All presentations
Patient Briefing · Preparation

Let's set up this session.

Enter the patient's name to personalise their welcome screen. The name and date are also stamped onto the PDF you can export for the chart.

Patient Briefing · 2026 · Barrie, ON
ORIENTATION PRESENTATION

Menopause & Perimenopause Foundation Program

Women's hormone care with a provider who listens, tests thoroughly, and builds a plan that fits.

Led by
Nurse Practitioner
Initial visit
60-min consultation
Outcomes
Symptom relief
Woman, mid-life, looking serene
Optimal · Barrie
WHY WE BUILT THIS PROGRAM

Most women going through perimenopause
are under-served.

In a typical Ontario primary-care setting, hormonal symptoms rarely get the time, testing, or follow-up they need.

10–15
Minutes per visit

Average Ontario family-physician appointment — not enough time to explore hormonal symptoms properly.

Ontario College of Family Physicians, 2023

73%
Of women surveyed

Report that their menopause symptoms were dismissed or not taken seriously by their doctor.

The Menopause Society National Survey, 2023

2+ yrs
Average wait

Women often wait over two years before receiving evidence-based hormone assessment and treatment.

SOGC Menopause Guidelines, 2021

02 / 16Foundation Program: Menopause & Perimenopause Care
WHAT'S DRIVING YOUR SYMPTOMS

The biology behind your symptoms.

Five hormones work in concert. When one or more shift — as they naturally do through perimenopause — the effects ripple across your whole wellbeing.

SYMPTOMS HORMONAL DRIVER Hot flashes night sweats Brain fog poor memory Mood shifts anxiety Sleep disruption Weight changes Low libido vaginal dryness Fatigue Muscle loss bone density Estrogen ↓ Declining through perimenopause Progesterone ↓ Often the first hormone to drop Testosterone ↓ Declines with age & stress Thyroid (T3/T4) Often missed on standard panels Cortisol ↑ Elevated by chronic stress
Estrogen ↓
Declining — the primary driver of menopausal symptoms
Progesterone ↓
Often the first to drop — affects sleep & mood
Testosterone ↓
Declines with age & stress — yet rarely tested
Thyroid (T3/T4)
Often missed on standard panels
Cortisol ↑
Elevated by chronic stress — disrupts the rest
Sources: NAMS 2022 Hormone Therapy Position Statement · Endocrine Society Clinical Practice Guidelines · ACOG Practice Bulletin on Menopausal Hormone Therapy
03 / 16Foundation Program: Menopause & Perimenopause Care
Is this protocol right for you?

This protocol could be for you
if you recognise yourself here.

  • You're perimenopausal or within 10 years of menopause (on the upper bound).
  • You have symptoms — hot flashes, poor sleep, brain fog, mood shifts, or low libido.
  • Your family doctor hasn't had time to fully explore your hormones.
  • You want a personalized protocol backed by proper testing.
  • You haven't yet reached menopause, or are within the first 10 years of menopause.

Common symptoms we address

8 areas
Vasomotor
  • Hot flashes
  • Night sweats
Sleep & Mood
  • Sleep disruption
  • Mood & anxiety shifts
  • Low energy & fatigue
Cognitive
  • Brain fog
  • Memory changes
Sexual & Genitourinary
  • Low libido
  • Vaginal dryness
Metabolic & Cycle
  • Weight changes
  • Irregular periods
04 / 16Foundation Program: Menopause & Perimenopause Care
The fuller symptom picture

Many symptoms aren't widely
recognised as hormonal.

The symptoms no one warns you about

7 categories · 29 symptoms
Vasomotor & Cardiac
  • Heart palpitations
  • Cold flashes & chills
  • Temperature intolerance
Musculoskeletal
  • Joint aches & stiffness
  • Muscle loss & weakness
  • Bone density loss
  • Frozen shoulder
  • Plantar heel pain
Genitourinary
  • Urinary urgency & frequency
  • Recurrent UTIs
  • Pelvic floor weakness
  • Vulvar burning & irritation
Skin, Hair & Nails
  • Skin dryness & thinning
  • Hair thinning
  • Skin crawling & itching
  • Brittle nails
  • Unwanted facial hair
Oral, Eye & Sensory
  • Burning mouth
  • Gum & dental changes
  • Dry eyes
  • Tinnitus
  • Dizziness & vertigo
Neurological
  • Migraine pattern changes
  • Electric shock sensations
  • Restless legs
Metabolic & Digestive
  • Rising cholesterol & ApoB
  • Insulin resistance
  • Visceral fat redistribution
  • Bloating & digestive changes

All mapped to validated instruments (Menopause Rating Scale, Greene Climacteric Scale), Menopause Society position statements (GSM 2020), and Wright et al., Climacteric 2024 (musculoskeletal syndrome of menopause).

