Great question! The average age of menopause is around 51 years old and is defined as the time at which you have gone 12 months without a menstrual period.

Perimenopause is the chaotic stretch of time before the menopause transition, with symptoms beginning anytime in the decade leading up to menopause. Symptoms can range from more classic vasomotor symptoms (hot flashes, night sweats) to more nuanced things like changes in libido or mood and generally not feeling like yourself. But this doesn’t mean every woman over 35 who has brain fog and night sweats is automatically perimenopausal. This stage of life is nuanced, and symptoms can overlap with many other conditions.

This is exactly why having a real human interaction with an experienced clinical provider who listens and believes you is so important. You do not have to navigate this alone!

Not necessarily. If you are unsure where to begin, an initial consultation is a good starting point. If your goal is purely educational, then choose the education visit. Reach out via the contact page if you are really stuck!

We get it - life is busy and typical weekday appointments can be hard to make work. We typically have some weekend, and before/afterhours slots open on our schedule. Please reach out to us via the contact form with any special appointment requests - provide a few days and time frames that you are hoping for, and we will do the best we can to accommodate you.

Unfortunately, we cannot care for Medicare patients at Rise. There are strict federal guidelines around cash pay services in a medical setting for Medicare patients. If you use Medicare and have already scheduled your appointment, then reach out and we can issue a refund and cancel your appointment.

We do not accept insurance at this time. Utilizing a cash pay approach allows us extended appointment times and shifts the focus to care planning based on shared decision making versus what insurances dictates. See our Services page for pricing. We can provide a super bill for submission and potential HSA reimbursement as requested.

Use the “Book Consultation” button on the header and footer to schedule an appointment. Or access the Services page to get more details on your options, then book a consult from there. We utilize OptiMantra EHR (electronic health record) and FiServ as our payment processing group.

After you complete the booking process, you will receive an email from Rise with some basic information, and a request to set up an account (patient portal) on our electronic medical record system, OptiMantra linked here. The single most important thing you can do to help us prepare for your visit, is fill out the initial visit questionnaire. The consents are also available to sign on the patient portal.

Once you book an appointment, you will receive an email prompting you to set up an account with our EHR (electronic health record) system called OptiMantra. Once you have an account, you can utilize the secure messaging service to contact us, review your chart, request refills, make appointments, and sign consents. Please use this resource to contact us with any sensitive medical information. Alternatively, you can follow the below link to reach the OptiMantra login page.

We are physically located at 207 East Main Street, Suite 202 in Missoula, MT. Our office is on the second level, accessible by either stairs or elevator (follow signs). However, telehealth allows us to service patients throughout the state of Montana. At this time, we are not licensed to practice outside the state of Montana - which means even our telehealth patients must physically be located in Montana at the time of their appointment.

We ask for at least 24 hrs notice prior to your scheduled appointment to cancel or reschedule. You can do this on the patient portal (OptiMantra). If you haven’t set up your account yet, then please reach out to us via the contact page messaging to notify us of your request for cancelation. We are happy to offer refunds in this instance as well.

Testing recommendations depend on your symptoms, history, and clinical needs. They are not always required but can be helpful in certain scenarios. During your consultation, we can discuss whether testing may be appropriate. We do not draw labs in clinic. If you have had lab testing done prior to the visit, please bring the results with you to your appointment.

Hormone therapy can be an incredibly effective tool for many women, but like any medical treatment, it carries both benefits AND risks. It isn’t the right fit for everyone—and that’s okay. Even when hormone therapy isn’t appropriate or preferred, women still deserve clear guidance and a full understanding of their options.

At Rise, we help you explore the full spectrum of evidence‑based approaches to midlife health, including lifestyle strategies, non‑hormonal medications, and supportive therapies for symptom relief. Our goal is to make sure you feel informed, empowered, and confident in choosing the path that aligns best with your needs.

Treatment options depend on each patient’s individual health history, goals, risks, and clinical evaluation. When appropriate, we prescribe both FDA approved hormonal and non-hormonal medications, as well as compounded medications. We do not prescribe or insert hormone pellets.

When medically appropriate, we will prescribe testosterone replacement therapy for women. For your safety, ongoing testosterone treatment requires lab work and follow up provider visits at a frequency determined by your provider in alignment with best medical practices for this Scheule III medication. This policy is essential for your safety and considered a non-negotiable at Rise.

Yes. When clinically appropriate, we absolutely prescribe these life‑changing medications.

However, we do not dispense or sell compounded versions in‑office. We follow FDA guidance and prescribe through traditional pharmacies or direct‑order programs such as LillyDirect (tirzepatide/Zepbound) and NovoNordisk’s Wegovy access programs, as these medications are often not covered by insurance.

For patients using these therapies for weight‑loss support, we pair treatment with nutrition and exercise guidance, along with a strong recommendation for registered dietitian (RD) involvement. This combined approach helps reduce the risk of rapid, unhealthy weight loss (particularly muscle loss), which can complicate the midlife health picture.

We are not trained in medical aesthetics; however, we can direct you to some great local clinicians if this is the support you are looking for!

We hear you — medication shortages are frustrating, and you’re not alone in dealing with them. This has become a nationwide issue, and while there’s no immediate resolution, we’re here to help you navigate it with as little disruption as possible. At Rise, we can adjust your treatment plan to alternative forms of estrogen or progestogen when certain products aren’t available.

We can also explore options like the HRT Club — a membership‑based platform (see below) that often offers lower prices and more reliable access to high‑demand medications, including estrogen patches. Our goal is to keep your care consistent, accessible, and tailored to what works best for you.

The HRT club is a quickly growing organization that offers low-cost cash pay prices for FDA approved HRT prescriptions via a mail order membership service. While they also offer provider services through this program, as a patient of RISE you will only require the prescription services. Your RISE provider would simply send your prescription to their platform like they would any other pharmacy. For more information, including membership fee details check out this link.

Cost Plus Drugs is a CASH pay online pharmacy. A great option for accessing lower‑cost medications when insurance doesn’t cover or under-covers your hormone medications. As their inventory grows, they remain a competitive (and surprisingly transparent) option for your medication needs. To send your prescriptions there, you’ll need to create a Cost-Plus account. Please follow the instructions on this link to set up your account.

Amazon Pharmacy accepts most commercial insurance plans, AND offers a cash pay option as well. You need an Amazon account to participate in this program. Follow this link for more details.

Fullscript is a platform we occasionally use to manage specialty lab testing. When you create a free account, you’ll have access to your lab results, and those results also flow directly into your chart here at Rise. Fullscript does offer supplement sales, though we don’t always utilize that part of the platform.

We use Fullscript primarily because it helps keep lab prices low. Even with insurance, copays for specialty labs can be surprisingly high — and some tests are denied based on “medical necessity,” which is determined by insurance. Fullscript allows us to offer more affordable options without compromising the quality of your care.

If you do not yet have a patient portal (aka not a patient yet), please submit your questions on the form located on the Contact page. Please do not submit sensitive medical information through the general contact form. The form is intended for basic inquiries only. If medical details are needed used the contact form to request a phone call.