Finally... the menopause care you deserve.
Our private telemedicine practice serves British Columbia residents looking for a higher level of menopause care.
We are the first practice in BC to combine personalized HRT management with a structured 12-week perimenopause lifestyle program, so you are not just getting a prescription, you are getting the full support your body needs during this transition.
choose your level of care:
We offer two levels of personalized menopause care: focused medical visits, or our most comprehensive approach that combines medical care with a 12-week lifestyle program.
Medical Visits (HRT focused)
1:1 virtual appointments for HRT assessment, prescribing, and monitoring. Lab testing, health screening recommendations, and ongoing menopause care.
For women in perimenopause through to postmenopause.
The Perimenopause Reset: Complete Care program
Medical visits combined with a 12-week lifestyle program covering nutrition, sleep, stress, gut health, movement, and more.
Our most comprehensive level of perimenopause care.
Are you in your late 30s, 40s, or early 50s and suddenly your body feels like it’s working against you?
Are you struggling with exhaustion, brain fog, and sleep that feels unpredictable- waking wired at 3am or dragging yourself through the afternoon?
Do you feel frustrated that no matter how clean you eat or how much you move, belly weight and bloating won’t budge?
Do mood swings, anxiety, or a short fuse leave you feeling unlike yourself?
Have you tried supplements, diets, or even HRT, but still don’t feel the steady improvement you were hoping for?
You’re not imagining it. your body is changing, and it needs a different kind of support now.
why what you've tried hasn't worked:
You May Have Tried:
Eating "Cleaner" and cutting calories
Exercising more and upping the cardio
Supplement Stacks
Cycle syncing
Specialized Hormone Tests
Meditation
Even Hormone Replacement Therapy....
And still feel like your symptoms aren't improving the way you hoped. That’s because perimenopause is a full-body transition, not a willpower problem.
Your body needs a system that matches this stage of life- one that supports:
Blood Sugar Regulation
Inflammation Reduction
Stress Management
Sleep Architecture
Gut Health
Nervous System Balance
No quick fixes.
No “burn more calories.”
No 20 supplements.
No guessing.
And it needs a clinician who understands all of it, in addition to hormone replacement therapy.
Introducing
the Perimenopause Reset:
Complete Care
The most comprehensive level of menopause care, designed to support every aspect of your hormonal health.
Perimenopause is not a hormone-only transition, and medical treatment alone doesn't always address everything women experience during this stage of life.
Hormone therapy can be incredibly helpful for symptom relief and long-term health. But hormones don't work in isolation. Sleep, nutrition, blood sugar balance, stress, gut health, and movement all influence how your body responds to treatment. When you address both the medical and the lifestyle foundations, you get better results.
This is the gold standard of perimenopause care: personalized hormone therapy guided by a Menopause Society Certified Practitioner, paired with a 12-week lifestyle program designed to support your body through this transition.
Everything included in
the perimenopause reset: complete care program:
Complete Care means personalized medical menopause care, combined with a structured lifestyle program to support your body from every angle
Please Note:
For safety reasons, we are currently unable to provide care if you have a history of breast, uterine, or ovarian cancer, deep vein thrombosis (DVT), are a current smoker, or are experiencing unexplained vaginal bleeding.
During The perimenopause reset You Will:
Gain a clear understanding of what’s happening in your body during perimenopause.
Learn practical strategies to stabilize blood sugar and support a healthy metabolism.
Improve sleep quality so you wake with more energy and fewer 3 a.m. interruptions.
Calm inflammation and ease bloating, joint pain, and fatigue.
Explore evidence-based options for HRT and learn how to use them safely and effectively (when appropriate).
Build movement, nutrition, and recovery strategies that actually work with your changing hormones.
Strengthen your nervous system resilience: lowering anxiety, mood swings, and daily stress.
Leave with a step-by-step plan that supports both immediate symptom relief and long-term health.
