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Evaluation
We help identify the factors contributing to your symptoms and build a plan that fits your life.
So many women live for years with painful periods, irregular cycles, PCOS, endometriosis, or PMDD — and somewhere along the way, they start to wonder whether they are simply supposed to tolerate it. Pain that disrupts your life is not something you should have to normalize. Mood changes that take over the week before your period are not something you should have to white-knuckle every month. And feeling like your body is unpredictable, or working against you, deserves real support. At Alpenaura Holistic Health in Bend, Oregon, we evaluate and treat the chronic gynecologic and hormonal conditions that are most often minimized: PCOS, endometriosis, adenomyosis, PMDD and severe PMS, pelvic pain, and irregular or heavy bleeding. We combine conventional gynecologic care with an integrative lens, looking at the full picture — your symptoms, your cycle, your labs, your hormones, your metabolism, your inflammation, your lifestyle, and your goals. We proudly serve patients in Bend, Redmond, Sisters, Sunriver, and throughout Central Oregon. We also offer telehealth services for Oregon, Washington, Alaska, and California clients.
PCOS is a metabolic and hormonal condition, not simply a reproductive one. Insulin resistance is central
for many patients, which is why care that addresses only the cycle often falls short. We evaluate the
hormonal and metabolic picture together and build treatment around what is actually driving your
symptoms.
Endometriosis is frequently diagnosed years later than it should be, in part because pelvic pain is so
often dismissed. We take pain seriously as a clinical finding, evaluate contributing factors, and
coordinate with surgical specialists when advanced care is needed.
PMDD is not ordinary PMS. When mood, anxiety, or irritability escalate predictably in the luteal phase
and interfere with work and relationships, that pattern is recognizable, treatable, and worth naming.
From the Nurse Practitioner
We help identify the factors contributing to your symptoms and build a plan that fits your life.
We offer individualized support around nutrition, movement, sleep, stress, blood sugar balance, and lifestyle habits without shame, crash dieting, or unrealistic expectations.
Hormonal shifts, thyroid dysfunction, PCOS, insulin resistance, perimenopause, menopause, medications, poor sleep, chronic stress, and under-fueling can all affect metabolism.
While GLP-1s can be an effective tool for some patients, we also explore lifestyle foundations, hormone and thyroid optimization, supplements, and other pharmaceutical interventions depending on the patient's history, goals, risks, and clinical needs.
Every woman’s health journey is unique. Here are answers to some of the most common questions about our approach to women’s health, hormone care, treatment options, and personalized care at Alpenaura.
Yes. Normal labs do not rule out endometriosis, adenomyosis, or PMDD — and standard screening often does not include the full hormonal and metabolic picture. Pain that disrupts your life warrants evaluation regardless of what a basic panel showed.
PCOS is diagnosed clinically, using a combination of cycle history, symptoms such as acne or hair changes, hormone and androgen labs, metabolic markers, and imaging when appropriate. We also rule out thyroid and other conditions that can produce similar patterns.
Not always. Many patients are managed medically with hormonal suppression, pain strategies, pelvic floor therapy, and anti-inflammatory support. When symptoms are severe or fertility is a concern, we coordinate referral for surgical evaluation and continue managing your care alongside it.
It can, though many patients with PCOS conceive with support. We offer cycle and ovulation evaluation, insulin resistance treatment, and referral coordination when advanced fertility care is needed.
Explore simple medication support or a more guided membership with monthly check-ins, provider visits, supplies, and included labs on select tiers.
Best for patients who want medication access and pharmacy coordination with visits/labs handled separately.
Best for patients who want structure, accountability, supplies, labs on select tiers, and follow-up built in.
| Pathway | Semaglutide | Tirzepatide | Best Fit |
|---|---|---|---|
| Basic GLP Support | $225-$325/mo | $275-$499/mo | Lower-touch support; visits and labs handled separately. |
| Comprehensive Reset | $325-$475/mo | $375-$625/mo | More structure: supplies, monthly MA check-ins, quarterly provider visits, labs on Standard/Advanced tiers. |
Comprehensive Standard and Advanced Reset memberships include an Expanded Metabolic Panel at initiation and a Basic Weight Loss Safety Panel at 6 months; both annually thereafter. Microdose Reset and Basic GLP Support patients may choose cash-pay labs a la carte, if they opt out of billing through insurance.
Medication is prescribed only when clinically appropriate.
Titration is based on tolerability, goals, and response.
Standard/Advanced Reset tiers include baseline and 6-month labs.
Monthly check-ins help you stay supported between visits.
| Start-Up | Commitment | Good To Know |
|---|---|---|
| $149 one-time enrollment/setup fee | 3-month initial commitment for medication-inclusive plans | Medication is not guaranteed. Eligibility, medication choice, and dose are determined after clinical review. |
Symptoms rarely have a single cause. Explore the other areas of Jade’s practice — hormone therapy, women’s health, medical weight loss, and comprehensive evaluation.
"Comprehensive women’s health care for every stage of life, from preventive care to hormone and cycle support."
"Bioidentical hormone therapy for perimenopause, menopause, and the symptoms you've been told to live with."
"An ongoing partnership in your health: comprehensive testing, personalized protocols, and a provider who knows your story."
YOUR CARE STARTS HERE
Stop guessing about your symptoms. Comprehensive testing, honest answers, and a plan built around
you — with Jade Carboy, NP