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Women’s Health
When your symptoms don’t fit neatly into one box, your care shouldn’t either.
Women’s health changes throughout life — and so can your symptoms.
Irregular or painful periods, heavy bleeding, PMS, PMOS (formerly PCOS), fertility concerns, hormonal changes, perimenopause, menopause, fatigue, sleep disruption, changes in mood or libido, and other symptoms can have many possible explanations.
At Sage Natural Health, we look at the whole picture rather than automatically assuming that one hormone, one nutrient, or one diagnosis explains everything.
Our multidisciplinary team includes naturopathic doctors, nurse practitioners, dietitians and other healthcare practitioners who can work together when appropriate. Depending on your needs, care may include lifestyle and nutrition support, prescription treatment, laboratory investigation, diagnostic imaging, hormone therapy, or referral and collaboration with your family physician, gynecologist, fertility specialist or another healthcare professional.
We use the right tools for the right patient at the right time.
Women’s Health Concerns We Help With
Women’s health encompasses much more than reproductive hormones. We support women through a wide range of concerns across the reproductive, hormonal and metabolic stages of life.
Menstrual concerns
Periods that are unusually painful, heavy, irregular, frequent or infrequent deserve attention. Changes in your cycle can sometimes be related to ovulation, PMOS, thyroid conditions, medications, fibroids, endometriosis, perimenopause or other medical conditions.
PMS and PMDD
Mood changes, breast tenderness, bloating, headaches, fatigue, sleep changes, irritability and other symptoms that occur before your period can significantly affect daily life. Severe cyclical mood symptoms may require assessment for PMDD, as well as consideration of other mental-health or medical conditions.
PCOS/PMOS
Polyendocrine metabolic ovarian syndrome or PMOS (formerly called polycystic ovary syndrome) can affect menstrual cycles, ovulation, androgen levels, fertility and metabolic health. Care may involve menstrual and symptom assessment, metabolic risk assessment, and nutrition and lifestyle support.
Endometriosis and pelvic pain
Severe menstrual pain, pain with sex, chronic pelvic pain or bowel and bladder symptoms around your period may warrant investigation for endometriosis or another pelvic condition. Naturopathic and nutrition care can provide supportive symptom management, but suspected or confirmed endometriosis may also require gynecological assessment and conventional treatment.
Perimenopause and menopause
Hot flashes, night sweats, sleep disruption, brain fog, mood changes, changes in periods, vaginal symptoms, reduced libido and other symptoms can begin during the menopausal transition — sometimes before periods stop.
Care may include lifestyle and nutrition strategies, symptom management, and discussion of hormone therapy when appropriate.
Fertility and preconception
If you’re trying to conceive, Sage can provide preconception and complementary fertility support. Assessment may include reviewing menstrual cycles, medical history, medications, nutrition, lifestyle and previous fertility investigations.
When fertility treatment or specialist assessment is indicated, care can be coordinated alongside your fertility clinic or reproductive specialist.
Hormonal and reproductive concerns
We also see concerns such as acne, unwanted hair growth, irregular cycles, vaginal dryness, painful intercourse, low libido and other symptoms that may overlap with reproductive, hormonal, metabolic or medication-related factors.
Thyroid and metabolic concerns
Fatigue, changes in menstrual cycles, temperature sensitivity, changes in weight, hair changes and other symptoms can sometimes overlap with thyroid or metabolic conditions. Appropriate medical assessment and laboratory testing can help determine whether further investigation is warranted.
Women’s preventive health
Our nurse practitioners can provide women’s health and preventive services, including appropriate screening such as Pap testing, depending on the service and clinical situation.
Preventive care should complement — not replace — your regular primary care and age- and risk-appropriate screening.
Your Symptoms Are the Starting Point — Not the Whole Story
The same symptom can have very different causes.
That is why we don’t start with a standard women’s-health protocol.
We start by understanding what is happening, when it started, how it has changed, what has already been investigated, and what matters most to you.
