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Decision Support for Bioidentical Hormone Therapy

About Us

Menopause, the cessation of the menstrual cycle, happens to all women who live long enough. It is usually a gradual process but can occur abruptly in cases where the ovaries are surgically removed or cease to function. During perimenopause, the five to ten years before menopause, the ovaries produce less and less hormone. The reduced amount of hormone causes menstrual periods to become irregular and eventually to stop completely. The hormonal changes often cause other symptoms as well. The Menopause Center of Minnesota was created to help women 35 and older who are dealing with issues and symptoms of perimenopause/ menopause. The Menopause Center is led by Sandy Greenquist, a certified nurse-midwife and NAMS certified menopause practitioner with more than 30 years’ experience providing care to women, and Rebecca Mendoza, a certified nurse practitioner and NAMS certified menopause practitioner.Your First VisitYour initial meeting with a provider at the center typically lasts 45 minutes to an hour. You will be asked to fill out a Patient Information form and a Health Survey either before hand or when you arrive. The Survey will be used as a basis for the session. (Both forms are currently available on our website.)All of the elements on the survey help to inform your provider and determine a course of action. If appropriate, you may be asked to do lab testing, most often of saliva, for your sex hormones (estradiol, progesterone, testosterone) and, if indicated, your adrenal hormone levels. If testing is done you will return to the Center 3 weeks later to review the results and a recommended plan of action. If testing is not necessary your provider will give you what options she recommends with relation to hormones, supplements, complementary care, nutrition and exercise whatever she believes will be beneficial to improving your current issues and establishing long-term health maintenance.If you start on hormones, you will be asked to return in 6 to 8 weeks. At this visit, usually 20 to 30 minutes, we will evaluate your previous symptoms, note changes with hormone therapy, answer questions and set a plan for ongoing care.An annual visit is required for providers to continue renewing/adjusting prescriptions. At this visit we will evaluate whether your current prescriptions continue to be correct, discuss any new research or recommendations that affect your care, determine if it is time to begin reducing your hormones to lower, maintenance doses (as symptoms subside) and address any questions/issues you may have.Providers will address simple questions and/or prescriptions issues on the phone or by email. Ongoing issues or more involved needs will require an interim office visit.

