Online Menopause & Perimenopause Services
Our Services
For too many women, menopause turns into a part-time job: researching symptoms, chasing appointments, sorting through conflicting advice, trying to connect the dots alone.
We bring the whole thing back into one place: expert care, straight answers, and a plan built around your body and your life.
More time with your doctor
Room to ask questions, weigh options, and build a plan, without feeling rushed.
Personalized treatment plans
Expert care without the referrals, waiting rooms, and extra steps.
Online, done right
Specialized menopause care from the comfort of home.
Menopause expertise
A board-certified OB/GYN and Menopause Society Certified Practitioner (MSCP) focused exclusively on perimenopause and menopause.
Ongoing support
Single-visit or membership options for continuity.
MORE TIME WITH YOUR DOCTOR · MENOPAUSE EXPERTISE · PERSONALIZED TREATMENT PLANS · ONLINE CARE · ONGOING SUPPORT
What We Treat
Perimenopause & Menopause Consultations
Whether you’re wondering if what you’re feeling is hormonal or you’ve already been diagnosed, this is where we start.
Menopausal Hormone Therapy (MHT/HRT)
Evaluation and management of estrogen, progesterone, and testosterone where appropriate, at doses individualized to you, not an average patient. We follow the evidence and take a current, individualized approach rather than a rigid one, and we'll explain what "bioidentical" does and doesn't mean so you can make an informed choice. We build your plan one step at a time, starting with the foundation and layering in the next piece only when it's right for you, so we always know what's working.
Non-Hormonal Options
For women who can’t take hormones or prefer not to, including newer FDA-approved medications, plus evidence-based sleep and lifestyle strategies.
Symptom Management & Personalized Treatment Plans
Hot flashes, night sweats, sleep, brain fog, mood, weight and metabolic changes, joint aches, and fatigue.
Sexual & Vaginal Health
Vaginal dryness, painful sex, and recurrent UTIs related to menopause, including options like local vaginal estrogen. Directly and discreetly.
Weight & Metabolic Health
The weight that settled around your middle and stopped responding to everything that used to work isn’t a willpower problem; it’s a metabolic shift that comes with this stage of life. We treat it as one, looking at hormones, sleep, muscle, nutrition, and metabolic health together and discussing medication when it’s clinically appropriate and right for you.
Sleep, Nutrition & Movement
Woven into your ongoing care, not crammed into one rushed visit. The healthspan work that’s the whole point.
Evidence-Based Lab Work
The right tests, ordered thoughtfully and explained clearly. We don’t order labs at random, and we don’t profit from them.
Ongoing Care & Follow-Up
Follow-ups, adjustments, and a clinician who already knows your story.
Not Sure Where to Start?
You don’t need all the answers before you book. Bring your questions and we’ll take it from there. The ones we hear most:
Yes, it could be. Perimenopause can affect more than your period. Changes in sleep, mood, energy, concentration, temperature regulation, vaginal health, and menstrual cycles can all occur during the menopause transition. Because these symptoms can overlap with other health concerns, we look at the full picture, not just one symptom, to understand what may be happening.
Not necessarily. Perimenopause most often begins in the 40s, but symptoms can start earlier. If your periods, sleep, mood, temperature regulation, or other symptoms have changed, age alone shouldn’t keep you from asking questions. For women under 45—particularly under 40—your clinician may also consider testing or other causes depending on your symptoms and history
Yes. Normal hormone labs do not necessarily rule out perimenopause. Hormone levels can fluctuate significantly during the menopause transition, so a single blood test may not capture what’s happening over time. Perimenopause is often identified by your age, symptoms, menstrual changes, and medical history rather than hormone testing alone.
Hormone therapy may be an option if menopause symptoms are affecting your quality of life, but the decision is individual. It is one of the most effective treatments for symptoms such as hot flashes and night sweats, and for many healthy women who begin treatment before age 60 or within 10 years of menopause, the benefits may outweigh the risks. Your symptoms, health history, risk factors, and preferences all help determine whether hormone therapy is appropriate for you.
Hormonal changes during perimenopause can affect how you feel physically, mentally, and emotionally. Changes in sleep, mood, concentration, energy, menstrual cycles, and other symptoms can add up, sometimes making you feel noticeably different from your usual self. These symptoms deserve to be taken seriously, and an evaluation can help determine whether perimenopause or something else is contributing.
HOW CARE WORKS HERE
Your first visit, and what comes after
Initial Visit
A 60-minute first visit: your full history, the hormone-therapy risk-and-benefit conversation, baseline labs ordered, your plan, and when it's right for you, your treatment started that day, including up to a three-month supply to get you going.
Your consult stands on its own, and if you continue, it covers your first month of membership.
And if I’m not the right fit for you, I’ll tell you, and point you toward who is, so this visit is never a waste.
$495
Your Membership Includes:
Ongoing Prescription Management
Your hormone therapy and related prescriptions are managed, adjusted, and renewed as part of your care, and sent to your pharmacy. (You pay for the medications themselves through your own pharmacy or insurance; we provide the management.)
Visits on a Clinical Cadence
About every two months while we optimize your treatment, roughly three visits over your first six months, easing to about every six months once you’re steady. Real follow-up appointments, never rushed.
Secure Messaging Between Visits
Reach your clinicians with questions about doses, side effects, and adjustments, with replies within two business days.
The Whole-Person Work, One Piece at a Time.
Hormones are the start, not the finish. Across your visits we go deep on the things that actually shape your long-term health, your sleep, your nutrition, your movement and strength, your weight and metabolism, one focused topic at a time, so each gets real attention instead of a rushed mention. And it’s built around you: if your sleep is already solid, we spend that time where you actually need it.
Continuity
A clinician who already knows your whole story, so you never start over.
Priority scheduling
Members get first access to the calendar.
About
The TelePause is a physician-led online practice specializing exclusively in perimenopause and menopause care, founded by Dr. Siân West, a board-certified OB/GYN, osteopathic physician, and Menopause Society Certified Practitioner (MSCP). Practicing a direct, cash-pay model, The TelePause offers a comprehensive first consult and an ongoing membership that covers visits, menopausal hormone therapy (MHT) evaluation and management, non-hormonal options, lab ordering and interpretation, and personalized care for sleep, nutrition, and long-term health, all through secure online visits in Michigan, with California coming soon.