For most healthy women, yes. The fear you may be carrying is usually bigger than the actual risk. A lot of it traces back to a single 2002 study that was widely misreported, and we've learned a great deal in the twenty years since. The honest answer is that "safe" isn't one-size-fits-all: it depends on your history, your risks, and your goals. My job is to give you the real evidence, tell you where I think it points for you specifically, and then make the decision together. I take a current, individualized approach rather than a rigid one. If a therapy is appropriate and safe for your situation and it's something you want, I'm not going to withhold it because a guideline is written for the average patient instead of you.

Yes, when it’s right for you. We prescribe evidence-based menopausal hormone therapy (MHT) at personalized doses: estrogen, progesterone, and testosterone when it fits your situation. What we don’t do is push it on you or hand it over without a conversation. You’ll understand the options and the reasoning before anything goes to your pharmacy.

Then we don’t use them. Hormones aren’t the only path, and they’re not right for everyone. We offer evidence-based non-hormonal treatments for symptoms like hot flashes and night sweats, including newer FDA-approved medications, alongside real work on sleep, nutrition, and the daily habits that move the needle. Your care, your call.

Very often, yes. This is one of the most common ways women get sent home without answers. Hormone levels swing dramatically from day to day in perimenopause, so a single “normal” result can completely miss what’s happening. We diagnose from your full symptom picture and your history, not one lab value on one day.

Probably not. Perimenopause usually begins in the early-to-mid 40s, and for some women, in their 30s. If your cycles or your symptoms are changing and something feels off, that’s worth a real conversation, whatever your age. “Too young” is one of the most common things women are told right before they’re dismissed.

Perimenopause is the lead-up: the years when your hormones start fluctuating and symptoms often begin, sometimes while your periods are still regular. Menopause is the point you’ve reached after twelve full months without a period. Most of the hardest, most confusing symptoms actually happen in perimenopause, before anything “official” has changed.

You're exactly who we built this for. Being dismissed is not a diagnosis, and "you're just getting older" is not an answer. If you've been told it's stress, that you're too young, or that your labs are normal, and you still don't feel like yourself, we take the time to look at the whole picture and explain what may have been skipped past. You're not starting over, and you will not be dismissed again. You're finally getting the appointment you needed the first time.

You start with a 60-minute consult: your full history, baseline labs ordered, and a plan you understand. If you want ongoing care, you continue as a member. Membership covers your follow-up visits (about every two months while we optimize, then about every six once you’re steady), prescription management, lab ordering and interpretation, secure messaging between visits, and the longer-term work on your hormones, sleep, nutrition, weight, and overall health. You pay for the medications and labs themselves through your own pharmacy and insurance; what membership provides is the medical management. The consult is the front door; membership is how we stay in it together.

No. If a prescription is the right next step for you, you'll leave your consult with that treatment started and up to a three-month supply, whether that's hormone therapy or a non-hormonal option, no membership required. And if the right next step is something else, like labs, lifestyle changes, or simply a clear plan, you'll leave with that instead. Membership is for what comes after: keeping your treatment managed, adjusted, and refilled over time, with labs, follow-ups, and direct access to your clinician between visits. The consult gets you started; membership keeps you going.

You meet your clinician face-to-face by secure video. No waiting room, no driving across town. She reviews your history and symptoms, talks through your options (including hormone therapy when it’s appropriate), orders any labs you need, and sends prescriptions straight to your pharmacy. For this kind of care, video isn’t a downgrade; it’s often more time and attention than you’d get in person.

The consult is $495 (a 60-minute first visit), and membership is $250/month. No insurance billing, no surprise codes, no mystery bills after the fact. You always know what you’re paying.

Because that’s honestly how long great optimization takes. We start with estrogen and progesterone, then add testosterone when it’s right for you, and testosterone alone can take up to six months to show its full effect. The commitment isn’t a contract for its own sake; it’s the real timeline for getting your treatment dialed in and actually feeling the difference. We’d rather tell you that up front than have you judge your results at halftime. After six months, membership is month-to-month.

Your prescriptions, lab support, and messaging between visits are part of being an active member; they’re the ongoing care, not one-time purchases. So if you pause or cancel, those pause too. And whenever you’re ready to come back, we’ll pick up where we left off with a brief re-establishment visit. No guilt, no hassle.

No. Membership is not health insurance and not a substitute for it. It’s a direct agreement between you and your clinician for the care described above, you pay for any services outside that directly, and we recommend keeping your own insurance for everything beyond our practice.

No, and that’s a deliberate choice, not a limitation. Billing insurance is exactly what forces the seven-minute visit and the rotating cast of clinicians. Working directly with you is what buys back the time, the access, and the continuity. We’d recommend keeping your insurance for care outside our practice.

Yes. We’re not a replacement for it. Keep your coverage for everything outside our practice: emergencies, hospitalizations, imaging, specialists, your prescriptions, and lab fees. Think of us as a better way to reach your menopause specialist, not a substitute for comprehensive insurance.

Possibly. It depends on your specific plan and how it treats medical visits and membership fees. We’d suggest checking with your plan administrator before counting on it.

Right now, Michigan, with California coming soon. Telehealth licensing works state by state, so a clinician has to be licensed where you are. This list is the definitive answer to whether we can see you, and we’re always expanding. If we’re not in your state yet, add it to the waitlist and you’ll be the first to know when we arrive.Join Waitlist

You see the same board-certified OB/GYN every visit: a real clinician who knows your story, not a rotating panel and not a questionnaire that spits out a generic protocol. You get more time, a peri-menopause or menopause-only focus, and care that goes past quieting symptoms into protecting your long-term health.

Nope. You can book directly with us. No gatekeeping, no waiting on someone else to decide if you deserve the care you need.

A Menopause Society Certified Practitioner has passed The Menopause Society’s competency exam in menopause medicine, specialized expertise held by only a small share of clinicians.Dr. West is MSCP-certified.

A conversation that isn’t rushed. We take time to talk through your history, symptoms, and goals, then map out a clear plan and next steps.