See If you’re a candidate
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. She is a member of the International Society for the Study of Women’s Sexual Health (ISSWSH).
Dr. Crisci draws on careful clinical assessment and ongoing management to inform each treatment plan. As a physician, she is able to assess and prescribe across the full range of hormonal, metabolic, and genitourinary care.

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.

Virtual Care Available

BC-wide

No physical exam

lab costs Included

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.

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. Your onboarding call also helps you choose between the two hormone programs.

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.

Your Priorities Are Personal

Choose the program that fits, from a complete hormone and metabolic assessment, to focused or targeted care.

Hormone and Metabolic Health for Women

Comprehensive Hormone & Metabolic Health

BEST FOR: Women who want to manage perimenopausal and menopausal symptoms while drawing on Dr. Crisci’s expertise to
reduce their long-term risk of cardiovascular disease, osteoporosis, cognitive decline, and insulin resistance.

HOW WE TAILOR YOUR THERAPY: Symptoms + in-depth labs

Lab Assessment: In-depth hormones, thyroid, cardiometabolic, and micronutrient & methylation assessment.

Initial Investment: $1899
and $125 per month. ($1500 per year.)
Proceed to Pre-Registration

Your subscription includes: Per year, 2 scheduled follow-ups with our RN (MD-led), with lab panels; 2 optional Short Symptom Check-ins; plus prescription coordination.

Hormone and Metabolic Health for Women

Focused Hormone Health

BEST FOR: Women who want to focus on the symptom management of perimenopause and menopause, and optimize their thyroid.

HOW WE TAILOR YOUR THERAPY: Symptoms + focused labs

Lab Assessment: Focused hormones and thyroid.

Initial Investment: $895
and $125 per month. ($1500 per year.)
Proceed to Pre-Registration

Your subscription includes: Per year, 2 scheduled follow-ups with our RN (MD-led), with lab panels; 2 optional Short Symptom Check-ins; plus prescription coordination.

Women’s Sexual & Genitourinary Health

BEST FOR: Women who want targeted GSM and testosterone replacement, alongside another clinician when this care falls outside their scope.

HOW WE TAILOR YOUR THERAPY: Symptoms only

Lab Assessment: None, symptom-based.

Initial Investment: $395
and $115 per visit. No subscription.
LEARN MORE About this special program

Your first year of Comprehensive Hormone & Metabolic Health includes your initial 45-minute consultation with Dr. Crisci, baseline laboratory testing, and both deeper assessments below, a $1,050 value.

Deeper Assessments

Included in your first year of Comprehensive Hormone & Metabolic Health, and available any time on Focused Hormone Health (or in later years). Recommended no more than once every 3–4 months.

Cardiometabolic Assessment With Dr. Crisci, $675

An in-depth look at your cardiovascular and metabolic risk: a detailed consultation with Dr. Crisci plus advanced laboratory testing that goes beyond a standard panel; fasting glucose and insulin, HOMA-IR, HbA1c, advanced lipid panel, lipoprotein(a), ApoB, atherogenic index of plasma, and hs-CRP, the measures that shift with hormonal change and that standard testing often leaves out. Reviewed alongside your hormones, these results shape your treatment plan. Labs included.

Micronutrient & Methylation Assessment With Our RN (MD-led), $375

A focused look at vitamin D, B12, ferritin, TIBC, and homocysteine, with personalized
recommendations from Dr. Crisci. Labs included.

Frequently Asked Questions

It depends on how much you want addressed and what your priorities are.

Comprehensive Hormone & Metabolic Health is for women who want their hormones, metabolism, cardiovascular risk, and micronutrient status assessed and optimized, then maintained over time.

Focused Hormone Health concentrates on hormonal and menopause care, with the deeper assessments available as add-ons whenever you want them.

During your onboarding call, the RN will recommend the level that best fits your symptoms and goals, and the final decision is always yours.

Women’s Sexual & Genitourinary Health is focused, pay-as-you-go care for genitourinary and sexual-health concerns only.

