Menopause care that takes your symptoms seriously.
Physician-led telemedicine care for perimenopause and menopause in Wisconsin and Massachusetts. Evidence-based treatment, including FDA-approved hormone therapy when it's right for you, and a clear plan when it's not.
Prefer to start with the visit itself? Book the 60-minute evaluation. → Consultation booking.
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Telemedicine for patients located in Wisconsin and Massachusetts
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Evidence-based care, including FDA-approved hormone therapy when appropriate
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A full 60-minute physician evaluation to start
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Direct-pay pricing, no automatic renewal
You're not sleeping through the night anymore. The heat comes out of nowhere: at work, at night, in the middle of a conversation. Your focus slips in meetings where you used to run the room. And when you finally brought it up, you got a shrug, a normal lab report, and the phrase every woman in this transition learns to hate: it's just part of aging.
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Here's what I want you to know. Perimenopause and menopause are medical transitions with real physiology and real treatments. Your symptoms are not a character flaw, and you are not required to white-knuckle your way through the next decade or two.
How it works
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Book a free 15-minute discovery call. We talk about what's going on and what you're looking for, I explain how the program works, and we decide together whether it's the right next step. It's a fit conversation, not a medical visit.
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Book the 60-minute evaluation, $350. Your complete history, a structured symptom inventory, your cardiovascular, bone, and metabolic risk picture, and a written treatment plan. This visit stands on its own whether or not you go further.
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If the program is right for you, I'll offer it after your visit. Enroll within 7 days and every dollar of your evaluation credits toward the program. There is no online enrollment and no checkout page: you never join a program I haven't examined you for, so you will never pay program pricing for a program you shouldn't be in.
You will leave your first visit with a written plan, clear next steps, and a follow-up date. Not a vague suggestion to wait and see.
The 3-Month Menopause Program
Good menopause care is not a prescription and a wave goodbye. Starting hormone therapy, or any menopause treatment, is a titration process: begin, measure, adjust. This program is built around it.
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What the program adds after your evaluation:
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Follow-up visits at weeks 4, 8, and 12. This is where titration happens: we adjust doses, track symptoms, and address side effects.
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Portal messaging for the full three months. Non-urgent questions about your care plan or your prescription, answered within one business day, Monday through Thursday.
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A treatment plan that stays current. Updated as your doses, labs, and symptoms move, not frozen at visit one.
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Prescriptions sent to your pharmacy when medication is appropriate. Medication costs are separate, and you can use your insurance for them.
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Lab work when clinically indicated, ordered to a lab near you. Lab fees are paid to the lab directly, and your insurance can cover them.
STEP ONE
60-minute evaluation - $350
Step one for every patient. Credits in full toward the program if you enroll within 7 days.​
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then, if it's right for you
STEP TWO
The 3-Month Menopause Program
Monthly billing: $300/month for 3 months. $900 total.
Pay in full: $810 once. Save $90 (10% off)​
With your $350 evaluation credited: $550 remaining on monthly billing, or $460 paid in full.
Enrollment is offered after your evaluation, never online. Cancel future monthly charges anytime by email or phone, effective when received; a reminder is sent before every charge. If you prepay and stop early, the unused portion is refunded under the patient agreement. Labs, imaging, and medications are separate costs, and you can use your insurance for them.
Is this a fit?
This is probably a good fit if you:
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Live in Wisconsin or Massachusetts and can attend video visits
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Have perimenopause or menopause symptoms that are interfering with your life: hot flashes, night sweats, broken sleep, brain fog, mood changes, cycle changes
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Want a physician-led, evidence-based plan
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Want FDA-approved options rather than pellets or compounded regimens
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Are comfortable with direct-pay care and transparent pricing
If you had your ovaries removed before natural menopause, you're exactly who should be here. Surgical menopause is abrupt, it's undertreated, and it carries bone and cardiovascular risks that deserve attention early, not at 65.
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This may not be the right fit if you: want pellet therapy or compounded hormones, need in-person gynecologic care such as pelvic exams or procedures (I coordinate that care but don't perform it), or need urgent or emergency care.
