Physician-Led Care For Women’s Genitourinary and Sexual Health
Symptom-based assessment and treatment for low libido, vaginal dryness, painful intercourse, recurrent UTIs, and other genitourinary symptoms of perimenopause and menopause. Available to British Columbia residents via virtual care.
Elisabeth Crisci, MD
Elisabeth Crisci, MD, is a licensed physician in British Columbia with 25 years of clinical experience, and focused expertise in women’s hormonal and genitourinary health.
Dr. Crisci’s training includes advanced certification in hormone therapy through the American Academy of Anti-Aging Medicine (A4M), the Hormonal Health Institute, and WorldLink Medical.
This service is delivered by Dr. Crisci at the initial visit, with follow-up care led by an experienced registered nurse under physician oversight. All visits are virtual, available to women anywhere in British Columbia. Dr. Crisci signs every prescription and reviews every treatment plan.
Virtual Care
BC-wide
No physical exam
No lab costs
Symptoms We Treat: Low Libido, Vaginal Dryness, Painful Sex
Pacifica MD offers focused, symptom-based care for women experiencing low sexual desire (HSDD: Hypoactive Sexual Desire Disorder) and GSM (Genitourinary Syndrome of Menopause).
Treatment options include systemic transdermal testosterone, local vaginal estrogen, vaginal DHEA, and compounded vaginal testosterone when appropriate for the individual.
Assessment is symptom-based, with no physical examination required. All visits are conducted virtually, making this service accessible to women across British Columbia.
This service may be right for you if:
Pacifica MD provides focused care for women’s genitourinary health. We do not provide or replace the primary care offered by your family physician or nurse practitioner. We strongly recommend that all our patients maintain an ongoing primary care relationship.
Treatment Options for HSDD and GSM
Treatment is individualized. Options include:
● Local vaginal estrogen (for GSM)
● Vaginal DHEA (for GSM)
● Compounded vaginal testosterone (for GSM, where appropriate)
● Systemic transdermal testosterone (for HSDD)
Dr. Crisci reviews your symptoms, history, and goals, and discusses which options are appropriate for you during your consultation.
How to Begin
Getting started is straightforward.
See If You’re a Candidate
Take our confidential symptom screening and contraindication review. Takes approximately 3 minutes. No obligation.
Virtual Consultation
A 20-minute virtual consultation with Dr. Crisci. Fee is $375, paid at time of booking. Fee includes chart review, the consultation, and post-visit treatment planning and prescribing.
Ongoing Care
Virtual RN-led follow-up appointments ($115) approximately every four months, with physician oversight. Prescriptions issued for up to four months at a time.
Fees
Initial Consultation $375
Review of your symptoms and contraindications, with treatment plan design by Dr. Crisci.
RN Follow-up Appointments $115
Approximately three follow-up visits per year. Prescriptions issued for up to four months at a time.
Medication costs are separate and vary by treatment. No lab work is required. This service is not covered by MSP. Receipts are provided for any extended health benefits coverage you may have.
What’s Included
Common Questions
What does this service cost?
The initial consultation with Dr. Crisci is $375. Follow-up appointments with our registered nurse are $115, with physician oversight. Medication costs are separate and vary by treatment. This service is not covered by MSP. Receipts are provided for any extended health benefits coverage you may have. GST applies.
When are payments charged?
Payment for the initial consultation is due at the time of booking. Payment for follow-up appointments is collected on the day of the appointment.
Do I need to be on hormone replacement therapy (HRT) to use this service?
No. This service treats genitourinary symptoms (GSM) and low sexual desire (HSDD) regardless of whether you are also on systemic HRT.
If you are already on systemic HRT: systemic estrogen and progesterone alone do not always resolve GSM or HSDD, which often need targeted local treatments and, in some cases, testosterone. We can complement your existing care, whether prescribed by your primary care provider or naturopathic provider.
If you are not on systemic HRT and you are interested in it: this service does not prescribe systemic estrogen or progesterone replacement. For that, please see your primary care provider, naturopathic doctor, or our comprehensive hormone care service and metabolic care.
How quickly will I notice an improvement?
For GSM symptoms, such as vaginal dryness, painful intercourse, urinary urgency, and recurrent UTIs, many women notice improvements in tissue comfort within days to weeks of starting local therapy, with continued improvement over the first few months.
For HSDD, response varies considerably between individuals. Testosterone therapy generally requires several weeks to months before effects on sexual desire become apparent, and not every woman responds to the same degree. We monitor response over time and adjust treatment when appropriate.
How often will I need appointments?
Prescriptions are issued for up to four months at a time, so most patients can expect approximately three follow-up appointments per year. The exact cadence depends on individual clinical needs.
Are these treatments safe?
Vaginal estrogen, vaginal DHEA, and vaginal testosterone have minimal systemic absorption and well-established safety profiles for treating GSM. Systemic testosterone for women, when prescribed at appropriate physiologic doses, has a well-studied safety profile in current research and is recommended by the International Society for the Study of Women’s Sexual Health (ISSWSH) for the treatment of HSDD.
Some of these treatments are prescribed off-label, meaning Health Canada has not formally approved them for these specific indications. This includes testosterone for women (no Health Canada-approved formulation currently exists for female use) and certain compounded
preparations dispensed by a compounding pharmacy. Off-label prescribing is legal, common in menopause and sexual health medicine, and supported by current clinical guidelines from bodies including ISSWSH and the Menopause Society.
Each treatment has its own indications, considerations, and potential risks, including its regulatory and compounding status. We discuss these individually during your consultation as part of informed consent.
Does this replace my primary care provider?
No. Pacifica MD provides focused care for women’s genitourinary health: we do not provide primary care, and we do not replace the care offered by a family physician or nurse practitioner. We strongly recommend that you maintain your relationship with a primary care provider for general health needs, screening, acute illness, and management of conditions outside our scope.
Note: we do not replace the care of your primary care provider, or lack thereof. You are encouraged to maintain your current care or continue looking for it, for example, by registering with Health Match BC.
What if I want broader hormonal and metabolic care?
If you are seeking comprehensive care, including systemic hormone replacement, advanced biomarker monitoring, and management of cardiovascular, metabolic, and bone health, please see our Comprehensive Hormone Care service. Patients who initially join this service and later decide they want broader care can transition to comprehensive care. Because the two services have different scopes and different clinical work, the comprehensive program is priced separately, and prior payments to this service are not credited toward its initiation fee.
Disclosures
• This service is not publicly funded through MSP.
• Dr. Elisabeth Crisci is licensed and regulated by the College of Physicians and Surgeons of British Columbia.
• Pacifica MD provides focused care for women’s genitourinary health. We do not provide primary care, and patients are expected to maintain an ongoing relationship with a family physician or nurse practitioner.
• Some treatments offered, including compounded preparations and off-label use of testosterone for women, are not approved by Health Canada for these indications. Their use is reviewed during individual consultation as part of informed consent.
• This page and any associated webinar content are for educational purposes. Clinical decisions are made during consultation with Dr. Crisci.
Ready to get started? Complete the eligibility form.
Your information is confidential. The form takes approximately 2 minutes to complete.
Elisabeth Crisci, MD, is a licensed physician in British Columbia with 25 years of clinical experience, and focused expertise in women’s hormonal and genitourinary health.