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Q. How long has the clinic been in operation?

A. The Westcoast Women's Clinic opened in 2002. It was founded by Dr. Nishi Dhawan and Dr. Bal Pawa to provide comprehensive and holistic treatment for women dealing with hormonal issues. Today, the clinic treats both young and mature women as well as men who are experiencing hormonal imbalances.

Q: Do I need a referral from my family doctor to attend your clinic?

A: You do not need a referral, and you may contact us directly to arrange your initial consultation. However many family doctors are referring their patients as they see the benefit in our comprehensive, preventative and holistic approach. We do encourage you to inform your doctor that you are attending this clinic.

Q: I live out of town! Can I still be a patient?

A: Of course! But your initial consultation and urine test results appointment must be in our office. Our physicians require that they meet you face-to-face and get to know you. This is done for your own medical safety. Out-of-town patients have the option of combining their initial consultation with their urine test results appointment, so that it is only one trip into Vancouver. All further appointments can then be conducted via telephone.

Q. Does the clinic treat men as well?

A. Yes, we have many requests from our patients who would like their partners to benefit as they have. Thus we now treat men who are undergoing hormonal and life changes.

Q. What type of testing does the Westcoast Women's Clinic utilize?

A. Our physicians have researched various forms of hormone testing. They use what many experts in Europe and the United States consider to be the Gold Standard  a comprehensive 24-hour urine test. In addition to providing a complete hormonal read, this test provides an analysis of adrenal and thyroid functions. This type of testing takes the guesswork out of the hormone assessment process. The added value of the urine testing is that it looks at how the liver is functioning, which is key to how hormones are broken down in the body. This type of testing is not fully available in Canada. The lab we currently use is in the United States and has been providing leading edge testing for three decades. Additional blood work may be ordered by your physician if required.

Q: Why use a 24-hour urine test and not blood or saliva testing?

A: Hormones are released in our bodies in a pulsed 24-hour cycle, so an analysis over the entire 24-hour period is a lot more informative than a single blood sample (which is a fixed point within the 24-hour cycle). Hormones do not float around in the blood freely - they are bound to proteins within the blood, which makes them difficult to assess. Saliva is not useful to evaluate the metabolism of hormones and for measuring thyroid levels. Urine tests provide us with the opportunity to have a look at liver function, which is extremely important in establishing the breakdown of pathways for your hormones.

Q: Do you work with Naturopaths?

A: We can work together with your naturopath as our holistic and multi-discipline approach to medicine can be complementary.

Q: What is included in my Annual Personal Health Plan?

A: Please refer to our section on the Personal Health Plan.

Q: How do you follow my progress during my Annual Personal Health Plan?

A: You will have 30 minute follow-up appointments every three months, during which your physician will review your lifestyle changes, health goals, symptoms and management plan, and discuss treatment options that may include nutraceuticals and bio-identical hormones. Questions, concerns and symptoms that come up between your quarterly appointments will be dealt with on an individual basis.

Q: Can I book telephone appointments for my follow-ups?

A: Telephone appointments are a courtesy reserved exclusively for our out-of-town patients. It is preferred that all other patients come in to the office for their appointments.


Q: Can I email my questions or health concerns to my physician?

A: For your medical safety, we ask that patients refrain from communicating medical concerns through our clinic email. It is for general clinic communications only and may not be time sensitive. We ask that patients call the office if you require medical assistance.

Q: What happens once my year is up?

A: At the end of your Annual Personal Health Plan, you will have a final appointment to review your progress and help you decide on your next steps. Various renewal options are available. Our Client Care Coordinator will assist you at this time.

Q. What are some of the attributes of the Westcoast Women's Clinic?

A. The doctors are caring, compassionate and dedicated individuals who provide their time and expertise in a warm, approachable manner. They combine the knowledge of the body's functioning (which they learned in medical school) with cutting edge testing and diagnostics along with wisdom of natural medicine. Women feel very relieved when they can openly talk about some of the natural approaches they have used or when they do not want to use medication- and not be criticized or judged about it.

Q. What do you do to educate your patients?

A. As part of our mandate and mission, the Westcoast Women's Clinic pays particular attention to educating and empowering women to improve their own health. We have designed a comprehensive three-hour physician-led seminar to educate women about how their hormones function; how stress, nutrition and exercise impact their hormone balance; and the importance of the adrenal and thyroid gland in the function of estrogen and progesterone. We also cover hormone testing, supplements, and bio identical hormones. The seminar is held for small groups in a private setting, and there is always ample time for questions.

In addition to our physician-led seminars, we have workshops with our team of health professionals, including a medical herbalist, psychologist, life coach and physiotherapist. These workshops are part of your Annual Health Plan. We have also designed various educational materials for our clients.

Q: Do you take new patients for family practice?

