Getting started
What does the complete bioidentical hormone service look like?
The complete service involves an initial, comprehensive assessment with one of our providers (naturopath, nurse, or MD) that may take up to one hour. This initial assessment includes questions on your medical history, current symptoms, diet, fitness, and sleep. Following this you are sent for blood work. Once the clinic receives the results of your blood work, you are contacted for a follow up appointment. Your provider will spend time prior to this appointment to review all your results in relation to your intake assessment and create a treatment plan. At your follow up appointment your results will be reviewed with you and your provider will go over the proposed treatment plan and send your prescription to a compounding pharmacy. The pharmacy will make your customized prescription and send it to you by courier or the post. Normally you should receive your bioidentical hormones in 24-72 hours.
What can I expect from my providers?
Medalma’s providers include medical doctors, nurses, and naturopaths. They all work together “behind the scenes” as a team. These providers are focused on your hormonal health from a holistic perspective. They review your intake assessment, blood results and any other relevant information. They create a treatment plan that is customized for you and see you in regular follow up appointments based on your plan. They are not meant to replace your family doctor. They do not address problems outside the scope of BHRT unless there is an abnormal result in the tests that have been ordered that require additional testing or referral to a specialist.
Medications & Treatments
How many follow ups will I need?
After your first appointment that follows your initial assessment, you will normally have a follow up every 3-6 months until your symptoms are properly managed with your BHRT prescription. You will be given a requisition for blood work at each follow up appointment that you must use immediately prior to your next appointment so that your hormone levels can be followed and treatment adjusted accordingly.
How/Where do I get my blood work done?
It is up to you where you choose to have your blood work done. If you are in Quebec and in the public system, you can make an appointment for blood work on www.cliquesante.com You can also go private at a cost to you. You need to book your appointment for before 9:00am so that we can measure your morning cortisol. You must be fasting for 12 hours including no coffee beforehand.
How long does it take for the blood work to come back?
It can take anywhere from 24 hours to 2 weeks for your results to come back to the clinic depending on where you go. We appreciate if you do not contact the clinic to ask if we have received the results as we will contact you once they come in.
What if some of the blood tests ordered are not done by the lab?
This does happen sometimes and it doesn’t seem to be lab dependent (e.g., even the most reliable labs sometimes do not do all the tests requested). If this happens, you will be provided a new requisition for the missing tests and these will be followed up on at your next appointment. If those results impact on your immediate treatment, you will be contacted and given an option to book another follow up sooner than your 3-6 month follow up.
What do I do after my blood work?
Wait until the clinic contacts you to book a follow up appointment.
When is it appropriate to contact the clinic or a provider directly?
It is appropriate to contact the care provider at the clinic to book or change appointments or if there is an emergency. If you have questions regarding your treatment plan, symptoms, or lab results, we kindly request that you make an appointment to see one of our providers. If your BHRT has not arrived in a reasonable amount of time, you need to contact Medalma directly at: 1-855-906-4006
How long does it take for the hormone treatment to start working?
It can take up to one month before you see any change in your symptoms. If you continue to have symptoms or side effects, you can always book a follow up appointment sooner than the recommended 3 month follow up.
What does compounding mean?
Your BHRT involves making compounded hormones that are formulated specifically for you. These hormones are synthetically derived from plants and closely mimic the hormones that are naturally found in your body. For example, you have 3 kinds of estrogen in your body and we can combine these to match your own composition. Compounding BHRT allows us to start at lower amounts than what is found in Estrogel or Estradot for example. Compounded medications do not have as long of a shelf life and are normally effective for 3 months from the date they are made. Therefore you need to get your prescription made every 1-3 months.
Pricing & Insurance
How much does the entire service cost?
The entire service costs $299.00 for the initial intake and $150.00 for each follow up appointment including the follow up after the first assessment. You can use the public system for your blood work or go private, but this is not included in your fee. Hormones are also not included. You must pay for each service prior to your appointment.
Why do I need to pay for a follow up?
Each follow up involves your provider spending time before the meeting to review your results in the context of the rest of your file. The follow up appointment involves 20 minutes of your providers time and then the provider spends more time to write their notes, prescribe your BHRT and complete requisitions for your next appointment.
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