Hormone therapy, prescribed the way it should be
I prescribe hormone therapy for symptomatic perimenopause and menopause, and I'm direct about why: for the right patient, it is the most effective treatment we have for hot flashes and night sweats. Medicine spent twenty years underusing HRT after the Women's Health Initiative headlines, and a generation of women paid for that overcorrection.
I'm equally direct about the line I hold. I prescribe FDA-approved formulations filled at licensed pharmacies. I do not prescribe compounded hormone creams, and I do not place pellets.
And when hormone therapy isn't right for you, we don't stop. There are effective non-hormonal prescription options, and we build a structured plan around them. Enrolling with me is a commitment to treat your menopause. It is not a promise of any particular prescription, because that decision belongs to your evaluation, not your enrollment.
Menopause care should not be another silo.
You may already have one clinician for blood pressure, another for cholesterol, bone density or thyroid, and no one connecting the dots between any of it and what menopause is doing in the middle. That fragmentation is exactly what I trained against.
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I'm an internal medicine physician, so your menopause plan gets built in the context of your whole health picture: the conditions, medications, and risk factors that change which treatments are safe and which are smart. I address what belongs inside this program, flag what needs additional evaluation, and coordinate with your primary care clinician or specialists when something sits outside its scope.
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You shouldn't have to choose between a clinician who understands menopause and one who understands the rest of your health.
A physician built for this transition
I'm Dr. Safa Shiari, double board certified in internal medicine and obesity medicine. The second certification matters here more than you'd think: menopause changes body composition, and weight, muscle, and metabolism sit at the center of how this transition feels and what it does to your long-term risk.
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I hold a master's in public health in epidemiology and biostatistics. I served as chief resident, then as a faculty physician teaching the residents and medical students who are now practicing, and I spent years as outpatient physician in one of the country's best health systems managing patients in their 60s, 70s, 80s, and 90s. That's where I learned what the decades after menopause look like when the transition is handled well, and when it isn't. I am a member of The Menopause Society.
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I treat my patients the way I like being treated.
Questions I get asked
Do you prescribe hormone therapy? Yes, when it's clinically appropriate after your evaluation. I prescribe FDA-approved oral and transdermal formulations from licensed pharmacies. I don't prescribe compounded hormones or pellets.
I'm already on HRT. Can you take over my care? If you're on an FDA-approved regimen, yes. We review it at your evaluation and continue, adjust, or change it based on your full picture. If you're on pellets or compounded hormones, I'll evaluate you and build a plan using FDA-approved options, but I don't continue compounded regimens.
How do I enroll in the program? You don't enroll online. Book the evaluation, and if the program is right for you, I'll offer it at or after your visit. Enroll within 7 days and your $350 credits in full.
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Do you take insurance? No. This is a direct-pay practice, which is why visits are 60 minutes instead of 15. You'll know exactly what everything costs before you book. You can still use your insurance for labs and prescriptions. HSA and FSA payment may be available depending on your account and plan rules, so confirm with your tax adviser or account administrator before using those funds.
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What happens after the three months? Most patients move to periodic follow-up visits, $200 each, on a schedule we set together, often every three to six months once stable. Nothing renews automatically. Some patients with complex health pictures choose ongoing membership instead; that's a conversation we have once I can see your whole picture.
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Is perimenopause included? Yes. You do not need to have had your last period to deserve treatment. Perimenopause is often when symptoms are loudest and care is hardest to find.
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What about weight changes? Midlife weight change is metabolic, not moral, and it's part of your evaluation and your plan. If you need dedicated weight-management treatment beyond menopause care, that's its own program at this practice, and I'll tell you honestly which one fits you.
You've waited long enough
You've spent enough nights awake and enough appointments being told everything is normal. Book the free discovery call. Fifteen minutes, and you'll know whether this is the right fit. I see patients in Wisconsin and Massachusetts by telemedicine.
Free, 15 minutes, through our secure patient-intake system. Not for urgent medical concerns.
Education, not personal medical advice. This page describes services offered by Present Future Health, LLC and is not a diagnosis or treatment recommendation. Care is provided by Safa Shiari, MD, licensed to practice medicine in Wisconsin and Massachusetts; telemedicine visits require that you are physically located in one of these states at the time of your visit. For emergencies, including chest pain, symptoms of stroke, sudden shortness of breath, or new leg swelling with pain, call 911 or contact local emergency services.
