VIRTUAL CARE ACROSS BRITISH COLUMBIA

Hormone and Metabolic Care for Women

Women’s Hormonal and Metabolic Medicine
Comprehensive care for women navigating perimenopause, menopause, and The metabolic changes that come with them.

See if you’re a candidate Watch The Introduction video

hormones and metabolism are connected

Private, Physician-Led Care for Midlife Women in British Columbia.

As estrogen and testosterone shift through perimenopause and menopause, they change how the body handles blood sugar, fat, cholesterol, and inflammation, which is why weight, energy, sleep, mood, and cardiovascular risk often change around the same time. Dr. Crisci assesses and treats these together, rather than as separate problems.

Care is longitudinal: we work with patients over months and years, not a single visit, and combines hormone therapy, in-depth biomarker testing, and ongoing clinical management. Sexual health concerns, including genitourinary symptoms and changes in sexual desire, are addressed as part of your care.

Serving patients virtually across British Columbia

Symptoms You May Recognize

Women often come to us with a combination of hormonal, metabolic, sexual, urinary, sleep, mood, and energy changes that have been dismissed, treated separately, or explained as “normal aging.” Our role is to look at the full picture.

Struggling to Lose Weight

Weight doesn’t come off as easily, or is concentrated around your waist.

Brain Fog

Difficulty concentrating and memory changes.

Libido and Desire

Vaginal dryness, painful sex, lower libido, or reduced arousal.

Hot Flashes and Sweats

Hot flashes, night sweats, or poor temperature regulation.

Sleep Disturbances

Trouble getting to sleep, waking during the night, or not feeling rested.

Loss of Strength

Reduced muscle tone, mass, and slower recovery from exercise.

Hair and Skin

Hair changes, dry skin, thinning nails, or dry eyes.

Joint Aches

Pain in joints, or muscle aches that were not there before.

Fatigue and Low Energy

Persistent tiredness or low energy that doesn’t improve with rest.

Mood Shifts

Moodiness, irritability, anxiety, or reduced stress tolerance.

Irregular Cycles

Irregular, heavier, or changing periods during perimenopause.

Metabolic Changes

Changes in cholesterol, blood sugar, or other metabolic markers.

Struggling to Lose Weight: Weight doesn’t come off as easily, or is concentrated around your waist.

Brain Fog: Difficulty concentrating and memory changes.

Libido and Desire: Vaginal dryness, painful sex, lower libido, or reduced arousal.

Hot Flashes and Sweats: Hot flashes, night sweats, or poor temperature regulation.

Sleep Disturbances: Trouble getting to sleep, waking during the night, or not feeling rested.

Fatigue and Low Energy: Persistent tiredness or low energy that doesn’t improve with rest.

Mood Shifts: Moodiness, irritability, anxiety, or reduced stress tolerance.

Irregular Cycles: Irregular, heavier, or changing periods during perimenopause.

Metabolic Changes: Changes in cholesterol, blood sugar, or other metabolic markers.

This is for you if:

  • You are a woman in midlife navigating perimenopause, menopause, or the years beyond, typically aged 40 through your 70s.
  • You are looking for ongoing physician-led care, not a one-time assessment.
  • You want to understand how hormonal and metabolic changes interact, and address them together.
  • You are experiencing symptoms like sleep changes, weight gain, mood shifts, vaginal or sexual changes, and fatigue, that haven’t been adequately addressed.
  • You are willing to invest in your health over the long term, including time, attention, and financial commitment.
  • You want care that is informed by current evidence in hormonal medicine and metabolic health.

If your concerns are limited to genitourinary symptoms, such as vaginal dryness, painful intercourse, recurrent UTIs, and low libido, our Women’s Sexual Health service may be a better fit.

Your Clinical Team

Dr. Elisabeth Crisci, MD
Your Physician

Dr. Elisabeth Crisci

Elisabeth Crisci, MD, is a licensed physician in British Columbia with over 20 years of clinical experience. Her practice has come to concentrate on women’s hormonal and metabolic health, the physiology of perimenopause, menopause, and the decades that follow, including the hormonal, metabolic and genitourinary changes that affect so many women in midlife.

