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Monica + Erika

Finally Heard: How Monica Unni and Erika Schilling Built Loop Wellness Clinic Around the Care Traditional Medicine Keeps Skipping

Between the two of them, they’ve logged nearly 50 years in medicine — from emergency rooms and labor and delivery floors to the Navy. Neither of them planned to end up here. Both of them are exactly where they’re supposed to be.

There’s a particular kind of frustration that drives someone to leave a stable career and build something from the ground up. For Monica Unni, it crystallized over nearly 20 years in the emergency room — not because she didn’t love medicine, but because she kept running out of time to actually practice it. The 15-minute window. The in-and-out pace. The pressure to move more patients through the door.

“I was always the lowest performer,” she says with a laugh, “because I always spent more time with the patients.”

That instinct — to stay in the room, to ask another question, to actually understand what was going on with the person in front of her — is what eventually led Monica to open Loop Wellness Clinic in downtown Leesburg. And it’s what continues to define the practice she runs alongside Erika Schilling, a doctorate-level nurse practitioner and midwife whose own path through the Navy, labor and delivery, and women’s health led her to the same conclusion: the people who need the most care are often the ones getting the least of it.

Two Careers That Were Always Pointing Here

Monica spent almost two decades in emergency medicine — starting in a small ER in West Virginia and eventually landing at Inova Loudoun — before she arrived at the fork in the road. The work was demanding and she was good at it, but continuity of care kept calling to her. She wanted to know what happened to people after they left. She wanted to follow the story.

Her path into hormonal management started with a patient encounter in the ER — a woman being treated for something unrelated who mentioned she was managed with pellets, and whose experience stopped Monica in her tracks. She started researching on her own. Eventually, through what she describes as fate, she connected with Dr. James Cannon, a physician in Chesapeake who had built his entire practice around hormone management. What started as a legal question to the Board of Medicine led to an email, a two-and-a-half-hour phone call, and a visit to his practice the following week.

What she saw there settled everything. Patient after patient — men and women, across a wide age range — stepping out of eight-minute appointments wanting to tell her how their lives had changed. The sentiment was nearly universal: why doesn’t my regular doctor offer this? Why didn’t I know this existed?

“That was it,” Monica says. “I knew I would spend the rest of my career doing this.”

Erika came to hormone management through her own body. Moving through perimenopause in her mid-forties, she experienced the full range of what that transition can feel like — mood fluctuations, temperature swings, disrupted sleep, a general sense of being out of sync with herself. Her best friend, who worked at Dr. Cannon’s practice, introduced her to Monica. The connection was immediate, the values aligned, and Erika eventually came on board at Loop — still delivering babies on the side, still fully herself, but with a new professional home that fits her in a way previous clinical environments hadn’t.

“I would love to encourage people down that road,” she says. “Live happy, healthy lives. We absolutely can do that with hormone management.”

What Gets Missed in 15 Minutes

Both Monica and Erika are clear-eyed about why so many patients arrive at Loop feeling like they’ve been overlooked. It isn’t that their previous providers didn’t care. It’s that the structure of insurance-driven medicine makes genuine hormonal care nearly impossible to deliver.

Primary care physicians and gynecologists are typically working with 15-minute windows. Their job is to screen — to make sure nothing dangerous is being missed, not to explore quality-of-life concerns that require time, nuance, and follow-through. Hormonal management sits almost entirely outside what that model can accommodate. Sleep, mood, libido, joint pain, cognitive function, how someone feels in their own body day to day — these aren’t things that get properly addressed in a standard physical.

So patients either don’t bring it up, bring it up and get brushed aside, or get told it’s just part of aging and there’s nothing to be done. Some have been living with symptoms for years by the time they find Loop.

The approach at Loop is almost the inverse of what most patients are used to. The initial consultation starts with 20 to 30 minutes of just listening — letting the patient talk through everything that’s been going on, without an agenda, without rushing toward a prescription. That conversation shapes everything that follows: which hormones make sense, what the realistic expectations are, and sometimes, which concerns fall outside the hormonal picture entirely and need to go somewhere else.

