Naturopathic Doctor · Kitsilano, VancouverMake the most of perimenopause
A normal transition, and a good time to look ahead.
Perimenopause can change your periods, sleep, brain function, mood and energy, sometimes all at once and sometimes barely at all. Together, we'll make sense of what's happening for you and build a plan to help things feel more stable. This is a dynamic time in life, so we shift treatment as you shift.
In person in Kitsilano
Online anywhere in BC
Licensed ND in BC · Prescribing rights
Receipts provided · Transparent fees
What is perimenopause?
Perimenopause is the stretch of years before menopause. Ovulation becomes less regular, and estrogen and progesterone, the two main hormones behind your menstrual cycle, rise and fall less predictably. It usually starts in your mid-40s (sometimes your late 30s) and lasts 4 to 8 years.
Menopause is technically a single point in time, marking 12 consecutive months without a menstrual period. It is confirmed retrospectively, with the final menstrual period marking the onset of menopause. Postmenopause is the time after this point. In Canada, the average age of menopause is approximately 51.
It's a normal stage of life, not an illness. The changes are still real, and you don't have to sort them out on your own.
What changes do people notice?
No two people go through it the same way, and the changes can shift from month to month. Common ones include:
- Periods & cyclesShorter or longer cycles, heavier or lighter periods, skipped months
- Hot flashes & sleepHot flashes and night sweats, trouble falling or staying asleep
- MoodIrritability, anxiety or low mood, and an increase in PMS
- Brain fogLosing words, trouble concentrating. It's very common, and for most people it's mild.
- Energy & body changesLower energy, achy joints and muscles, changes in where you carry weight
- Vaginal & sexual healthVaginal dryness, changes in desire
- Cardiovascular & metabolic changesIncreasing cholesterol, blood sugars and/or insulin resistance
What does making the most of it look like?
To me, it means two things. First, understanding what's going on in your body, so the changes feel less mysterious and you can decide what to do about them.
Second, looking ahead. Bone loss speeds up around menopause, and cholesterol, blood pressure and metabolism tend to change too. So alongside what's bothering you now, we can look at your bone, heart and metabolic health to set you up for the years ahead.
You can't skip perimenopause. You can go through it informed, with a plan that fits your life.
How I approach perimenopause care
Testing when it guides care
Bloodwork I order isn't covered by MSP (though some extended plans cover it), so a test has to be able to change what we do next. Otherwise, what's the point in spending that money?
A plan that fits your life
We talk through your options, including menopausal hormone therapy, then build a plan together around your priorities, schedule, budget and how much change you have room for right now. It may include nutrition, movement, sleep and stress strategies, botanical and/or nutraceutical medicine, and acupuncture.
With care and understanding
Perimenopause often lands when life is at its busiest: work stress, kids, aging parents (hello, sandwich generation), and still wanting to show up and do your best work. I see you.
What to expect
Care usually unfolds over several visits, at your own pace.
- Step 1Up to 60 minutes
Your first visit
We go through your symptoms, history, any labs you already have and what you'd most like to focus on. We aim to start something foundational by the end of it, or at your second visit if we need more information.
- Step 2Usually by visit 2 or 3
Building your plan
Your second visit is up to 45 minutes. We go over any results and build your plan together.
- Step 3Visits 3 to 10+, then ongoing
Track and adjust
You put the plan into practice between visits, and we track what's changing and adjust as perimenopause shifts.
Have labs from other providers? Here's how to find your previous lab records.
A single visit for a quick answer isn't how I approach perimenopause care.
If you're looking for one test or one fix, this probably isn't the right fit, and that's okay.
Is this right for me?
It's likely a good fit if you're in your 40s or early 50s, noticing changes, and want a say in your plan. Already through menopause? Much of this still applies, and you're welcome too.
Not sure? Send me your question before you book in, and I'll point you to the best next step.
Ready to make the most of it?
Your first visit is up to 60 minutes, in person or online. Bring any recent labs and notes on your periods and symptoms.
In person at 415-2184 West Broadway · Online anywhere in BCLicensed ND in BC · Regulated by CCHPBC
Good to know before you book
- Fees
- Fees can be found on the booking page.
- Direct Billing Insurance
- We are not set up for direct billing. Receipts are issued after the visit with all the information necessary for patients to submit to their insurance provider.
- Credit Card
- We require a credit card to be held on file for your appointments. If you are not comfortable leaving a credit card number on file, we cannot book you an appointment.
- Cancellation Policy
- We have a 48-hour cancellation policy. Appointments cancelled with 24 to 48 hours' notice are charged 50% of the visit fee. Appointments cancelled with less than 24 hours' notice, on the day of the visit, or missed are charged the full visit fee.
Frequently asked questions
- Do I need a blood test to know if I'm in perimenopause?
- There isn't a blood test to determine if you are in perimenopause or menopause. It's identified from your age, periods and symptoms because hormone levels swing too much in these years for one test to settle it. I order bloodwork when it will change what we do, like checking for thyroid changes or anemia from heavier periods, or checking baseline cardiometabolic function, which can cause similar symptoms and/or change significantly over this transition.
- Can you help if I'm considering hormone therapy?
- Yes. Menopausal hormone therapy is one of the main options for hot flashes and night sweats, and whether it suits you depends on your age, time since your last period, health history and preferences. We can talk through the benefits, risks and alternatives.
- How many visits will I need?
- Care usually unfolds over several visits. Your plan usually comes together by the second or third, then follow-ups track what's changing and adjust.
- Can I see you online?
- Yes, from anywhere in BC, or in person at my clinic on West Broadway in Kitsilano.
- Is it covered by my extended health plan?
- Receipts are provided after each visit so you can submit them to your extended health plan. Coverage depends on your plan, so check with your provider before you book in.
Still have a question? Send it to me.