RESOURCES No Frame

Resources

Patient Inf form 2011.pdf

Patient_Health_History_FormNewPG1.pdf

Internet_Resources_for_Midlife_Women.doc

www.fairygodmotheronline.com

www.survivorstraining.org

www.wellwithin.org

www.healthcentral.com/menopause

Isagenix Movie

www.hotflashhavoc.net/

FAQ'S

FAQ's

Q: What is menopause?A: The word menopause is defined as a woman's last menstrual period. One year without any bleeding confirms that a woman is menopausal. The average age for menopause is 51.Q: What is perimenopause?A: Perimenopause is the time leading up to menopause. Hormone levels can begin to change and symptoms can occur as early as age 35. Perimenopause is the period of time when symptoms will be most apparent and may be significant enough to affect a woman's quality of life.Q: What are bioidentical hormones?A: Bioidentical hormones are plant based and compounded to be biochemically the same as the reproductive hormones a woman's body produces. The molecules of estradiol (estrogen), progesterone, and testosterone are exact replicas and perform in the body as the original hormones did.Q: Where can I get bioidentical hormones?A: There are both pharmaceutically-produced hormones and custom compounded products. The pharmaceuticals are available with prescription at any pharmacy. The custom-compounded must be obtained at a compounding pharmacy which is licensed to produce these products at their facility.Q: How do the 2 types of bioidentical hormone products differ? A: The pharmaceuticals are mass-produced and, therefore, do have preservatives for a longer shelf life. They also have fewer different dosage levels, so it is harder to individualize dosing. Compounded bioidentical hormones are ordered on an individualized basis, contain no preservatives, can be made in whatever dosage or form (capsule, cream, lozenges) prescribed and can combine hormones together into one form.Q: What hormones do you prescribe at the Menopause Center?A: We prescribe only bioidentical hormones: estradiol, progesterone and testosterone, in both pharmaceutical and compounded forms.Q: Do I need to have lab work done?A: Not always though lab values can be helpful. At the center, our primary form of testing is salivary. Decisions whether to test are based on each woman's history, current issues, hormone status and references. Testing may include both reproductive and adrenal hormones.Q: What is the Menopause Center?A: The Menopause Center is a place where we listen to women. Its a mentoring program to help you through the transition of midlife and perimenopause.Together, you and the provider create a plan that is tailored to your needs and respectful of your choices. At your first visit, you will be asked about the issues or symptoms you are experiencing. This discussion forms the basis for your plan. Follow-up sessions and appointments can determine if any changes need to be made to your plan.Q: Why create a center just for menopause?A: Menopause is a natural part of a woman's life. It is not a disease and does not necessarily require any treatment. However, certain health problems such as osteoporosis, are associated with low estrogen. Because of this and because many of the physical and psychological symptoms can interfere with daily activities and quality of life, a menopause center that provides counseling and services is beneficial.During perimenopause/menopause, you may experience physical and psychological symptoms. These may occur for a few weeks, months or sometimes over several years. Your symptoms may come and go or occur regularly. Symptoms can include:• Changes in menstrual cycle and flow• Hot flashes and night sweats• Excessive fatigue or insomnia• Dizziness• Headaches• Weepiness• Unpredictable mood swings• Loss of libido• Dry skin and hair• Fuzzy thinking• Inability to concentrate• Memory lapses• Vaginal dryness• Heart palpitations• Redistribution of body fat• Restless, jumpy legs• Urine leakage• Breast tenderness• Negative reaction to touchQ: How is menopause diagnosed?A: Most women go through menopause between ages 45 and 60. The average age for menstrual periods to stop completely is 51 for women in the United States. Your health care provider will ask about your health history. You may have saliva or blood tests.Q: How is menopause treated?A: There are a number of options that can help prevent problems and diminish symptoms, including herbs and supplements. Many women choose to take estrogen, progesterone and /or testosterone to replace what their body is no longer producing. This treatment is called hormone replacement therapy (HRT). The types of HRT prescribed at the Menopause Center are bioidentical, biochemically identical to, and mimicking the function of your own body's hormones.Q: What services are available at the Menopause Center?A: You may schedule appointments for:• Menopause and health education• Hormone decision making and therapy• Menopause discussion/support groups are offered periodically

SANDY GREENQUIST No Frame

Sandy Greenquist, CNM

Sandy Greenquist has provided OB/GYN and well-woman care in the Twin Cities for over 32 years. She received her Master of Arts degree and Nurse-Midwifery certification from the U of MN Nurse-Midwifery Program in 1975 and later taught in the program for 12 years. Sandy began developing her expertise in perimenopause/menopause in 1990 and opened her first Midlife Women's Clinic at that time. She became known in the community as the Midlife Midwife. In 2000, she became certified as a menopause clinician and, in 2002, opened The Menopause Center at United Hospital in St. Paul. After 6 satisfying years there, Sandy decided to take her practice out of the system and into private practice. On March 3, 2008, The Menopause Center of Minnesota opened with her as its Director. At the Center, Sandy provides women with education, counseling, resources and guidance in the management of the perimenopause/menopause transition. Throughout her career, she has lectured to lay and professional audiences on a variety of women's health issues.

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REBECCA MENDOZA

Rebecca Mendoza, CNP

Becky Mendoza is a Women's Health Nurse Practitioner and certified Menopause Clinician, She has more than 16 years of experience providing OB/GYN care to women, with a focus on perimenopause/menopause, and a special interest in the hormonal issues of breast cancer survivors. She started her career as a Nurse Practitioner in Seattle , Washington, and moved back to Minnesota in 1995 and started working at Parkview OB/GYN in Maplewood,MN. She joined Sandy in the Menopause Center of United Hospital in 2006, and continues to practice with her at The Menopause Center of Minnesota. Becky has been a Certified Menopause Clinician since 2002. Since that time she has given seminars, taught classes, and has been on the radio in the Twin Cities discussing perimenopause and menopause. She is a member of the North American Menopause Society and the Association of Nurse Practitioners in Women's Health.

