Menopause is a point in time 12 months after a women's final menstrual period. The years leading up to that point is perimenopause - when women may have changes in their monthly cycles, hot flashes, bone pain, insomnia, increased anxiety and other symptoms. The perimenopause can begin up to 10 years prior to menopause - which typically occurs between the ages of 45-55.

• No. Menopause is defined as your final menstrual period with no menstrual bleeding for 12 months.

• Natural Menopause occurs between the ages of 45-55; Surgical Menopause can happen at any age when the ovaries are removed.

• If you are younger than 40 years old, and are no longer having your period and have not had surgery, then labs are indicated to determine the cause.

• There are many other reasons labs may be indicated such as anemia due to heavy bleeding, changes in mood, weight, sleep and joint pain.

YES. Together, you and your doctor will discuss your symptoms and goals. They are knowledgeable in the various hormone therapy options, including creams, gels, oral hormones, patches, vaginal rings, and other options as applicable to you. They can prescribe estrogen, progesterone, and testosterone therapy. They does not recommend pellet implantation of any kind.

• No. There are several non-hormonal prescription medications available. Your doctor can discuss the use of gabapentin, SSRI, SNRI, fezolinetant, and oxybutynin.

• There are many supplements on the market such as magnesium, black cohosh, pollen extract (Relizen), ammonium succinate (Amberen), and more. There is limited scientific data to support this use of supplements, however, some people do get relief.

• There are other options such as cognitive behavioral therapy and clinical hypnosis to reduce the destress from hot flashes. Some have found acupuncture helpful.

Depending on your personal story labs may be indicated:

• Thyroid labs – to check for underlying thyroid issues.

• Cholesterol labs – depending on your personal and family history.

• Complete metabolic profile and complete blood count – if not done in the last year to check on kidney, liver, and blood status.

• Hormone levels are rarely indicated, unless on testosterone or under the age of 40.

3 out of 4 women experience hot flashes, which often start in perimenopause and continue several years after the final menstrual period (menopause).

Hot flashes are a sudden feeling of heat in the upper part of your body, face and neck which can cause redness and heavy sweating. When the wave passes, you may experience intense cold chills.

- Cardiovascular Health - blood pressure, risk of stroke, heart attacks

- Bone Health - osteoporosis or thinning of the bones

- Sexual Health

- Libido

- Vulva and vaginal dryness

- Urinary incontinence

- Weight

- Sleep

- Emotional health - increase or new onset anxiety, depression

- and more

NO Our doctors will not be acting as your primary care physician; They are happy to partner with your physician. They will provide you with a list of recommended screening tests depending on your current health status. You can take this list to your next primary care appointment, or if your insurance allows, they can assist you with referrals.

NO. We are out of network with all insurance providers, including Medicare or Medicaid. Upon request, we can provide a superbill for you to submit to your insurance. Depending on your plan you may be able to get reimbursed some of the cost. Please look at the back of your insurance card and call the members or customer service line to ask if you have out of network benefits. We do not make any guarantees of any insurance reimbursement. Our cost is $450 for up to 60 minute new patient appointment, $250 for up to 30 minute follow up, and $300 for yearly check ins. We cannot see patients who have Medicare or Medicaid as part of their insurance.

Dr Busch is able to see patients who have Medicare, they will need to sign an "opt out" contract. This means those with Medicare will sign a private contract with Dr Busch agreeing to pay directly for services and cannot seek reimbursement from Medicare. They agree that they will not submit any invoice to Medicare as Dr Busch is not a Medicare contracted physician.

We are not able to see patients who have Medicaid. This includes all Managed Medicare and AppleCare product, etc.

You will be asked to sign our financial policy certifying that you do not have Medicare or Medicaid. (IF you have Medicare you will sign an opt out contract).

Dr Ellingson cannot see Medicare or Medicaid patients.

Click here to schedule a new patient appointment, a credit card is required and there is a $150 deposit which will be applied to your appointment. If you cancel prior to 48 hours your deposit will be refunded.

YES. We provide care onsite or via telehealth through your Charm Health Portal

Occasionally, your doctor will request you come into the office for a visit if your concerns need to be seen and examined. If you are looking for telehealth and there are no appointments listed in the schedule please contact the clinic.

YES. You can submit your HSA or FSA card to have on file. We can provide a detailed receipt called a "superbill" for you to keep for your records. Receipts can also be found in your Charm Patient Portal. Please check with your tax accountant for more details.

While we do not provide any on-call or after hour services, your doctor is available via the patient portal for non-urgent questions. If you are having an emergency - like heavy bleeding, chest pain, shortness of breath or other critical issue please go to your nearest urgent care center or emergency room. E-visits may result in a follow up visit charge of $100.

The OASH (Office of the Assistant Secretary of Health) Office of Women's Health webpage about menopause.

The Menopause Society, formerly known as North America Menopause Society, is an amazing resource for evidence based information. Their website is https://www.menopause.org/for-women