Her approach is grounded in current clinical evidence, and in the understanding that hormonal and metabolic health are connected and best addressed together. She has pursued focused continuing education in hormone therapy and metabolic medicine through programs including A4M, the Hormonal Health Institute, and WorldLink Medical, and applies it in day-to-day practice with the women she sees.

Dr. Crisci uses in-depth biomarker testing and ongoing clinical management to inform each treatment plan. As a physician, she is able to assess and prescribe across the full range of hormonal and metabolic care.

Pacifica MD provides focused care for hormones and metabolism. We do not provide or replace the longitudinal primary care offered by your family physician or nurse practitioner. We strongly recommend that all our patients maintain an ongoing primary care relationship.

Heather Gagnon, RN
Your Registered Nurse

Heather Gagnon, RN

Heather was the first Registered Nurse to join Pacifica MD. She brings over 11 years of healthcare experience and a background in public and community health, and under Dr. Crisci’s direction, she conducts most follow-up visits. Her focus is evidence-based, patient-centred care and a strong working relationship with each patient over time.

Pacifica MD provides focused care for hormones and metabolism. We do not provide or replace the longitudinal primary care offered by your family physician or nurse practitioner. We strongly recommend that all our patients maintain an ongoing primary care relationship.

Virtual Care Available

BC-wide

No physical exam

lab costs Included

Play

Watch Our Introductory Video

The Missing Conversation: Hormonal and Metabolic Medicine for Women in Midlife

In this presentation, Dr. Crisci explains how hormonal change and metabolic dysfunction interact during perimenopause and menopause, why integrated care matters, and what evidence-based hormonal and metabolic medicine looks like in practice.
We recommend you watch the webinar before completing your eligibility form.

See if you’re a candidate

How does it work?

Virtual Intake and Appointments Servicing Patients across British Columbia

1

Fill out the candidacy form.

Complete the candidacy questionnaire online so we can understand your situation. Our clinic will then call you to book your onboarding call with our Registered Nurse and send your full medical intake questionnaire.

2

Onboarding call with our Registered Nurse.

Our RN reviews your medical history and answers your questions to confirm the practice is a good fit. If we both agree it’s a good fit, initial payment is completed at this stage.

3

You receive your lab work requisition.

You’ll receive your comprehensive laboratory requisition, which can be taken to any LifeLabs location in BC. Labs are completed no fewer than 7 days before your consultation so results are ready to review.

4

Attend your treatment plan consultation.

Your first appointment with Dr. Crisci, where she reviews your results, discusses your treatment options, and creates your initial treatment plan.

What’s Included

At the start of YEAR ONE

Treatment Planning Consultation

$1899.00 INITIATION FEE
  • Initial 45-minute Treatment Planning Consultation with Dr. Crisci
  • Baseline Laboratory Testing
  • Comprehensive Metabolic Assessment (One in First 6 Months)
Monthly subscription

Ongoing Care Program

$125.00 PER MONTH or $1500.00 per year
  • two hormone follow-up visits with lab panels
  • four symptom follow-up visits if needed
  • scheduled hormone laboratory testing
  • ongoing clinical access between appointments
  • coordination of your prescriptions and care

    Most follow-up visits are conducted by Heather, our Registered Nurse, under Dr. Crisci’s direction. Medications, additional testing, and imaging are billed separately.

One Comprehensive Metabolic Assessment is included.

Within your first six months, Dr. Crisci completes an in-depth metabolic assessment: a detailed medical consultation plus advanced laboratory testing that goes beyond a standard panel. It examines cardiovascular risk markers, insulin and blood-sugar regulation, lipid particles, and markers of inflammation (including measures such as ApoB, lipoprotein(a), and insulin resistance), the measures that shift with hormonal change and that standard testing often leaves out. Reviewed alongside your hormones, these results shape your treatment plan.

Subscription or à La Carte

Most patients choose the subscription, as it matches what the vast majority require in terms of testing and medical visits. Hormonal and metabolic care works best as an ongoing relationship, and the subscription keeps costs predictable by bundling your scheduled medical appointments and lab testing into a single monthly or annual fee.
You can also remain in Dr. Crisci’s care on an à la carte basis, paying for appointments and lab work as you go. 
After your initial Comprehensive Metabolic Assessment, supplemental assessments with Dr. Crisci are available at $675 each.

