Who this is for
Women in perimenopause through post-menopause. Surgical menopause and chemotherapy-induced menopause in scope. Severe symptoms requiring HRT decisions coordinated with GYN/PCP, not replaced.
What brings people here
MRS >=15; perimenopause or menopause symptoms; member request; PCP referral for HRT conversation.
Clinical framework
OneVillage-developed (NAMS-aligned).
How the 8 weeks run
Baseline assessments, your first SMART goal, and the 1:1 that sets up everything after it.
Specialist coaches rotate in, and sessions come thickest here. One change at a time, in the domains your baseline flagged.
Re-score, refresh the care plan, and check in 1:1 on what is and is not working.
The remaining domains, at a lighter cadence, and the work of making the early weeks hold under pressure.
Final re-score, relapse prevention, and the plan for what happens next.
When your sessions fall
The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.
| Module | Weeks | Sessions | Cadence |
|---|---|---|---|
| Module 1 | Weeks 1 to 4 | 2 | every other week |
| Module 2 | Weeks 5 to 8 | 2 | every other week |
Week by week
- Before you beginBefore you begin
This is the reading before your first visit. Start with the number almost nobody is given.
- Week 1What the Women's Health Initiative actually found
In July 2002 a large trial was stopped early, the finding led every news bulletin, and within a few years a generation of women had come off hormone therapy. Many of them still believe the original headline.
- Week 2The hormone therapy conversation
This week you meet Alexandra Chamorro, our menopause coach, for 45 minutes. The purpose is not to decide anything. It is to make sure that when you sit down with the clinician who can decide, the fifteen minutes are spent well.
- Week 3Hot flashes without hormones
Some women cannot take hormone therapy. Some can and choose not to. Some are waiting for an appointment. This week is what the evidence supports in the meantime, and it is also the week we tell you which of the things sold to you do not work.
- Week 4Halfway: the re-score, and the parts nobody warned you about
This week you see Cindy again for 45 minutes and repeat every measure you did at week 0. Bring the numbers, not the impression.
- Week 5Sleep
Ask a woman in the menopause transition what she would fix first and she usually says sleep. She is right to. Sleep is where vasomotor symptoms do most of their damage, and it is one of the few places in this pathway where a non-drug treatment has direct trial evidence.
- Week 6Bone, muscle and the pelvic floor
This week you meet Tonia Burke, DPT, for 45 minutes. Hot flashes end. Bone loss does not undo itself. This is the week about the changes that are permanent if nothing is done, and it is the one where what we deliver directly does the most good.
- Week 7The heart, the body and the years after
Menopause is treated as a symptom problem, and the symptoms end. The changes in this week's reading do not end, and they are the reason the American Heart Association wrote a scientific statement about a reproductive transition.
- Week 8Making it hold
This is the last reading and the last 45 minutes with Cindy. Menopause is not an eight-week problem, so week 8 is a handover rather than an ending.
Who you will work with
Your Whole Health Coach takes your first visit and closes every module, so it is the same person from the first session to the last. The specialists below lead the weeks where their work is the focus.
Professionally, Cindy has been a clinical nurse for nearly a decade. She served in both clinical and administrative capacities throughout her career and holds a Master's degree in Nursing Leadership. As a staff nurse, nurse leader, and quality improvement specialist, she led multidisciplinary teams in academic medical settings throughout Boston, New York, and Ohio to deliver high-quality care to patients across complex diagnoses.
Alexandra Chamorro is a passionate advocate for women's health. As a dedicated Menopause Coach, she is committed to empowering women with the knowledge, tools, and unwavering support they need to confidently embrace their health with vitality and grace through integrative lifestyle changes. Her specialization lies in hormonal transitions, where she excels in deep empathetic understanding, creating a safe and non-judgmental space for her clients.
Tonia is a Doctor of Physical Therapy, Integrative Nutrition Health Coach, and Certified McKenzie Spine Specialist with over 25 years of experience helping clients heal from pain, injury, and chronic conditions. She specializes in spine care, orthopedic rehabilitation, and restoring strength and vitality through personalized, science-based treatment.
What we work on
| Domain | What this pathway does |
|---|---|
| Nutrition & Metabolism | Hormone-supportive: protein, calcium 1200mg, vit D 800-1000 IU, fiber, soy/legumes if tolerated. |
| Movement & Mobility | Bone-density-protective: strength 2-3x/wk + impact loading. Pelvic floor. Coordination. |
| Sleep & Recovery | Vasomotor disrupts sleep. CBT-I principles. Bedroom cool. ISI tracked. |
| Stress & Resilience | Stress amplifies vasomotor. Daily relaxation. |
| Hormonal Balance | MRS tracked. HRT conversation supported, not directed. |
| Mind & Mood | Mood + cognition shift common. PHQ-9 + GAD-7 monthly. Brain-fog conversation normalized. |
How progress is measured
These are the validated tools this pathway uses: at your first visit, at the mid-program review, and at the end.
| Tool | Cadence | Owned by |
|---|---|---|
| MRS (Menopause Rating Scale) | Onboard, q4 weeks | WHC |
| ISI | Onboard, q4 weeks | Sleep Coach |
| PSS-10 | Onboard, q4 weeks | Stress Coach |
| PHQ-9 + GAD-7 | Onboard, monthly | WHC |
| FSFI (Female Sexual Function) | Onboard, q4 weeks | Sexual Health Coach |
| Bone health screen (DXA) | Per PCP; tracked | WHC |
The research behind this pathway
Your clinician playbook was built from the guidelines and studies below. They are listed so you can read them yourself: every one is a real, published paper and the number at the end of each line is its PubMed ID.
Guidelines this pathway follows
- 2022 hormone therapy position statement · The North American Menopause Society
Who benefits from hormone therapy and who should not take it. PMID 35797481
- 2023 nonhormone therapy position statement · The North American Menopause Society
What this pathway can actually offer, including cognitive behavioral therapy and clinical hypnosis. PMID 37252752
- Menopause Transition and Cardiovascular Disease Risk · American Heart Association
Why this pathway tracks heart measures and not only symptoms. PMID 33251828
Key studies
- The North American Menopause Society (2022). MenopauseThe 2022 hormone therapy position statement of The North American Menopause Society
The North American Menopause Society's current position on hormone therapy: who benefits, who should not take it, and how the balance shifts with age and time since menopause. PMID 35797481
- The North American Menopause Society (2023). MenopauseThe 2023 nonhormone therapy position statement of The North American Menopause Society
The same society's position on everything that is not hormone therapy, which is what this pathway can actually offer, including cognitive behavioral therapy and clinical hypnosis. PMID 37252752
- El Khoudary SR et al. (2020). CirculationMenopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association
The American Heart Association's statement that the menopause transition itself changes cardiovascular risk, which is why this pathway tracks heart measures and not just symptoms. PMID 33251828
- Xu Q et al. (2014). MenopauseExamining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis
Pooled the studies of sleep across the menopause transition and confirmed that disturbed sleep genuinely rises with menopausal stage. PMID 24800878
- El Khoudary SR et al. (2019). MenopauseThe menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN)
SWAN followed a diverse group of women through the menopause transition for over 20 years. It is where most of what this pathway assumes about timing and symptoms comes from. PMID 31568098