A perimenopause and menopause doctor in St. Louis who takes your symptoms seriously
Dr. Kathryn Shoemaker is a board-certified internal medicine physician who treats perimenopause and menopause as part of your whole health. You see her in person, your labs are drawn right in our office, and you can call or text her when questions come up.
Board-certified physician · Labs drawn in our office · Call or text your doctor
Free, in person or virtual, with no commitment. After you send the form, our team will call you within 24–48 hours to answer your questions and find a time.
Perimenopause and menopause symptoms we treat
Perimenopause can begin years before your last period, and symptoms can continue well after menopause. The most common:
- Hot flashes and night sweats
- Trouble falling or staying asleep
- Irregular, heavier or more frequent periods
- Mood changes, anxiety or irritability
- Brain fog and trouble concentrating
- Weight gain, especially around the midsection
- Low libido, vaginal dryness or pain with sex
- Joint aches
- Heart palpitations
- Fatigue that doesn't lift
- Urinary changes or repeat urinary infections
Many of these overlap with thyroid problems, low iron, sleep disorders, medication side effects or heart issues. Dr. Shoemaker checks for those before deciding what's hormonal, using labs drawn here and, when needed, an EKG or ultrasound right in our office.
Not sure where your symptoms fit? Answer six quick questions in the quiz below.
How your care works
- A free meet & greet. Meet Dr. Shoemaker in person or virtually, ask your questions and see whether membership is right for you. There's no commitment.
- A full evaluation. Your first visit is unhurried (it typically runs 1–2 hours). Dr. Shoemaker goes through your symptoms, cycle history, medications and personal and family history. Our in-house phlebotomist draws your blood during the same appointment. It takes minutes, and there's no separate trip to Quest or Labcorp.
- Your plan. Together you decide on a plan that may include hormone therapy, non-hormonal treatment and lifestyle medicine for sleep, nutrition and strength.
- Follow-up and adjustments. Perimenopause changes over time, so your plan does too. Follow-up visits are available same day or next day when you need them, repeat labs are drawn here, and you can call or text Dr. Shoemaker between visits, including after hours for urgent needs.
You leave your first visit knowing what's most likely behind your symptoms and what happens next.
Treatment options, including hormone therapy
There's no single right treatment for perimenopause or menopause. Dr. Shoemaker explains your options and what the benefits and risks look like for someone with your health history, and you decide together.
- Hormone therapy. For healthy women with bothersome symptoms, hormone therapy is the most effective treatment for hot flashes and night sweats, and it also helps protect bone (The Menopause Society, 2022 Hormone Therapy Position Statement). Dr. Shoemaker weighs your age, how long it has been since your last period, and your personal and family history of breast cancer, blood clots, stroke and heart disease. Then she chooses the type, dose and form with you, such as a patch, gel, pill or vaginal treatment, and adjusts it at follow-up visits.
- Non-hormonal options. If hormone therapy isn't right for you, or you'd rather not take it, there are prescription and non-prescription treatments for hot flashes, sleep and mood.
- Vaginal and urinary symptoms. Low-dose treatments applied locally can ease dryness, discomfort and repeat urinary symptoms.
- Lifestyle medicine. Sleep, nutrition, strength training and stress all shape how you feel now and your health later. They're part of your plan alongside any prescription.
- Your heart, bones and metabolism. Cholesterol, blood sugar and bone density all change around menopause. Dr. Shoemaker screens for them as part of your ongoing care, including the executive physical that comes with membership.
The goal is a plan you understand, adjusted as your body changes.
