Alisha Ghajar is a naturopathic doctor who sees women in perimenopause and menopause from an office in Seattle, and by video for anyone living in Washington. Washington lets naturopaths prescribe, and she does prescribe hormone therapy, though she also runs a hormone-free track of food, movement, stress work and herbs for women who cannot or would rather not use hormones. First visits run 60 to 90 minutes, and you fill out long health questionnaires and upload past lab results before you come in. Once a woman is past menopause she shifts the focus to long-term risk, naming osteoporosis, heart disease and type 2 diabetes as what she wants to head off. Weight and body composition are a large part of the practice, and she will use weight-loss medication when nutrition and training are not enough. She does not work as a primary care doctor and asks every patient to keep their own PCP for anything outside her focus.
Lumina is a West Seattle clinic that mixes vascular care, lasers and skin work with a menopause program. Stacy sees menopause patients virtually and starts everyone with a short free phone call before the paid intake, which covers two or three visits, a full history and symptom review, and referrals for labs and diagnostic testing. That intake ends with a hormone therapy plan, and later follow ups by video or phone are included at no extra charge. She has been a labor and delivery nurse at a Washington hospital since 2005 and says her own perimenopause is what pushed her into midlife care. She is a registered nurse rather than a prescriber, and the clinic owner, a nurse practitioner, is the other certified menopause provider on the team. The menopause page spends most of its space arguing that the early reading of the Women's Health Initiative was wrong and that hormone therapy works best started early.
Kate Behning runs a solo gynecology practice in downtown Seattle that she opened after leaving a healthcare corporation over its limits on abortion care. She has held Menopause Society certification since 2013 and follows its guidance closely, so she prescribes standard hormone therapy but not compounded hormones or pellets. Visits happen in her office or virtually by video, phone or portal message. She is not a primary care provider and asks patients to keep one for non-gynecologic care and routine screening labs. A longer menopause consultation can be added to an annual exam but is billed as a separate visit. She describes her style as plain explanations with no upselling of trendy hormone treatments.
A physician-led longevity and performance practice based in Seattle, where the practitioner is medical director. Care begins with an in-person day in the Seattle area for baseline diagnostics, covering over a hundred biomarkers, body composition, cardiorespiratory fitness, continuous glucose monitoring, genomics and multi-cancer screening. It then moves to quarterly labs and structured medical reviews, with follow-ups virtual or in person. A women's track is described for perimenopause, menopause and after, with hormone and metabolic diagnostics and ongoing telehealth support, and physicians provide prescriptions and referrals as clinically appropriate.
Septima is a solo practice in Seattle for perimenopause, menopause and the years after, and Heather Vincent is the only clinician, so every visit is with her. She prescribes menopause hormone therapy and non-hormonal medication, and she does office gynecology such as IUDs, endometrial biopsies and pap smears. First visits run 90 minutes, with a 60 minute option for a tighter schedule or budget, and she prefers the intake in person in case a pelvic exam is needed. Follow-ups work in person or by video from anywhere in Washington, and each visit comes with 20 messages to her and a month of access to her strength training and education library. She spent six years in OB/GYN before opening Septima and works in collaboration with Jodie Wohl MD, a family practice and women's health physician. Bone health is a stated emphasis, which is why strength training instruction comes with every visit, and she holds community gatherings with an outside speaker four times a year.
