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Evaluation
We help identify the factors contributing to your symptoms and build a plan that fits your life.
Let’s talk about the things women often deal with quietly — bladder leakage, pelvic pressure, vaginal dryness, pain with intimacy, or simply feeling like something has changed and not knowing what to do about it. These symptoms can feel frustrating, embarrassing, even isolating. They are also incredibly common, especially after childbirth, with hormone changes, or through perimenopause and menopause. And common does not mean normal forever. At Alpenaura Holistic Health in Bend, Oregon, we offer a private, judgment-free space to talk about intimate health in a way that feels comfortable, honest, and supportive. We look at the whole picture — your symptoms, your hormones, your tissue health, your pelvic floor, your goals, and what actually makes sense for your life. Your comfort, confidence, and quality of life matter at every stage. 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.
Leakage with coughing, laughing, or exercise is common after childbirth and around menopause — and it is not something to manage privately with pads for the rest of your life. Most cases improve substantially with the right evaluation and treatment.
Declining estrogen thins and dries vaginal tissue, causing dryness, irritation, and pain that will not resolve on its own — and typically worsens without treatment. This is one of the most treatable conditions in menopause care and one of the least often raised.
Pain during sex is common and it always has a cause. Tissue changes, pelvic floor muscle tension, scar tissue, hormonal shifts, and other conditions can each contribute, often in combination — and each is addressable.
Low libido is rarely caused by one thing. Hormones may play a role, but so can stress, medications, sleep, relationship dynamics, pelvic pain, thyroid function, and metabolic health. We evaluate the contributors rather than assuming the cause.
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.
It is common, but it is not something you have to accept permanently. Pelvic floor therapy, vaginal estrogen, behavioral strategies, and other treatments help the majority of patients meaningfully, and many resolve their symptoms entirely.
You are not the first person to feel that way, and these conversations are a routine and welcome part of our practice. Appointments are private and unhurried, we follow your lead on pace, and no examination happens without discussion first.
Yes. Non-hormonal options, vaginal moisturizers, pelvic floor therapy, and in selected cases localized vaginal estrogen may be appropriate. Decisions are individualized based on your cancer history and current risk profile, in collaboration with your oncology team when appropriate.
Yes. Pelvic floor physical therapy is an important tool and we refer to excellent local therapists, but our care also includes hormone evaluation and treatment, vaginal therapies, medication management, and evaluation of the other contributors involved.
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