For example:
That is why we don’t start with a standard women’s-health protocol.
We start by understanding what is happening, when it started, how it has changed, what has already been investigated, and what matters most to you.
Our Approach
Individualized care, grounded in clinical assessment
Your first appointment is not about fitting you into a predetermined protocol.
Your practitioner may review:
- Your current symptoms and when they began
- Menstrual and reproductive history
- Previous diagnoses and investigations
- Medications, including hormonal contraception or hormone therapy
- Supplements and other treatments
- Nutrition and lifestyle
- Sleep, stress and mental health when relevant
- Family and personal medical history
- Fertility or pregnancy goals, when relevant
- Other health concerns that may be connected to your presentation
From there, your practitioner can determine what needs attention now, what can be monitored, and whether another healthcare professional should be involved.
Sometimes the best next step is naturopathic or nutritional care.
Sometimes it is medication.
Sometimes it is testing.
Sometimes it is a referral.
And sometimes it is a combination.
There is no single “Sage protocol” for women’s health.
Comprehensive Care Without Unnecessary Testing
Testing can be useful when it answers an important clinical question or when the result is likely to change treatment. It is not automatically better to order more tests.
Depending on your symptoms and medical history, assessment may include:
Blood work
When clinically appropriate, laboratory testing may help investigate concerns such as anemia or iron deficiency, thyroid conditions, metabolic health, hormonal or reproductive concerns, or other suspected medical conditions.
Diagnostic imaging
Ultrasound or other imaging may be appropriate when symptoms suggest a structural or pelvic concern, such as fibroids, ovarian abnormalities or other conditions requiring further investigation.
Condition-specific testing
Additional testing may be considered when your history or symptoms point toward a specific condition. The type and extent of testing should be individualized rather than based on a standard panel.
Referral or specialist investigation
Some concerns require assessment beyond what can be provided at Sage. We may recommend follow-up with your family physician, gynecologist, fertility specialist, endocrinologist or another healthcare professional when appropriate.
Our goal is not to test everything. It’s to investigate what matters.
One Team. Multiple Healthcare Perspectives.
Women’s health often crosses several areas of medicine. At Sage, your care can draw from different healthcare perspectives depending on what you actually need.
Naturopathic medicine
Naturopathic doctors can provide assessment and evidence-informed support using nutrition, lifestyle interventions, botanical or nutritional therapies, acupuncture and other approaches within their scope of practice.
Nurse practitioner care
Our nurse practitioners can provide conventional medical assessment and treatment for appropriate women’s-health concerns, including preventive care and prescription medications. This can be particularly valuable when symptoms require a conventional medical approach or when prescription treatment is appropriate.
Nutrition and dietitian support
Nutrition can be relevant to PCOS, metabolic health, fertility, pregnancy, iron status and overall health. Our dietitians can provide individualized nutrition care without automatically recommending restrictive diets or eliminating foods unnecessarily.
Mental health support
Hormonal and reproductive health concerns can affect mood, sleep, relationships and quality of life. Therapy can be incorporated when useful — without assuming that physical symptoms are psychological.
Collaboration and referral
Sage practitioners can work alongside your existing healthcare providers when appropriate. If a concern requires specialist investigation or treatment, referral is part of good healthcare — not a failure of the integrative approach.
The goal isn’t to choose between conventional and naturopathic medicine. It’s to use the right tools for the right patient at the right time.
Meet Some of Our Practitioners
Dr. Rahima Hirji, ND
Doctor of Naturopathic Medicine
Dr. Deanna Walker, ND
Doctor of Naturopathic Medicine
Dr. Heather Robinson, ND
Doctor of Naturopathic Medicine
Dr. Emile Sabga, BSC (Hon), ND
Doctor of Naturopathic Medicine
Dominique Williams, MSW, RSW
Registered Social Worker
What Might Treatment Look Like?
Treatment depends on what we find.
