Menopause care that treats the woman, not the prescription pad.
Most clinics start with a script — or a refusal. We start with sixty unhurried minutes, a complete workup, and a plan that's yours — whether or not hormone therapy is part of it.
Delivered by James Scribner, MD — A4M Fellow in Anti-Aging, Functional, and Metabolic Medicine; ABAARM board-certified.
7 min
Average length of a primary care visit
0 hrs
Required menopause training in most U.S. medical residencies
Every woman who lives long enough reaches menopause. Fewer than one in four get medical care for it.
Menopause is one of the most predictable transitions in medicine and one of the least supported. The average primary care visit is seven minutes. Most physicians have no formal menopause training because it isn't covered in most residencies. The result is millions of women dismissed, undertreated, or handed a prescription for the wrong problem. I needed a doctor who actually listens is the phrase we hear most often.
Menopause care is for you if
You're in active or post-menopause.
It's been twelve consecutive months without a period, and the symptoms are affecting how you live.
You want a real conversation about hormone therapy.
Not a checklist questionnaire and a generic script — a sixty-minute visit with a physician who knows the evidence.
You want one physician tracking your whole health.
Menopause changes cardiovascular risk, bone density, metabolism, and cognition. One physician should be tracking all of it.
You've been dismissed before.
A previous doctor told you your labs were "normal" while you knew something was wrong.
Menopause symptoms span vasomotor, urogenital, cognitive, metabolic, and musculoskeletal systems. Most aren't treated because the connecting cause — the post-menopausal hormonal floor — isn't being addressed. We treat the cause.
Vasomotor & Sleep
Hot flashes and night sweats
Sleep disturbances and insomnia
Mood & Cognitive
Mood changes, anxiety, depression
Brain fog, memory, and concentration changes
Urogenital & Sexual
Vaginal dryness and painful intercourse
Recurrent UTIs and urinary symptoms
Low libido and sexual function changes
Genitourinary syndrome of menopause (GSM)
Musculoskeletal & Bone
Joint pain and inflammation
Bone density loss and osteoporosis risk
Metabolic & Cardiovascular
Weight changes and body composition shifts
Cardiovascular risk changes
Fatigue and energy loss
Skin & Hair
Skin, hair, and nail changes
How we approach menopause care
Evidence-based, unrushed, and physician-led from intake to long-term follow-up.
01
Sixty-minute initial visit. Full symptom history, family risk profile (breast, ovarian, cardiovascular), current medications, and lifestyle. Nothing rushed.
02
Comprehensive lab evaluation. Hormone panel, full thyroid, fasting insulin, ApoB, hsCRP, lipids, vitamin D, and bone density assessment when indicated — at member-discounted rates.
03
Hormone replacement therapy when it's the right tool. Bioidentical estradiol, progesterone, testosterone, DHEA, and thyroid where indicated. Delivery by oral, transdermal patch or cream, pellet, or vaginal route. Prescribed and titrated by a board-certified physician, not an algorithm.
04
Non-hormonal options when hormone therapy isn't right for you. Evidence-based alternatives for women with contraindications or personal preference against hormone therapy.
05
Ongoing titration and monitoring. Symptoms and labs reviewed at follow-up visits. Adjustments as your body changes through and beyond the transition.
06
Long-term risk tracked, including CGM when metabolic shifts are part of the picture. Post-menopausal cardiovascular and metabolic risk changes meaningfully. We track it across years, not appointments.
"We read the data, not the headlines."
What the WHI study actually found, and what it missed
The 2002 Women's Health Initiative is the reason hormone therapy fell out of favor for a generation. The headlines reported a breast cancer signal that wasn't what the data actually showed. The trial combined oral synthetic hormones — different from modern bioidentical regimens — in women a decade or more past menopause, which is not when hormone therapy is typically initiated.
Subsequent re-analyses, including from the original investigators, have substantially revised the conclusions. For most healthy women within ten years of menopause, modern bioidentical hormone therapy is safe and effective, and the benefits outweigh the risks. Vaginal estrogen, in particular, carries an entirely different risk profile from systemic hormones — the WHI data does not apply to it.
Two ways to get menopause care here
Hormone therapy at Mt. Baker Medical isn't a $49 telehealth subscription with a clinician you'll never meet twice. It's medicine, prescribed and managed by a physician who knows your full medical picture. Choose the level of relationship that fits your life.
Most Comprehensive
Concierge Membership
All your primary care, plus menopause and hormone therapy included
$300/month individual
$570/month couple
Unlimited 60-minute visits with Dr. Scribner
Menopause and perimenopause evaluation, hormone therapy prescribing and titration — included
Full primary care: physicals, acute care, preventive screening, chronic condition management
Your physician's direct phone line and same-day access
Member-rate labs, imaging, and specialist coordination
Cardiovascular, bone density, and cancer screening built into your care plan
Full primary care (physicals, acute care, preventive screening)
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Unlimited 60-minute visits
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Member-rate labs & imaging
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Your physician's direct phone line
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Most women start with Concierge. Hormone-Focused exists so no one is turned away from real medical hormone therapy because they're satisfied with their current PCP. Switch tiers anytime.
Frequently asked questions
Is hormone replacement therapy safe?
For most healthy women within ten years of menopause, modern bioidentical hormone therapy is safe and effective, and the benefits outweigh the risks. The 2002 Women's Health Initiative scare was based on oral synthetic hormones in women a decade or more past menopause — a regimen and population that doesn't reflect modern practice. Dr. Scribner will review your personal and family history and explain where you sit on the risk spectrum.
Is vaginal estrogen safe?
Yes. Vaginal estrogen has a fundamentally different risk profile from systemic hormone therapy. It treats genitourinary syndrome of menopause (GSM) — vaginal dryness, painful intercourse, recurrent UTIs, urinary urgency — with minimal systemic absorption. The WHI data does not apply to vaginal estrogen. It is appropriate for many women who cannot or choose not to take systemic hormones, including most breast cancer survivors after consultation.
Do you prescribe bioidentical hormones?
Yes. Most modern hormone therapy is bioidentical — molecularly identical to what your body produces. We use FDA-approved bioidentical estradiol, progesterone, testosterone, DHEA, and thyroid (T3/T4) as indicated, and compounded preparations when clinically appropriate.
What hormones do you offer, and how are they delivered?
Estradiol, progesterone, testosterone, DHEA, and thyroid (T3/T4). Delivery routes include oral, transdermal patch, transdermal cream, pellet implant, and vaginal — the choice depends on your clinical picture, symptom profile, and preference.
I'm post-menopausal — is it too late to start hormone therapy?
The clinical evidence is strongest for women starting hormone therapy within ten years of menopause. After that window, the risk-benefit calculation shifts and the decision becomes more individualized. We don't categorically refuse to treat women past that window — we evaluate the full picture and discuss what makes sense.
Do I have to use my insurance?
No. We don't bill insurance for visits — the membership replaces it for primary care. Lab work, imaging, and prescriptions can still go through your insurance if you prefer, or at member-discounted cash rates.
What if I want to try hormone therapy but I'm not sure it's right for me?
The free consultation exists for exactly this. No commitment. Dr. Scribner will evaluate, review your history, and tell you what he recommends — including telling you if hormone therapy isn't the right tool for your situation.
Where is your office?
1200 Harris Ave, Suite 308, in the historic Sycamore Square building in Fairhaven, Bellingham. Hours are Monday through Saturday, 9 AM to 5 PM.
Book a free sixty-minute consultation with Dr. Scribner. He'll review your symptoms, talk through targeted labs, and tell you what he recommends — including whether hormone therapy is the right tool for your picture. No commitment to join either membership.