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DIANE FELLER

Diane Feller, CNM

Diane Feller received her Masters of Science degree from the University of MN and certification in Nurse-Midwifery in 1998. Since then Diane has provided OB/GYN and well woman care in the Twin Cities as a Certified Nurse Midwife. Diane has held director positions at two nurse midwife practices tohelp ensure the promotion of midwifery care for womens health within the larger OB/GYN practices.Diane has a total of 30 years experience working with women in all aspects of womens health. Throughout Dianes career, Sandy Greenquist has been a valued mentor. At this point in her career, Diane wants to devote herself to helping the underserved population of midlife women.

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ISAGENIX

Isagenix is a nutritional cleansing lifestyle, a natural way of cleansing without depleting your body. At the same time, by giving your body the best in all-organic, nutrient-dense foods, you allow your body to do what it was designed to do:Remove impuritiesReplenish every cellRejuvenate the entire bodySandy on Isagenix:I came to Isagenix because I wanted to deal in a healthy way with those unwelcome pounds around my middle which are frustratingly common for us women-of-a-certain-age. Ive stayed with it and incorporated it into an opportunity at the Menopause Center because it did all they promised: I lost the weight and a significant number of inches; my energy level increased; my sleep improved; and my aches and pains disappeared. Sounds too good to be true, but I've researched it quite thoroughly and have met literally hundreds with similar outcomes.Benefits of IsagenixIsagenix provides you with over 100 nutrients that cleanse and replenish, over 100 specially-sourced ingredients from around the world and exclusively-sourced undenatured New Zealand whey and casein protein from grass-fed cows with no added hormones or antibiotics. My favorite part: a 30-day money-back guarantee. So they give you your health back or your money back. And its food replacement, so its not even an added part to your grocery budget.For More InformationIf you'd like to know more, you can call any of the Center staff or come to one of our informational meetings listed on our website.

Please watch this informational video on the benefits of Isagenix!

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CLASSES MEETINGS SMALL GROUPS No Frame

Classes | Meetings | Small Groups

MENOPAUSE 101: White Bear Lake Community Services & RecreationWhiteBearRegistration.org651-407-7501WHEN: Wed, Feb 1, 2011 6:00PM -7:30PM WHERE: White Bear South Campus, 3551 McKnight Rd, #302_________________________________ISAGENIX INFORMATIONAL MEETINGSWHEN: Please check w/ us WHERE: Menopause Center of MNplease contact us for information. 651-698-0891_________________________________

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Contact

Please do not hesitate to contact us to make a booking or with any questions you may have regarding our servicesMENOPAUSE CENTER OF MINNESOTA1619 Dayton AvenueSuite #109Saint Paul, MN 55104Office : 651-698-0891 Fax : 651-644-2609 OPENING HOURSMonday | Tuesday | Thursday 9:00 -5:00Wednesday 10:00 - 6:00Friday 9:00 -12:00DIRECTIONSGoing east on I-94: Exit at Snelling Avenue. Go south (right) three blocks to Marshall Avenue. Turn right; the Richards Gordon building is on the first block on your left. Take the first left turn off Marshall onto Fry Street and turn left into the parking area. Going west on 94: Exit at Snelling Avenue and turn left. Move to the right hand lane and turn right onto Marshall Avenue. The Richards Gordon building is on the first block off of Snelling. Take the first left turn off Marshall onto Fry Street and turn left into the parking area.

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WHO WE ARE

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SANDY GREENQUIST

REBECCA MENDOZA

DIANE FELLER

ISAGENIX

CLASSES MEETINGS SMALL GROUPS

1619 Dayton Avenue, Suite 109Saint Paul, MN 55104T: (651) 698-0891F: (651) 644-2609Monday | Tuesday | Thursday 9:00 AM to 5:00 PMWednesday 10:00 AM to 6:00 PMFriday 9:00 AM to 12:00 PM