“I’m here to advocate for you,” Monica says. “And that means for the whole person — not just the hormonal piece.”

No One-Size-Fits-All

One of the things both Monica and Erika repeat throughout their conversation is that hormone management is not a standardized protocol you apply uniformly. People metabolize differently. Symptoms shift over time. Life circumstances — stress, sleep, activity level, family dynamics — are all part of the picture. What works for one patient at one stage of life may need to be adjusted six months later.

Loop offers a range of delivery options — topicals, oral medications, pellets, and others — and the conversation about which is right for a given patient depends on lifestyle, preferences, how they tend to respond to things, and how much time they’re realistically willing to commit to a particular method.

For women who have been told for years that perimenopause and menopause symptoms are just something to endure, that range of options can feel genuinely surprising. Monica and Erika hear the fears regularly — concerns about cancer risk, family history of breast cancer, the general anxiety that comes with decades of conflicting information about hormone therapy. Their response is always education first. Understanding what each hormone actually does, what the research shows about safety and benefit, and which concerns are based on outdated information versus which warrant real consideration.

The goal isn’t to push anyone toward treatment before they’re ready. Monica sometimes ends a first consultation by explicitly asking a patient not to make any decisions right away — to go home, process, form questions, and schedule a follow-up call in a week. Most patients, she notes, are ready to move forward immediately. But the option of slowing down is always there, because the practice is designed around the patient’s timeline, not the clinic’s.

The Lab Work, the Whole Person, and the Long Game

Labs are central to how Loop operates. Before Monica or Erika can sit down with a patient and have a meaningful conversation about what’s going on and what might help, they need to see the numbers. That data, interpreted alongside everything a patient has shared about how they’re actually feeling, gives the full picture.

What patients often find surprising is how much time gets spent explaining those results. Not just what the numbers are, but why they look that way, what they indicate, and how any therapy being considered would interact with them. Patients who have never had their labs explained to them before — which turns out to be a large percentage of people — frequently comment on it.

The relationship that develops from that kind of transparency tends to go well beyond the clinical. Erika talks about knowing what’s happening in patients’ families, understanding how a difficult stretch at home is affecting how someone feels on a given visit, being asked questions that fall well outside the scope of the practice but that people feel comfortable asking because the environment invites it. Monica describes her patient days as feeling like seeing friends — connections built over years of three- to six-month visits, checking in on college tours and job changes and life transitions alongside labs and dosage adjustments.

That’s why the patient appreciation events matter. Loop recently hosted one celebrating weight loss clients — a genuine party to mark progress and reconnect with patients whose journeys the team has been part of. It’s not a marketing exercise. It’s a reflection of what the practice actually is.

What Loop Offers

Beyond hormone management, Loop Wellness provides medically supervised weight loss guided by a functional medicine nutritional nurse, Allie Burton, alongside a body composition scale that tracks muscle retention rather than just total weight loss — an important distinction in a space where muscle preservation matters as much as the number on the scale. Peptides, available only through FDA-regulated sources. IV therapies. NAD. Body contouring equipment including the EMSELLA chair for urinary incontinence, which Monica describes as a significant quality-of-life intervention for women who have been managing that issue quietly for years.

The Alexandria satellite office has added a different patient demographic — a faster-paced, business-driven clientele that Monica says she works well with. She describes it as her growing baby. On the horizon: genetic testing and biomarker analysis that would add another layer of personalization to how Loop supports patients as they age.

The thread running through all of it is the same one that runs through everything Monica and Erika do: you deserve to feel good, the information exists to help you get there, and you have options. The work is helping people understand what those options are and making sure they feel confident enough to use them.

Monica Unni and Erika Schilling practice at Loop Wellness Clinic, with locations in downtown Leesburg, Virginia and Old Town Alexandria. Visit loopclinicdmv.com or find them on Instagram and Facebook, or call the clinic to speak with the care team directly.

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