Perimenopause & Menopause
Specialist group medical care and consultation.
Virtual, across British Columbia.
Shannon Lockhart, MD, FRCPC · Menopause Society Certified Practitioner (MSCP)
The problem this practice addresses. The menopause transition is under-taught in medical training, under-researched in the literature, and too often attributed to stress or anxiety. Physiological symptoms — vasomotor, cognitive, musculoskeletal, and genitourinary — are frequently ascribed to temperament rather than endocrinology, delaying effective treatment. This practice closes that gap with care grounded in current evidence and explained clearly enough that patients understand why symptoms occur, what the options are, and where the evidence remains uncertain.
Who this is for. Referrals are welcome for women with:
Vasomotor symptoms (hot flashes, night sweats), including atypical presentations
Sleep disruption, particularly early-morning awakening or non-restorative sleep
Mood changes, anxiety, or irritability
Cognitive changes (reduced focus, memory concerns)
Musculoskeletal symptoms (arthralgia, frozen shoulder, reduced exercise tolerance)
Genitourinary and sexual-health symptoms of menopause
Metabolic or weight changes despite stable lifestyle
Questions about menopausal hormone therapy (MHT) — including with a family history of breast cancer or pending genetic testing
Natural or surgical menopause
How care works. Most of your care happens in Group Medical Visits (GMVs) — MSP-covered, physician-led sessions offering evidence-based guidance on perimenopause and menopause physiology, presentation, and management, with the clinical reasoning behind each recommendation.
If the idea of a group visit gives you pause, you're not alone — but it's likely different from what you're picturing. A GMV is structured education (assessment, diagnosis, evidence-based treatements) with open Q&A, not a session where you recount your personal history in front of others. Sharing is 100% optional, and everyone agrees to keep what's discussed private. Many women find that hearing others brings real validation — the reassurance of how much is shared, and questions they'd never thought to ask.
This model is well-established elsewhere in medicine. In diabetes, chronic disease, and prenatal care, GMVs show high patient satisfaction and outcomes comparable or better than one-on-one care, with no adverse effects reported.¹²³ Its use in menopause is newer: early studies find it feasible and well-received, with larger trials still emerging.⁴
Two foundational sessions are recommended for everyone, each combining education and open Q&A:
Menopause physiology and healthcare context
MHT: options, risks, and benefits
From there, sessions are tailored to your experience. Examples:
Vasomotor symptoms
Bone and muscle health
Menopause-related sleep disturbance
Mood and mental health
Sexual health
Cardiometabolic health
Skin and hair changes
…and more.
Reports and recommendations are sent to your referring provider to support shared, continuous care.
Individual preventive health visits. Nutrition, physical activity, sleep, and stress are among the most significant modifiable influences on how the menopause transition is experienced, and on cardiometabolic and bone health well beyond it. They work alongside treatment rather than in place of it, and they are difficult to address properly in a group, where what matters most differs for every patient. Comprehensive individual preventive health visits cover these areas in depth, with the same emphasis on evidence and clinical reasoning. These visits are not covered by MSP and are available by private pay.
Selected references
Housden L, Wong ST, Dawes M. Effectiveness of group medical visits for improving diabetes care: a systematic review and meta-analysis. CMAJ. 2013;185(13):E635–44.
Cunningham SD, Sutherland RA, Yee CW, et al. Group medical care: a systematic review of health service performance. Int J Environ Res Public Health. 2021;18(23):12726.
Kirsh SR, Aron DC, Johnson KD, et al. A realist review of shared medical appointments: how, for whom, and under what circumstances do they work? BMC Health Serv Res. 2017;17:113.
Gerontakos S, Leach M, Steel A, Wardle J. Feasibility and efficacy of implementing group visits for women's health conditions: a systematic review. BMC Health Serv Res. 2023;23:549.