Services

Start Here: Choose Your First Visit

Every experience with perimenopause, menopause, and hormone therapy is different. Your care should be, too.

All new patients begin with one of two initial visits:
a Comprehensive Evaluation or Focused Hormone Assessment.

Both options provide individualized recommendations and a clear plan for moving forward. The right starting point depends on the complexity of your symptoms, your health goals, and the level of evaluation you are seeking.

Which First Visit Is Right for You?

  • Choose the Comprehensive Evaluation if:

    • You have multiple or complex symptoms

    • You want a broad review of your overall health

    • You have cardiometabolic, cardiovascular, thyroid, weight, or other health concerns in addition to hormone symptoms

    • You would like an in-depth evaluation and long-term health strategy

  • Choose the Focused Hormone Assessment if:

    • Your primary concerns are perimenopause, menopause, or hormone therapy

    • You want a focused review of your symptoms and hormone options

    • You are considering starting hormone therapy

    • You are currently using hormone therapy and would like another approach or a more individualized plan

You do not need to have everything figured out before scheduling. Your first visit is where we begin—by listening to your concerns, reviewing your health history, and creating a clear path forward.

  • Option 1: Comprehensive Evaluation

    A whole-person evaluation for women with complex symptoms or multiple health goals.

    Your evaluation is with Stephanie Elder, DNP, MBA, ARNP, AGPCNP-BC

    The Comprehensive Evaluation is designed for women who want an in-depth assessment of their hormone health as well as the broader factors that may be affecting how theu feel.

    During your evaluation, we take a comprehensive look at your symptoms, health history, laboratory results, current medications, lifestyle, and long-term health goals.

    Depending on your individual needs, your evaluation may include a review of:

    • Perimenopause and menopause symptoms

    • Current or previous hormone therapy

    • Cardiometabolic and cardiovascular health

    • Weight, body composition, and insulin resistance

    • Thyroid and adrenal health

    • Sleep, energy, mood, cognition, and sexual health

    • Bone health and healthy aging

    • Nutrition, exercise, and supplement use

    • Relevant laboratory and diagnostic testing

    You will leave with a personalized care plan that addresses your immediate concerns while also supporting your long-term health.

    The Comprehensive Evaluation may be the best starting point for women who have multiple symptoms, more complex medical histories, cardiometabolic concerns, or who want a broad and detailed health assessment.

  • Option 2: Focused Hormone Assessment

    Clarity about your hormones and a personalized plan for what comes next.

    Your initial visit is a 75-minute consultation with Lavonne Searle, ARNP, Menopause Specialist.

    The Focused Hormone Assessment is designed for women whose primary concerns are related to perimenopause, menopause, or hormone therapy.

    The visit includes:

    • An InBody body-composition assessment

    • A conversation about your symptoms, concerns, and goals

    • A focused review of your medical and hormone history

    • Review of relevant laboratory results

    • Education about hormone therapy and other treatment options

    • An individualized care plan based on your needs

    You will leave with a clearer understanding of what may be contributing to your symptoms and a personalized plan—not a one-size-fits-all protocol.

    Focused Hormone Assessment: 75 minutes | $425

    This appointment may be the best fit for women who want a focused evaluation of symptoms such as hot flashes, night sweats, sleep disruption, mood changes, brain fog, low libido, vaginal symptoms, menstrual changes, or concerns about hormone therapy.

What Happens After Your First Visit?

After your initial evaluation, your provider will recommend the level of follow-up support that best fits your treatment plan.

You may choose to enroll in a structured Hormone Optimization Program or continue with individual visits. If you are already on hormones and would like to continue, you would be considered for maintenance sessions.

  • Six-Month Hormone Optimization Programs

    More guidance, closer monitoring, and consistent support

    Hormone Optimization Programs are designed for patients who are beginning hormone therapy, making significant treatment changes, or who would benefit from closer guidance while their bodies adjust.

    Programs begin at $997 and may include:

    • Three to four 45 to 60 minute follow-up visits to ensure your symptoms and progress is addressed

    • Repeat laboratory testing and comprehensive review at approximately three and six months

    • Repeat InBody assessments at approximately three and six months

    • Medication monitoring and treatment adjustments

    • Weekly educational and coaching emails

    • Guidance related to hormone therapy, nutrition, exercise, sleep, stress, and lifestyle habits

    • Ongoing education to help you understand your treatment and actively participate in your care

    • Metabolic, weight loss, and anti-aging support with the Signature and Elite Programs

    This more hands-on approach is designed to help you feel informed, supported, and confident throughout the first six months of treatment.

    Rather than trying to navigate hormone therapy alone, you will have a structured plan, scheduled checkpoints, and guidance as your symptoms and hormone needs evolve.

    Hormone Optimization Programs start at $997.

    Specific program recommendations and pricing will be reviewed with you following your initial appointment.

  • Stand-Alone Hormone Initiation Visits

    For new hormone therapy patients who do not enroll in an optimization program

    Patients who are beginning hormone therapy and choose not to participate in a Hormone Optimization Program may continue with individual follow-up visits.

    Starting hormone therapy often requires closer monitoring during the first several months. Appointment length will be based on the complexity of your symptoms, medication changes, laboratory results, and treatment plan.

    New Hormone Therapy Patient Pricing

    • 30-minute follow-up visit: $275

    • 45-minute follow-up visit: $350

    • 60-minute follow-up visit: $425

    Follow-up appointments are commonly recommended at approximately six weeks, three months, and six months. Your schedule may vary depending on your symptoms, response to treatment, laboratory results, and whether additional medication adjustments are needed.

    Laboratory testing, imaging, prescriptions, medications, and supplements are not included in the individual visit price unless specifically stated.

  • Transition to Maintenance Care

    The first six months of hormone therapy are considered the initiation and optimization phase. During this time, appointments may be more frequent as we evaluate your response, review laboratory results, address side effects, and make treatment adjustments.

    After six months, patients will automatically transition to maintenance-care pricing.

    Maintenance Visit Pricing

    • 30-minute visit: $225

    • 45-minute visit: $285

    • 60-minute visit: $345

    Maintenance care is designed for patients whose treatment plan has stabilized and who no longer require the same level of frequent monitoring or medication adjustment. Also for patients who are new to the clinic and would like to continue their current hormones.

    The frequency of maintenance appointments will depend on your individual needs, medications, laboratory results, and clinical stability. Most patients will continue to have periodic follow-up visits and laboratory monitoring to ensure that treatment remains safe, effective, and aligned with their health goals.

Ready to Get Started?

Choose the initial appointment that best reflects your needs and goals.

Schedule a Comprehensive Evaluation

Schedule a Focused Hormone Assessment

Next Steps

Your Path to Hormonal Balance starts here.

Whether you’re struggling with hot flashes, brain fog, weight changes, or fatigue, we provide the medical expertise and personalized care you need to thrive.

Visit our Issaquah clinic for in-person care or book a free virtual consultation anywhere in Washington.

Evolve Menopause & CardioMetabolic Clinic - Stephanie Elder - Issaquah, WA