HOW IT WORKS:
step 1:
Enroll in The Perimenopause Reset: Complete Care program, and book your initial visit
step 2:
Complete your health intake form and attend your initial visit (60 minutes) where we review your history, symptoms, and goals and create your personalized treatment plan
step 3:
Work through the 12-week lifestyle program at your own pace. At week 6, your follow-up medical visit connects your medical care to your lifestyle progress.
step 4:
At week 12, your final medical visit wraps everything up. You receive your personalized consultation summary report and a clear plan for the months ahead.
Why Hormone Replacement Therapy matters
(but is not enough on its own)
Hormone Replacement Therapy can be incredibly effective for symptom relief and long-term health protection. Benefits include relief from hot flashes and night sweats, prevention of bone loss, improved mood and cognitive function, improved vaginal and sexual health, better sleep, cardiovascular benefits when started within ten years of menopause, and improved quality of life overall.
But expecting HRT alone to resolve all your symptoms is a common misconception that will leave you disappointed. Sleep, nutrition, blood sugar balance, stress, gut health, and movement all influence how your body responds to treatment. That is why The Perimenopause Reset pairs medical care with a structured lifestyle program, so your hormones have the best environment to work in.
Why Choose Us?
We are dedicated to redefining menopause care. Here's what sets us apart:
Menopause Experts: Our providers are Certified Menopause Practitioners' from the Menopause Society. We have a deep understanding of the complexities of perimenopause, midlife health, and HRT. This is all we do!
The First Integrated Program in BC: Four Eras Health is the first practice in BC to combine personalized HRT management with a structured lifestyle program in a single offering.
Personalized Approach: We understand that every woman's menopause journey is unique, there is no one size fits all with menopause. Your care plan is tailored to your individual needs, preferences, and health goals. Initial appointments are 60 minutes to capture everything we need to know to create the best plan for you.
Face-to-Face Virtual Visits: We prioritize real, human connections. With our face-to-face virtual visits, you’ll have dedicated, one-on-one time with a provider who listens, understands, and tailors your treatment to your specific needs. This personalized approach ensures you receive the highest quality care, and can get all questions answered.
Evidence-Based Treatments: We stay up-to-date with the latest research and advancements in menopause care to ensure you receive the most effective treatments available.
Empowerment through Education: We believe in empowering you with knowledge. Our goal is to help you understand your body and make informed decisions about your care.
Meet Akemi
Hi, I am Akemi. I am a Nurse Practitioner and Menopause Specialist.
As a Menopause Society Certified Practitioner and Microbiome Clinical Science Practitioner, I bring together the best of evidence-based menopause medicine, lifestyle science, and clinical practice. I am currently pursuing advanced training in Functional Medicine through the Institute for Functional Medicine, and have additional training in Advanced
Bioidentical Hormone Replacement Therapy through Worldlink Medical.
Over the past 15+ years, I have worked with hundreds of women in their 40s and 50s who were told "everything looks normal" while still struggling with stubborn symptoms like poor sleep, weight gain, fatigue, and mood changes. What I have seen again and again is that you do not have to settle for feeling this way.
That is why I created The Perimenopause Reset: Complete Care, a structured, clinically guided program designed to relieve symptoms, calm inflammation, and optimize your long-term health.
My mission is to give you credible answers, clear strategies, and the right support so you can feel like yourself again and optimize your health for the long term..
Let's Get You the Perimenopause & Menopause Care You Need...
Did You Know?
(Stats From The Menopause Foundation of Canada)
The average Canadian woman will spend up to half of her life in a menopausal state: perimenopause, menopause, or postmenopause
3 out of 4 women experience menopausal symptoms that interfere with their daily lives
10% of women will stop working due to unmanaged symptoms of menopause
common symptoms
Hot Flashes
Fatigue
Joint Pain
Never Sleeping
Irregular Periods
Hair thinning
Weight Gain
Vaginal Dryness
Brain Fog
Bladder Issues
Unstable Moods
Sexual Problems
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Ready to Finally Feel Like Yourself Again?
The Perimenopause Reset Complete Care is $1,297 CAD, or three monthly payments of $475 CAD.
Both payment options give you immediate access to the full 12-week lifestyle program from the moment you enroll, including all video lessons, workbooks, and action task checklists.
After enrolling, book your initial visit and begin your personalized medical care right away
Looking for medical visits only?
