Rheumatologist OnCall

11/12/2025

Menopause isn’t just about hot flashes — it’s a turning point that can tip the scales for autoimmune diseases, making symptoms dramatically worse for many women.

Research shows that hormonal changes at midlife cause immune imbalances, which can trigger painful flares, new diagnoses, or rapid changes in existing conditions like lupus, rheumatoid arthritis, and thyroid disease.

Awareness of this connection is critical in delivering timely, science-based care for women’s health at this stage.

That’s where Dr. Mirela Titianu comes in — a Menopause Society–certified physician who specializes in hormone replacement therapy, menopause, and autoimmune health.
She helps women feel like themselves again — with science-based, compassionate care tailored to your body and your journey.

🌸 Now accepting new patients in California, Florida, and Oregon.

Link to book an appointment in the comments.

11/12/2025

➡️Book a Consultation: https://rheumatologistoncall.com/Are your joints suddenly aching after 40? Do you wake up stiff, sore, and feeling older than your age...

11/11/2025

Could that mysterious brain fog, fatigue, or stubborn joint pain actually be menopause knocking at your door?

Menopause can show up in more ways than you might expect:
hot flashes,
unpredictable night sweats,
mood swings,
insomnia,
heart palpitations,
changes to your skin,
decreased s*x drive, and
Memory loss is just one of the symptoms women may encounter as hormones shift during this natural stage of life.

For some, these changes are subtle; for others, they're surprisingly disruptive and can affect work, relationships, and daily confidence.

If these symptoms sound familiar, know that there are science-backed, compassionate solutions available.

You don't have to navigate menopause alone or in the dark.

Dr. Mirela Titianu is a Menopause Society–certified physician who specializes in hormone replacement therapy, menopause, and autoimmune health.
She joined our team at to help women feel like themselves again!

Now accepting new patients in California, Florida, and Oregon.

Are you ready to feel better?

11/11/2025

What’s the link between Menopause, Autoimmune Disease, and HRT?

When women enter or , their levels drop — and that change does so much more than trigger hot flashes or mood swings.

Estrogen is a powerful regulator, bone protector, and joint stabilizer.
When it declines, the body becomes more vulnerable to and degeneration.

Here’s what research shows:
1️⃣ Immune dysregulation — estrogen keeps inflammation in check; when it drops, diseases like and psoriatic may appear or worsen.
2️⃣ Cartilage loss accelerates, leading to or worsening .
3️⃣ Bone density plunges, causing , especially in women with chronic inflammation.
4️⃣ , pain, and stiffness intensify in women already living with autoimmune arthritis.

Now, here’s the good news ⬇️

The just removed the BLACK BOX warning on Replacement Therapy ( ) — a major step backed by years of new research.

This means: when prescribed safely and individually, can help restore balance, protect your bones and joints, and reduce inflammation during menopause.

For women with , this can be life-changing.

That’s why we’ve created a specialized program for women navigating perimenopause, menopause, and autoimmune disease, led by Dr. Titianu, a board-certified and menopause-certified physician.

💪 It’s time to bring science — and hope — back into the conversation about hormones, menopause, and autoimmune health.

👉 Learn more about our program designed to help you thrive through this stage of life. Link in comments.

11/10/2025

Breaking News for Women’s Health!

The just announced the removal of the BLACK boxed warning from hormone replacement therapy — a label that for 20 years implied increased risk for and .

This is a huge shift in women’s health and care.

Boxed warnings are reserved for the most dangerous medications.

But for low-dose and local ( ) , that label was never scientifically justified.

Now, evidence confirms that vaginal hormones are safe — and incredibly beneficial:

💧 Prevent urinary tract infections, sepsis, and even death
💪 Reduce urinary urgency, frequency, and leakage
❤️ Improve vaginal lubrication, pain with s*x, and s*xual satisfaction
🚫 Have never been shown to cause cancer or blood clots

For women living with or , this update matters even more.

Many of my patients with or autoimmune disease experience early , dryness, urinary issues, and infections — often worsened by their condition or medications.

Now, with this change, we can have a more open and personalized conversation about hormone therapy without unnecessary fear. We offer care to our patients and our menopause certified specialist can help people in 3 US states OR, FL, CA.

The work begins now — to educate clinicians and empower women to understand how and when to use vaginal hormones safely.

Thanks, and , for all your work!

This is the time to bring science and compassion back into menopause care — especially for women with autoimmune diseases.

11/10/2025

Could menopause increase the dementia risk for women with arthritis ?