Why choose a concierge internist for menopause care
Perimenopause doesn't happen in isolation. Heart risk, bone density, sleep, mood and metabolism all shift in the same years. A board-certified internist is trained to care for all of it, and as your concierge doctor, Dr. Shoemaker has the time to.
| Telehealth menopause programs | Hormone-only clinics | Three Rivers Concierge Medicine | |
|---|---|---|---|
| Who you see | Often a nurse practitioner, by video | A clinic focused on hormones | Dr. Shoemaker, a board-certified physician, in person |
| Blood work | A trip to an outside lab such as Quest or Labcorp | Varies | Drawn in our office during your visit |
| The rest of your health | Managed somewhere else | Managed somewhere else | Heart, bones, thyroid and metabolism, with the same doctor |
| Reaching your clinician | App messages | Varies | Call or text Dr. Shoemaker directly |
You keep your gynecologist. Dr. Shoemaker coordinates with them and with any other specialists you see.
Part of your concierge membership
Perimenopause and menopause care is part of membership at Three Rivers Concierge Medicine. The doctor treating your symptoms is your primary care doctor for everything else, too.
$325 a month, billed annually.
What's included:
- Dr. Shoemaker as your own physician, with visits that last as long as you need (typically 30 to 60 minutes)
- Same-day and next-day appointments
- Call or text Dr. Shoemaker directly, including after hours for urgent needs
- Executive physical included
- In-office EKG and ultrasound
Your labs, drawn in our office
Members don't wait in line at Quest or Labcorp. Our in-house phlebotomist draws your blood here in a few minutes, during an appointment you already have or at a time that suits you, and our daily courier takes it to the lab. Lab processing goes through your insurance as usual. Your hormone, thyroid and other labs are drawn at your first full visit, and repeat labs at follow-ups.
Insurance still matters. Lab processing, imaging, prescriptions, specialist visits and hospital care go through your insurance as usual, and you can keep using your HSA or FSA for that care.
Membership is an annual commitment. The meet & greet is free and comes with no commitment. We're accepting new members now.
Book your free meet & greet
Frequently Asked Questions
What kind of doctor treats perimenopause and menopause here?
Dr. Kathryn Shoemaker, a board-certified internal medicine physician. She provides perimenopause and menopause care as part of comprehensive primary care, so your hormone care, heart health, bone health and everything else are managed by one doctor who knows your history. If you need a gynecologist or another specialist, she coordinates the referral.
Do I need to be in menopause already?
No. Perimenopause can start in your late 30s or 40s, years before your last period. We also care for women after menopause who still have symptoms or want to talk about hormone therapy.
Do you prescribe hormone therapy?
Yes, when it's right for you after a full evaluation. Dr. Shoemaker monitors it at follow-up visits, with any labs drawn here in our office.
Is hormone therapy safe for me?
That depends on your health history, which is why it's a conversation to have with a physician who knows yours. For many healthy women under 60, or within about 10 years of their last period, current guidance finds that the benefits of hormone therapy for bothersome symptoms generally outweigh the risks (The Menopause Society, 2022 Hormone Therapy Position Statement). It may not be appropriate if you've had breast cancer, a blood clot, a stroke or heart attack, or certain liver conditions, or if you have unexplained vaginal bleeding. Dr. Shoemaker reviews your history, explains the benefits and risks for you specifically, and chooses the type and dose with you. If hormone therapy isn't a good fit, there are effective non-hormonal options.
Can a blood test tell me if I'm in perimenopause?
Usually not on its own. Hormone levels swing from day to day during perimenopause, so the diagnosis rests mostly on your symptoms and cycle history. Blood work is still valuable: it checks your thyroid, iron, blood sugar, cholesterol and other causes of similar symptoms. It's drawn right in our office.
Do I need to be a member?
The meet & greet is free and doesn't require membership. Ongoing perimenopause and menopause care, including hormone therapy and follow-up, is part of membership, so your hormone care and the rest of your health stay in one place.
How much does it cost, and does insurance cover it?
Membership is $325 a month, billed annually. The membership fee isn't billed to insurance. Your insurance still covers lab processing, imaging, prescriptions and specialist care, and you can use your HSA or FSA for those as usual.
Talk with a board-certified physician about perimenopause and menopause
Start with a free meet & greet, in person or virtual. There's no commitment, and you'll know whether membership is right for you.
Not sure yet? Take the quiz: Are your symptoms hormonal? · See membership details