Direct Patient Care is a membership-based model that removes insurance barriers and allows you direct access to your clinician. You pay a flat monthly or program fee, which covers your visits, messaging access, and ongoing support. So your care is unrushed, personalized, and free from surprise billing.

We do not bill insurance for our services. However, you can use your insurance for lab work, imaging, or specialty referrals. We can also provide superbills for potential reimbursement, depending on your plan.

Both 6-month plans include two 1-hour evaluation visits, a complete history review, physical and vulvar exam, lab testing and interpretation, InBody body composition testing, and a personalized treatment plan. You’ll also receive multiple follow-up visits and unlimited secure messaging with your clinician.

The Midlife Upgrade includes everything in the Basic plan plus 45-minute follow-ups (instead of 30), medical weight management, intensive lifestyle coaching, and repeated InBody evaluations for progress tracking.

We support women experiencing perimenopause and menopause symptoms such as hot flashes, sleep changes, weight fluctuations, brain fog, mood shifts, libido changes, vaginal dryness, cycle changes, and more. We specialize in connecting symptoms that are often overlooked or dismissed in traditional care.

No. We offer a Second Opinion Visit for women who are not ready for membership but want an expert review of their current treatment plan. This is a one-time, 60-minute comprehensive consultation.

Your initial visit is a full hour and includes a detailed review of your medical, reproductive, menstrual, and family history, a thorough physical exam, labs, an InBody analysis, and a conversation about your goals. Together, we begin building your personalized midlife care plan.

Yes. We offer Precision Endocrine Therapy (HRT/MHT) when appropriate and desired. Hormone therapy is always personalized, evidence-based, and monitored closely across follow-up visits to optimize effectiveness and safety.

Members have unlimited Spruce messaging, allowing you to ask questions, share updates, or request guidance anytime. This helps you feel supported throughout your entire plan, not just during appointments.

We serve women 35+ throughout the Puget Sound region, both locally and from surrounding areas. Our practice is in University Place, and we’re dedicated to supporting women navigating perimenopause, menopause, and midlife transitions.