Depending on your goals and clinical needs, care may include:
Evidence-informed nutrition and lifestyle strategies
Support for sleep, physical activity and stress management
Treatment of identified nutritional deficiencies
Botanical or nutritional therapies when appropriate
Acupuncture for selected symptoms or as complementary care
Prescription medications when indicated
Hormone therapy for appropriate patients
Contraceptive counselling or other reproductive health care
Support during preconception and fertility treatment
Symptom management alongside conventional treatment
Referral for gynecological, fertility or other specialist care
For some women, treatment may involve one practitioner.
For others, the best plan may involve an ND, NP, dietitian or therapist working together.
Treatment also does not have to stay the same forever. As your symptoms, health priorities or circumstances change, your plan can change with you.
What to Expect
We listen.
Your symptoms, concerns, history and goals are the starting point. You don’t need to arrive with a diagnosis or know exactly what tests you need.
We assess the bigger picture.
We review your medical, menstrual and reproductive history alongside medications, nutrition, lifestyle and previous investigations that are relevant to your concern.
We decide whether further investigation is necessary.
If testing, imaging, prescription treatment or specialist assessment would help clarify the situation, we’ll discuss why it may be useful.
We build an individualized plan.
Your plan may involve one or more Sage practitioners and can include both conventional and naturopathic approaches when appropriate.
We reassess and adjust.
Your care should evolve based on how you’re doing, what we learn and what your health priorities are over time.
Frequently Asked Questions
No. You can book if you’re experiencing symptoms or have a health concern but aren’t sure what is causing it. The initial assessment can help determine what needs further investigation and what type of care is appropriate.
No. Hormone testing is not necessary for every women’s-health concern. Testing should be selected based on your symptoms, medical history and the clinical question your practitioner is trying to answer.
Our nurse practitioners can provide conventional medical assessment and prescription treatment within their scope of practice. Some naturopathic doctors at Sage also have prescribing authority for specific medications within their scope. Whether medication is appropriate depends on your individual situation.
Yes. Care may include assessment of menstrual and androgen-related symptoms, metabolic risk, nutrition and lifestyle factors, and discussion of conventional or naturopathic treatment options. Some patients may also benefit from prescription treatment or referral to another healthcare professional.
Sage can provide supportive care for people with endometriosis, including symptom-focused nutrition and lifestyle support where appropriate. Suspected or confirmed endometriosis may also require gynecological assessment and conventional treatment, and Sage care should not replace that evaluation.
Sage offers preconception and complementary fertility support. Your practitioner can review your health history, menstrual cycles, nutrition, lifestyle and previous investigations. If fertility treatment or specialist assessment is appropriate, Sage care can be coordinated alongside your fertility team.
Absolutely. Integrative care does not mean replacing your existing healthcare providers. We can work alongside conventional medical care and recommend referral when additional assessment or treatment is needed.
Not necessarily. Supplements are not automatically recommended. If a nutritional supplement is suggested, your practitioner should be able to explain what it is for, why it may be appropriate and how it fits into your overall plan.
Not necessarily. Sage does not believe that more testing is automatically better. Investigations should be recommended when they are clinically appropriate and when the result could meaningfully influence assessment or treatment.
Yes. A free discovery call can help determine whether Sage is an appropriate fit and what type of appointment may be most suitable for your concerns.
Women’s Health Care That Meets You Where You Are
Your health history is individual. Your symptoms are individual. Your treatment should be too.
Whether you’re dealing with painful periods, PCOS, fertility concerns, perimenopause, menopause, hormonal symptoms or a health concern you simply haven’t been able to make sense of, Sage can help you understand your options and determine what should happen next.
Sometimes that means naturopathic care.
Sometimes it means nutrition or lifestyle support.
Sometimes it means medication, testing or imaging.
And sometimes it means working alongside your physician or referring you to a specialist.
The goal is thoughtful, evidence-informed care — using the right tools for the right patient at the right time.