05 / 16Foundation Program: Menopause & Perimenopause Care
Your 6-step journey

What happens, and when.

At your onboarding visit

InBody scan.

A 60-second body composition scan: muscle mass, body fat %, visceral fat, and hydration levels— repeated at follow-up to track your body composition over time.

60 sec
Step 02
Repeated at follow-up
InBody body composition scanner
Medical-grade
The full path · 6 steps
Step 01
Initial phone call
Care coordinator reviews your history and confirms candidacy.
15 min
Step 02 · Featured
Onboarding visit
Protocol orientation, InBody scan, bloodwork requisition.
In-clinic
Step 03
Bloodwork
Comprehensive panel at LifeLabs or Dynacare (OHIP covered).
Off-site
Step 04
60-min NP consultation
Results review, personalized plan & prescriptions.
60 min
Step 05
Follow-up #1
Symptom check, dose review, adjustments as needed.
30 min
Step 06
Follow-up #2
InBody repeat, treatment review, 1-yr Rx renewal & annual plan.
Annual
06 / 16Foundation Program: Menopause & Perimenopause Care
Your care team

The people looking after you.

Chantelle Oostwoud, MN, PHC-NP
Chantelle Oostwoud
MN, PHC-NP · Our Clinician
  • Your dedicated clinician for this program
  • Master of Nursing, Athabasca University
  • A decade in emergency, critical & remote care
  • Small panel — more time, more answers
Cheryl Cairns, Care Coordinator
Cheryl Cairns
Care Coordinator
  • The first person most members meet
  • Onboarding & care navigation
  • Coordinates your consults and follow-ups
  • Your first call for scheduling & results
07 / 16Foundation Program: Menopause & Perimenopause Care
Lab work & optional add-ons

Your panel is OHIP-covered, with two
add-ons worth considering.

Optional add-ons
SHBG
$69
Sex-hormone binding globulin

SHBG controls how much of your testosterone and estradiol is biologically active, so measuring it lets us calculate free (bioavailable) hormone levels — a more accurate read than total hormones alone.

Vitamin D
$54
25-Hydroxy

Low vitamin D is a common, correctable driver of fatigue, low mood and musculoskeletal aches that overlap with menopausal symptoms — so testing separates a treatable deficiency from hormone-driven complaints.

Both are uninsured and paid directly at LifeLabs or Dynacare.

Your complete lab panel

29 tests · 8 systems
Hormones
  • Estradiol
  • Progesterone
  • FSH
  • LH
  • Free & Total Testosterone
  • DHEAS
  • Cortisol AM
  • SHBG
Thyroid
  • TSH
  • Free T3
  • Free T4
Metabolic & Glucose
  • Glucose — Fasting
  • HbA1C
  • Insulin (fasting)
Cardiovascular & Lipids
  • Lipid Assessment
Kidney & Electrolytes
  • Creatinine (eGFR)
  • BUN
  • Sodium
  • Potassium
  • Bicarbonate
Liver & Protein
  • ALT
  • Alk. Phosphatase
  • Bilirubin
  • Albumin
  • Total Protein
Iron & Vitamins
  • Ferritin
  • B12
  • Vitamin D (25-OH)
Hematology
  • CBC
Optional add-on (uninsured) — every other test is OHIP-covered.
08 / 16Foundation Program: Menopause & Perimenopause Care
Understanding your options
Foundation

Lifestyle &
Nutraceuticals

  • Evidence-based supplement protocols
  • Nutrition, sleep & movement guidance
  • Stress support strategies
  • Personalized to your labs & symptoms
Core therapy

Menopausal
Hormone Therapy

  • Transdermal estrogen (preferred route)
  • Progesterone (for those with a uterus)
  • Creams, patches, gels, or oral options
  • Evidence-supported — not one-size-fits-all
When indicated

Targeted
Therapies

  • Therapies targeted toward specific issues
  • Testosterone (when clinically indicated)
  • DHEA if adrenal function is low
  • Compounded options when appropriate
Care Coordinator Support

Dedicated, personalized administrative support throughout your care journey.

Secure Patient Portal

Messaging, lab results & treatment-plan delivery via our encrypted system.

Your NP will discuss which options are appropriate based on your labs, symptoms, and full medical history.

09 / 16Foundation Program: Menopause & Perimenopause Care
What treatment can do for you

Evidence-based benefits of
hormone optimization.

"Reduced hot-flash frequency & severity by 70–90% with appropriate MHT."
Outcome benchmark · MHT
Sleep

Improved sleep

Reduced night sweats and improved sleep continuity and quality.

Cognition

Mood & cognition

Improved mood stability, reduced brain fog, better memory and focus.

Skeletal

Bone protection

Reduces risk of osteoporosis and fracture — one of the strongest protective interventions available.