Costs and Coverage

Pacifica MD’s hormonal and metabolic care and associated blood testing are private-pay and not covered by MSP (Medical Services Plan). Your scheduled appointments and hormone testing are included in your subscription, even the blood tests, performed at LifeLabs locations across BC. Medication costs, if prescribed, are separate, and coverage may vary by individual insurance plan.

Frequently Asked Questions

This program is private-pay and not covered by MSP. Year one begins with an initiation fee of $1,899, which covers your 45-minute Treatment Planning Consultation with Dr. Crisci, your comprehensive baseline laboratory testing, and one Comprehensive Metabolic Assessment within your first six months. From your first appointment, your subscription begins at $125/month, or $1,500 per year, which includes your scheduled hormone follow-up visits, symptom follow-ups, hormone lab testing, and ongoing clinical access. Medications, additional testing, and imaging are billed separately. (All prices are in CAD and subject to GST.)

Most patients choose the subscription, as it matches what the majority require in terms of testing and medical visits, and it keeps costs predictable by bundling scheduled appointments and lab testing into a single monthly or annual fee. You can also remain in Dr. Crisci’s care on an à la carte basis, paying for appointments and lab work as you go, with lab work billed directly to you by LifeLabs. After your initial Comprehensive Metabolic Assessment, supplemental assessments with Dr. Crisci are available at $675 each.

It is an in-depth assessment with Dr. Crisci, included once within your first six months. It combines a detailed medical consultation with advanced laboratory testing that goes beyond a standard panel, examining cardiovascular risk markers, insulin and blood-sugar regulation, lipid particles, and markers of inflammation (including measures such as ApoB, lipoprotein(a), and insulin resistance).

These measures matter because hormones and metabolism are closely linked. As estrogen and testosterone decline through perimenopause and menopause, the body’s handling of blood sugar, fat, and cholesterol changes, and cardiovascular and metabolic risk tends to rise, shifts that often go unmeasured in standard testing. Hormone therapy is one of the factors that influences these markers, which is why Dr. Crisci reviews them alongside your hormones rather than in isolation. The assessment is designed to surface and monitor the longer-term health risks that can accompany menopause, across cardiovascular, metabolic, and bone health, so they can be tracked over time. Together, the results inform a treatment plan aimed at both your current symptoms and your long-term health.

Initial Treatment Planning Consultation is with Dr. Crisci. Most follow-up visits, including hormone and symptom reviews, are conducted by Heather Gagnon, our Registered Nurse, under Dr. Crisci’s direction. The management plan and prescriptions are reviewed and managed by Dr. Crisci.

Care follows a regular cadence rather than a fixed calendar, timed to your individual treatment plan. Your subscription includes two scheduled follow-up visits with our Registered Nurse, and two standard sets of lab work per year, along with ongoing clinical access for questions in between. Additional symptom follow-ups are available as needed.

After your first appointment, you’ll be sent lab requisitions ahead of each scheduled follow-up. Treatment plans, prescription types, dosages, and adjustments, are fully individualized based on your lab results and clinical picture.

Your Treatment Planning Consultation includes a comprehensive medical evaluation with Dr. Crisci: a review of your symptoms, health goals, and current and past medical history, and a discussion of potential treatment approaches. Laboratory testing, completed beforehand, is reviewed as part of this assessment.

Bioidentical hormones are structurally identical to the hormones the body produces. Conventional preparations may be synthetic or derived from other sources. Each option has its own evidence base, risks, and benefits. During your consultation, Dr. Crisci will review the options and routes of administration available to you, so you can decide together what fits your symptoms, health history, and goals.

Consultations, follow-up appointments, and associated testing at Pacifica MD are not covered by MSP. Some prescription medications may be covered by private insurance or a health spending account, though coverage varies by individual plan. We recommend checking with your provider.

No Referral Needed

Need more information before you begin?

After you complete the eligibility form, our team will call to schedule your onboarding call with our Registered Nurse, a step every patient takes before starting care. It’s a chance to review your history, ask questions, and confirm that the practice is a good fit for you before you decide to move forward.

We accept patients from across British Columbia, as consultations and follow-up appointments can be conducted remotely, with testing available at your local LifeLabs location. Prescriptions are sent to your local pharmacy.

See if you’re a candidate