New ACR #2025 research reveals that early or surgical menopause in nearly doubles the risk of and increases overall .

This is huge!

That is why we at are again one step ahead of the game, offering menopause and counseling and management that helped thousands of patients already.

Our menopause certified expert, Dr. Mirela Titianu, serves patients in OR, FL, and CA.

Our disease , Drs. Diana Girnita and Vishnuteju Devalla serve patients in AL, CA, FL, GA, ID, IL, IN, KY, MD, MI, MN, OH, OK, PA, TX, AZ, WI, MT, and OR.

Book an appointment today and protect your long-term health with expert, compassionate care.

11/09/2025

Do your joints ache more since menopause began?
Are you waking up stiff, sore, and wondering if your autoimmune disease is flaring — or if something else is going on?

You’re not alone.

As estrogen levels drop during perimenopause and menopause, many women experience a “menopausal musculoskeletal syndrome.”
It can cause:
Joint and muscle pain
Morning stiffness
Fatigue
Reduced flexibility

Unfortunately, many women are told, “It’s just aging,” or are given pain medications without addressing the underlying hormonal imbalance that worsens inflammation.

Estrogen plays a vital role in immune regulation. When it drops, the immune system can become unstable — increasing inflammation and aggravating autoimmune symptoms.

That’s why personalized hormone replacement therapy (HRT), when guided by an expert who understands both menopause and autoimmune diseases, can make all the difference.

👩⚕️ Meet Dr. Mirela Titianu -Triple board-certified in Internal Medicine, Obesity Medicine, and Lifestyle Medicine, and certified by The Menopause Society, Dr. Titianu bridges the gap between hormonal and autoimmune health.

11/08/2025

Menopause isn’t just about hormones—it’s about *you.*
Your energy, your confidence, your relationships, and your quality of life.

For too long, women have been told that feeling exhausted, foggy, or dismissed is “just part of getting older.”

Dr. Mirela Titianu knows that’s not true.
Triple board-certified in Internal Medicine, Obesity Medicine, and Lifestyle Medicine, and certified by The Menopause Society, Dr. Titianu is redefining what menopause care should look like—compassionate, evidence-based, and personalized.

She says, “My mission is to walk hand in hand with women through the transformative journey of menopause. I offer more than evidence-based hormone therapy and lifestyle medicine—I provide a partnership rooted in trust, understanding, and care. Together, we break the silence around midlife changes and embrace the vibrant, fulfilling life that awaits.”

Through the Women’s Hormone & Autoimmune Balance Program, Drs. Titianu and Diana Girnita help women with autoimmune diseases.

11/08/2025

Ever had a sudden, excruciating pain in your toe or foot that came out of nowhere?

That might be — one of the most painful yet misunderstood forms of .

In my latest 10-minute video, I explain everything you need to know about gout: what it really is, why it happens even when your uric acid levels are normal, and how you can prevent painful attacks before they start.

We’ll cover:

The real causes and hidden triggers of gout (including diet, alcohol, dehydration, and medications)

What treatments actually work — from NSAIDs and colchicine to allopurinol and pegloticase

If you’ve ever struggled with recurring gout flares or just want to understand this condition better, this video is your complete guide to taking control and feeling better.

https://youtu.be/eXZlBDyNuOA

➡️Book a Consultation: https://rheumatologistoncall.com/Gout is one of the most painful types of arthritis, yet it’s often misunderstood. In this complete gu...

11/08/2025

Big shout out to my new rising fans!

Priyanz Kachari

11/07/2025

Confused about whether your symptoms come from arthritis (RA) or menopause?

You’re not alone.

VA research presented at ACR #2025 shows women with have trouble distinguishing the two—and want more menopause support from their rheumatologists. However, most do not feel prepared for these conversations since they are not trained to address , .

Our clinic is again ahead of the game, with a menopause-certified specialist ready to help our patients.

Drs. Mirela Titianu and Diana Girnita have already helped thousands of patients navigate menopause and autoimmune care with professionalism, expertise, and compassion.

If you feel lost in hormonal transitions and arthritis symptoms, our expert team at Rheumatologist OnCall is ready to help.

Menopause/HRT consults are now available in CA, FL, and OR.

Arthritis and autoimmune disease care in AL, CA, FL, GA, ID, IL, IN, KY, MD, MI, MN, OH, OK, PA, TX, AZ, WI, MT, OR.

Get guidance and personalized support—schedule your telemedicine consult today.