STILL NOT SURE?
please email: [email protected]
I read and respond to every message personally
FAQS
Do I need to be in British Columbia??
Yes, you must be physically located in BC at the time of your medical appointments.
Please Note:
For safety reasons, we are currently unable to provide care if you have a history of breast, uterine, or ovarian cancer, deep vein thrombosis (DVT), are a current smoker, or are experiencing unexplained vaginal bleeding.
What if I am already on HRT from another provider?
That is completely fine, and great actually, because we can fine-tune your treatment if needed. During your initial visit we will review your current treatment, assess whether adjustments would benefit you, and build from there. The lifestyle program will support your body alongside whatever HRT plan we establish together.
what is the process if i want HRT only, without the program?
You are welcome to book medical visits on their own.
Initial visits are $400 (60 minutes) and follow-ups are $175 (25 minutes-standard) or $300 (45 minutes-extended)
You can book directly through our Jane App booking page HERE. If you are postmenopausal, this is a great option for you. For perimenopausal women, I recommend considering The Perimenopause Reset: Complete Care for the most comprehensive approach.
Do you Prescribe HRT or BHRT?
We prescribe FDA approved HRT and prefer Bioidentical HRT when possible. We also prescribe non-hormonal treatments for menopause if needed. Testosterone and compounded hormones may be considered depending on the situation. We do not prescribe injectable HRT or pellets.
All prescriptions are sent to the pharmacy of your choosing in BC.
Where do i book my medical appointments?
After enrolling in the program, you can book all your visits through our Jane App booking page HERE
If you are a returning patient, or would like medical care only, please also book through the above booking link.
Please provide at least 24 hours' notice if you need to cancel or reschedule your appointment.
Pricing: Is This Covered by Health Care Insurance?
Medical Care Only: Each appointment is billed separately
Initial Appointment (60min): $400 CAD
Follow up Appointments Standard (25min): $175 CAD, OR Extended (45min): $300 CAD
*Prices Subject to Change
The Perimenopause Reset Program: Complete Care: $1297 CAD, or three monthly payments of $475 CAD.
-Price includes 3 medical visits: 60min initial, Extended 45min Follow up at week 6 and 12. And the 12 week Lifestyle program.
As a private telemedicine practice, appointment consultation costs and the Perimenopause Reset Program are not covered by MSP and you will have to pay out of pocket for the appointment fee. If you have a Health Spending Account (HSA), you may be able to submit receipts for reimbursement. Please check with your plan to confirm.
All lab tests are covered by MSP. Prescription coverage is dependent on your drug plan. As of March 1 2026, most HRT medications are covered.
How much time will the program take each week?
All videos are bite-sized and no longer than 15 minutes each. Most women spend about 30 minutes to 1 hour per week on the lessons. You will also need to put the strategies into practice to see a transformation.
I am really busy. What if I cannot keep up with the program?
The modules are self-paced and designed for busy women. You can watch or listen on your own time, and even small changes can make a big difference. Many women tell me this program actually saves them time by cutting out all the guesswork. Plus, your medical visits are built-in touchpoints where we can adjust and refocus together.
Do I have to give up my favorite foods or follow a strict diet?
No. This is not about rigid dieting or restriction. Instead, you will learn how to stabilize blood sugar, calm inflammation, and nourish your body with practical strategies you can stick to long-term.
What services do we NOT provide?
We cannot serve as your primary care clinician. Since all appointments are virtual, we cannot do physical assessments, pelvic or breast exams, IUD insertions, biopsies, or pap smears. You should see your primary care provider or walk in clinic for all your other medical needs. You will be asked to sign an agreement consenting to virtual care prior to your appointment.
Please Note:
For safety reasons, we are currently unable to provide care if you have a history of breast, uterine, or ovarian cancer, deep vein thrombosis (DVT), are a current smoker, or are experiencing unexplained vaginal bleeding.
Please Join Our Facebook Group HERE for community support.
What happens after the program?
After your 12-week program and final visit, you have the option to continue as a patient with follow-up visits as needed to manage your HRT and ongoing care. Follow-up visits after the program are billed separately.