate. Compounded vaginal estrogen (for example, certain estriol products) is dispensed by a state-licensed 503A compounding pharmacy based on a patient-specific prescription. Compounded medications are not FDA-approved for specific indications. FDA-approved alternatives are available and will be recommended when appropriate.
Systemic absorption. Vaginal estrogen has much lower systemic absorption than oral or transdermal estrogen, but absorption is not zero. Tell us about any history of estrogen-sensitive cancer or other conditions affected by estrogen.

See our full prescribing and safety terms, including our compounded-medications disclosure.

Common Questions

Vaginal estrogen, answered.

Local vaginal estrogen is applied directly to the vaginal tissues and has minimal systemic absorption. It treats vaginal and urinary symptoms without the full-body effects of oral HRT. Many patients use both for different symptoms.

Most patients notice improvement in dryness and discomfort within 2–4 weeks. Full tissue restoration typically takes 6–12 weeks. Results are maintained with continued use.

Not through our online service. Patients with current or recent estrogen-sensitive cancer require in-person specialty care with oncology coordination. Please discuss local estrogen options with your oncologist.

Estradiol is the strongest naturally occurring estrogen and is FDA-approved for vaginal use. Estriol is a weaker estrogen and is typically used in compounded formulations. We help you choose the best option based on your history and preferences.

Estradiol (FDA-approved) is typically covered with a copay. Compounded estriol/DHEA cream is typically not covered by insurance. Our $50 service fee is separate.

Ready to address
menopausal symptoms?

$50 service fee. Clinician-reviewed. Insurance may cover the medication. Available in 16 states.

131 N Washington St, Suite A · Papillion, NE 68046 · Info@midwestmindandbodyhealthcare.com

Please do not send protected health information (PHI) by email. For secure communication about your care, use our patient portal after booking.

If you are experiencing a mental health crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911.