Metabolic

Metabolic health

Improved insulin sensitivity, reduced risk of type-2 diabetes, body-composition support.

Cardiovascular

Cardiovascular health

Started early — within 10 years of menopause — MHT is associated with lower coronary heart disease risk and mortality. New 2026 data: symptomatic women who started early had a 22–27% lower risk of cardiovascular events.

Genitourinary

Genitourinary & sexual health

Relieves vaginal dryness, painful sex, urinary urgency and recurrent UTIs (genitourinary syndrome of menopause).

Cardiovascular benefit reflects the SOGC "timing hypothesis" (Guideline No. 422e) and the 2026 SWAN cohort analysis (Wang et al., JAMA Internal Medicine — observational): it applies to early initiation and is not an indication to use MHT for heart-disease prevention.

10 / 16Foundation Program: Menopause & Perimenopause Care
Safety & risk information

Our safety-first approach.

We prioritize appropriate patient selection, evidence-informed prescribing, and ongoing monitoring. Each hormone — estrogen, progesterone, and testosterone — carries a distinct and manageable risk profile, which your NP reviews with you before any prescription is made.

Hormone 01

Estrogen Therapy (MHT)

Considerations
  • Blood clots
  • Stroke risk varies by age, timing, and health profile
  • Breast tenderness, bloating, nausea, mood changes
  • Without adequate progesterone: endometrial risk
01
Hormone 02

Progesterone / Progestins

Considerations
  • Drowsiness or dizziness (often at bedtime dosing)
  • Mood sensitivity in some patients
  • Breakthrough bleeding or spotting
  • Formulation-dependent cardiovascular effects
02
Hormone 03

Testosterone (if indicated)

Considerations
  • Acne, increased body/facial hair
  • Scalp hair thinning
  • Voice deepening
  • Changes in lipids requiring monitoring
03
11 / 16Foundation Program: Menopause & Perimenopause Care
When to seek urgent care

Call 911 or go to the ER
immediately if you experience:

01

Chest pain, shortness of breath, or coughing blood.

02

One-sided leg swelling or pain.

03

Sudden weakness or numbness, facial droop, severe headache, or speech changes.

04

Severe allergic reaction — swelling, hives, difficulty breathing.

Non-emergency
For any new or concerning symptom while on therapy that isn't an emergency, contact our clinic via secure message and we'll guide you on next steps.
12 / 16Foundation Program: Menopause & Perimenopause Care
Appendix

A couple
of notes.

Two quick housekeeping details before we wrap — purely for expectation-setting. Nothing here needs action today.

Optimal Clinic reception
Optimal Clinic treatment hallway
13 / 16Foundation Program: Menopause & Perimenopause Care
Before your consultation

Certain lab results may put your
consultation on hold.

Occasionally, bloodwork reveals something unrelated that deserves attention first. Here's exactly what happens if it does.

YOUR FOUNDATION PROGRAM YOUR FAMILY PHYSICIAN
Step 1

Results reviewed

Your NP reviews your complete panel first.

Step 2

Incidental finding

Something unrelated needs attention before care begins.

Step 3

NP notifies you

Your NP will give you a quick call to notify you.

Program on hold

Routed to your FP

Your family physician takes over, with a full copy of your results.

Step 5

You return

Resolved — you continue right where you left off.

Prefer a refund?

We provide a pro-rated refund minus $150, covering your bloodwork analysis and initial onboarding.

14 / 16Foundation Program: Menopause & Perimenopause Care
A friendly reminder

Your bloodwork keeps everything on time.

The sooner your labs are done, the sooner your NP can build your plan. Here's how timing works from the day you register.

SWEET SPOT WK 1WK 3WK 4 WK 5WK 6WK 7 $
Day 0 · Registration

You're enrolled

Requisition in hand — LifeLabs or Dynacare, any day that suits.

Weeks 1–2 · Priority

First in line

Labs done in this window mean your NP consult is booked within about a week of your results arriving.

Weeks 2–8

We'll still see you

No problem at all — though one-week scheduling is no longer guaranteed once results arrive.

Week 8

A $100 admin fee applies

If bloodwork isn't complete by week 8, the fee covers re-coordinating your program.

Life gets busy — we understand. Running behind? Call us and we'll keep you on track. (437) 370-0291

15 / 16Foundation Program: Menopause & Perimenopause Care
Pricing & immediate next steps

Let's get you started.

Option A · Pay in full
Best value
One-time payment
$895+ HST
Paid at your onboarding appointment.

Includes all six protocol elements shown today.

OPTION B · MONTHLY INSTALMENTS
New
Spread over three months
$325/ mo × 3
Total $975 + HST · first payment at onboarding.

Same six protocol elements — paid in equal monthly installments.

16 / 16Foundation Program: Menopause & Perimenopause Care