Yes. You can move up to a more comprehensive level at any time. Because moving up means beginning that level’s full assessment, the new level’s initiation fee applies in full. You can also step down to a lighter level going forward.

Fees already paid are non-refundable when you change levels, so it’s worth choosing the level that fits your goals now, and if you only want one extra piece, you can add an individual assessment rather than moving up.

Your subscription (Comprehensive Hormone & Metabolic Health or Focused Hormone Health) includes two scheduled follow-up visits and two hormone lab panels per year. The panels are drawn at LifeLabs and covered by your subscription, with no separate lab bill.

You also have two optional Short Symptom Check-ins with our RN each year, brief visits for when a specific issue comes up between your scheduled follow-ups. The two scheduled follow-ups are part of your ongoing care, and are there if you need them. Beyond the two included, additional follow-ups are $115 each.

Beyond that, additional follow-up visits are $375 each (30 min); a Cardiometabolic Assessment is $675 (45 min); and a Micronutrient & Methylation Assessment is $375 (30 min). Comprehensive Hormone & Metabolic Health includes one of each assessment in the first year.

Women’s Sexual & Genitourinary Health is pay-as-you-go, with no subscription. This program is $375 to start, and $115 per additional visit. Because this is symptom-based, no labs are included or required.

No. Pacifica MD’s hormonal and metabolic care and the associated blood work are private services, not covered by the BC Medical Services Plan (MSP). Your scheduled visits and included hormone panels are covered by your subscription. Medications, if prescribed, are not included, and prescription coverage varies by plan, your extended health insurance may reimburse some costs, so it’s worth checking with your provider.

Your first appointment is with Dr. Crisci. Beforehand you’ll complete your medical intake and have baseline labs drawn at LifeLabs, ideally at least seven days ahead so results are ready. At the visit she reviews your history and results, explains what they mean, and builds your initial plan with you. You’ll leave with a clear picture of where you stand and what your options are.

Subscription members have two scheduled follow-up visits and two hormone lab panels every 12 months, usually spaced to track how you’re responding and fine-tune treatment, plus two optional Short Symptom Check-ins with the RN for issues that come up in between. If you need
to be seen more often, additional follow-up visits are $375 each and additional labs are payable directly to LifeLabs. Care is highly personalized, some patients need closer monitoring than others, and your clinician will recommend what’s appropriate for you.

Your initial consultation and Cardiometabolic Assessments are with Dr. Crisci. Your routine follow-up visits, your Short Symptom Check-ins, and your Micronutrient & Methylation Assessments are with a registered nurse working under her direct clinical supervision. Dr. Crisci oversees your care throughout, and remains responsible for your treatment plan, so a physician stays at the centre of your care even when a nurse conducts the visit.

No. Pacifica MD provides focused care for your hormones and metabolism; we don’t provide or replace the longitudinal primary care your family physician or nurse practitioner offers. We strongly recommend every patient maintain an ongoing primary-care relationship. We do, however, provide care that often falls outside a primary-care provider’s usual scope, for example, prescribing testosterone for women.

Our focus is women ages 40 to 65, approximately a decade before and after the onset of menopause, the window where hormonal and metabolic changes shape long-term health, and where focused care makes the biggest difference.

We also consider men aged 40 to 65 on a case-by-case basis; contact us for details.

There are two in-depth assessments included in the first year of Comprehensive Hormone & Metabolic Health, and available à la carte in later years, or any time on Focused Hormone Health. They address the metabolic, cardiovascular, and nutritional markers that ordinary checkups often miss.

The Cardiometabolic Assessment is 45 minutes with Dr. Crisci, and includes a review and treatment plan around fasting glucose and insulin, HOMA-IR, HbA1c, full lipid panel, lipoprotein(a), ApoB, atherogenic index of plasma (AIP), and hs-CRP, plus other tests where clinically appropriate based on your cardiovascular risk; $675, labs included.

The Micronutrient & Methylation Assessment is 30 minutes with our RN under Dr. Crisci, and includes recommendations around vitamin D, B12, ferritin, TIBC, and homocysteine; $375, labs included.

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