A: No, we do not. We are not a primary care facility but we do encourage you to inform your family physician of your care with us. All general health issues should be addressed by your family physician. We are a specialty clinic focusing on hormones and midlife health. To make the most out of your appointments with your physician at the Westcoast Women's Clinic, we recommend you see your family physician for things such as cuts and colds, broken bones and injuries, and disability/unemployment forms and ongoing care of your other medical concerns.


Q. Why did the clinic's physicians get into this line of medicine?

A. The founding physicians realized that women had very specific health concerns as they age that required extra time, expertise and a holistic approach. They believed an integrated health model that addressed hormones, physical health, and emotional needs as well as the mind body connection was essential to provide the best care for midlife health. They decided to pursue this line of medicine more intently and furthered their education in this area.

Q. What specific training do the clinic's physicians have in midlife health?

A. All our doctors are certified by the North American Menopause Society as menopause clinicians. They have completed courses on hormonal assessment and advanced hormone replacement, preventative and mind body medicine, and continue to attend courses and seminars on a variety of issues related to aging  for both men and women.


Q. When should you start thinking about midlife health?

A. Aging begins after 30, so it is never too soon to take measures to optimize your health. Hormone imbalances can occur at any age and we need to listen to our body when it tells us with symptoms that it is out of sync. We see younger women in their 20's and 30's who are concerned about hormone issues, as well as women in their mid 30's to early 40's who want to be proactive about their hormonal health. For mature women it is often a quality of life issue  managing their symptoms but also optimizing their health for today and the future. The clinic has many older patients who say they have never felt better because they have taken the time and effort to make their health a priority.

Q. What type of symptoms do patients typically have?

A. Some of the most common symptoms include hot flashes, insomnia, night sweats, emotional fragility, mood disorders, weight gain (and the inability to lose weight like they used to), bone density issues, etc. For a more complete list, please the section on Symptoms We Treat.

Q. What are the biggest factors that affect the aging process?

A. Aging is a natural process that occurs as our hormones decline, but today's fast-paced lifestyle can rapidly accelerate the aging process. Stress, poor nutrition and environmental stressors can all impact the optimal function of our hormones and this has significant impact on the aging process. Making important changes in lifestyle and replacing hormones if needed can help slow down the aging process and renew the body's function.


Q. What exactly are hormones?

A. Hormones are chemical messengers that are delivered to body tissues through the blood. Once hormones enter tissues, they turn on genetic "switches" that regulate everything from reproduction to emotions, general health and well-being. Different glands and organs in the body produce hormones. For example, the pancreas produces the hormone insulin, the ovaries produce estrogens and progesterone, and the adrenal glands produce cortisol and DHEA. Other glands, such as the pituitary in the brain, secrete hormones such as FSH (follicle stimulating hormone) and LH (luteinizing hormone), which control how much estrogen and progesterone are produced by the ovaries.

Q. What is bio identical hormone therapy?

A. Bio identical Hormone Therapy refers to the therapeutic use of hormones that are identical in every way to the hormones released naturally in the body. Bio identical hormones include estradiol, estrone, estriol, progesterone and testosterone in addition to others. Some bio identical hormone therapies are available from drug companies as standard prescriptions, others must be compounded for the individual by a pharmacist.


Q: Are your services covered by MSP?

A: Our clinic focuses on preventative, integrative medicine. We spend a lot of time educating and providing you with personal nutrition, stress management and multidisciplinary strategies that you will use every day to maximize your midlife health and enjoyment. For this reason our Annual Personal Health Plan, which exists beyond the boundaries of MSP coverage, has been created. At times, we may also prescribe or recommend medically necessary services that are covered under MSP.

Q: Are your services covered by my extended health plan?

A: We do not accept insurance assignments on your extended medical benefits. Your insurance company may reimburse you directly whatever they determine reasonable as per their own guideline for claims. You are strongly advised to contact your insurance carrier directly regarding your extended benefits. You can ask for key phrases such as "physician-based risk assessments", "wellness coverage," and "alternative therapies" similar to a naturopath or herbalist.

Q: Are my bio identical hormone prescriptions included in my health plan?

A: No, they are not as not all patients will need to use hormones. The cost for your prescriptions and supplements is an additional cost and is dependent upon the pharmacy you have them filled at.

Q: How much do the bio identical hormones cost?

A: It depends. Different compounding pharmacies will charge different prices. The average cost of bio-identicals is about $1/hormone per day. So it will depend on how many bio identical hormones you will need. When choosing a compounding pharmacy, ensure they are certified by the Professional Compounding Centers of America.

Q: Do you have a compounding pharmacy on site?

A: No, we do not. But we can provide our patients with a list of compounding pharmacies in various parts of Metro-Vancouver and in B.C.

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