FAQ

Frequently Asked Questions

Perimenopause, Menopause & Symptoms

What symptoms does Shelley typically treat?

Shelley evaluates common midlife concerns including hot flashes, perimenopausal/menopausal night sweats, poor sleep, fatigue, brain fog, mood changes, vaginal dryness, painful sex, low libido, weight changes, hair thinning, joint pain, muscle loss, stress, and burnout. Her approach is to understand what is driving the symptoms, then address them with a plan that is targeted and clinically appropriate. When a concern requires care outside her scope, she helps patients connect with the appropriate specialist.

How do I know if I’m in perimenopause or menopause?

Perimenopause can begin years before your periods stop completely, and symptoms may show up even if your menstrual cycle still seems mostly regular. Menopause is diagnosed after 12 consecutive months without a menstrual period. If you’re noticing changes in sleep, mood, temperature regulation, energy, libido, or weight gain, it may be time to look more closely at whether hormones are part of the picture.

What treatments do you offer for hot flashes and night sweats?

Treatment is individualized based on your symptoms, health history, risk profile, and goals. For some patients, hormone therapy is the most appropriate option, especially for hot flashes, night sweats, and symptoms related to genitourinary syndrome of menopause. When hormone therapy is recommended, each care plan is tailored by type, dose, route, timing, duration, and safety considerations. For others, nonhormonal treatment may be a better fit.

Can you help with fatigue, brain fog, or poor sleep?

Yes. Fatigue, brain fog, and disrupted sleep are among the most common concerns women experience in midlife. If symptoms require additional testing, specialty care, or a higher level of workup outside of our scope, appropriate referrals can be coordinated.

Can you help with joint pain or muscle changes?

Yes. Many women notice increased stiffness, soreness, muscle loss, or slower recovery during midlife. These changes can be related to the musculoskeletal effects of menopause, along with strength, inflammation, injury history, and other medical factors. Buoy Healthcare Group evaluates joint pain, muscle changes, and physical function as part of the larger midlife health picture. With Dr. Darin Davidson, an orthopedic surgeon and epidemiologist, serving as Medical Director, our care includes a strong musculoskeletal perspective when appropriate.

What if I have had a hysterectomy or have undergone surgical menopause?

Yes, we can help. Care planning depends on your surgery, whether your ovaries were removed, your age, symptoms, medical history, and risk factors.

How soon will I feel better?

It depends on your symptoms, treatment plan, and what’s driving the issue. Some symptoms improve relatively quickly, while others require more time, follow-up, and ongoing adjustment. Our goal is to create a collaborative plan and refine it as we learn how your body responds.

Hormone Therapy & Sexual Health

Do you offer treatment for vaginal dryness or painful sex?

Yes. Vaginal dryness, irritation, and painful sex, also called dyspareunia, are common in midlife and often related to genitourinary syndrome of menopause. Shelley evaluates what may be contributing to your symptoms and recommends evidence-based treatment options to help improve comfort, intimacy, and daily quality of life. Buoy Healthcare Group also shares clinical space with a pelvic floor physical therapist, which allows for streamlined referrals and coordinated care when pelvic floor therapy is appropriate.

Can you help with low libido?

Yes. Low libido is common in midlife, and it is often affected by more than hormones alone. Sleep, stress, relationship changes, pain with sex, mood, medications, and metabolic health can all play a role. We take a whole-person approach so we can better understand what may be changing your desire and discuss treatment options that make sense for you.

Is hormone replacement therapy (HRT) safe for everyone?

No single treatment is “right” for everyone. HRT safety depends on your symptoms, medical history, risk factors, and goals. Many women still feel cautious because of the early Women’s Health Initiative headlines, but the conversation around hormone therapy has become much more nuanced since then.

Do you prescribe compounded hormones?

Buoy Healthcare Group generally prioritizes FDA-approved hormone therapy when appropriate, because dosing, safety information, and quality standards are more consistent. Compounded hormones are not our routine approach and are considered only in limited circumstances.

Do you manage abnormal bleeding?

Abnormal bleeding should always be evaluated. Buoy Healthcare Group can review your symptoms, history, and risk factors, but additional evaluation may be needed. This could include imaging, lab work, endometrial biopsy, OB-GYN referral, or urgent evaluation depending on the bleeding pattern.

Do you provide pelvic exams or Pap smears?

Buoy Healthcare Group is not a replacement for routine gynecologic care. Pap smears, routine pelvic exams, and preventive gynecology should stay with your OB-GYN or primary care provider. If a pelvic exam or specialty evaluation is needed, we will help coordinate the appropriate next step.

Weight Management & Hair Changes

Do you treat weight gain in midlife?

Yes. Many women notice changes in weight, body composition, appetite, and energy during perimenopause and menopause, even when their habits have not changed much. We help patients understand what may be contributing to those changes and build a plan that may include medical weight loss support (like GLP-1 medications), nutrition guidance, and treatment for the hormonal and metabolic shifts that can happen in midlife. If additional referrals are recommended, they will be coordinated.

Do you treat hair thinning or female pattern hair loss (androgenetic alopecia)?

Yes. Hair thinning can be related to menopause, genetics, thyroid changes, nutrient deficiencies, stress, and other medical factors. Shelley evaluates possible contributors and discusses evidence-based treatment options for female pattern hair loss, also called androgenetic alopecia, and related concerns. If your symptoms require care outside of our practice’s scope, appropriate referrals can be coordinated.

Labs, Prescriptions & Care Planning

Do I need labs to understand what is going on?

Not always! Lab ranges are useful guideposts, but they don’t always tell the full story. Results can also be affected by timing, fasting, hydration, supplements, medications, lab methods, and your personal baseline. That is why we interpret labs alongside your symptoms, history, life stage, and overall health picture. In many cases, the most important information comes from a careful medical history and a detailed symptom review, because hormone levels can fluctuate a lot during perimenopause/early menopause.

How are labs selected for each patient?

Our lab recommendations are individualized to the patient in front of us. We don’t rely on cookie-cutter lab bundles or prepackaged panels meant to create the appearance of value. When appropriate, we also consider functional measures of health, such as heart rate variability, alongside your lab results, symptoms, and health history to better understand your overall health.

What should I expect from my first visit?

Your initial visit is 60 minutes and may be completed in person or virtually if you are located in Washington state. Shelley will review your symptoms, health history, medications, goals, lifestyle, nutrition patterns, and prior concerns in depth.You will receive a personalized care plan, which may include labs, prescriptions when appropriate, nutrition guidance, and clear next steps. Shelley also provides a nutritional coaching framework that is refined over time as your care evolves. Virtual care is convenient, but some concerns may require an in-person exam, additional testing, imaging, or referral. Follow-up visits are 45 minutes.

Can you order imaging or referrals?

Yes, when clinically appropriate. Buoy Healthcare Group can help coordinate referrals or imaging related to midlife concerns, including pelvic ultrasound, bone density screening, sleep evaluation, pelvic floor physical therapy, dermatology, endocrinology, cardiology, OB-GYN, and other specialty care.

How often will I need follow-up?

Follow-up depends on your care plan. Patients starting or adjusting medications, hormone therapy, weight management support, or lab-guided treatment often need closer follow-up at first. Follow-up visits are typically scheduled in 30-minute blocks.

Can I use my existing labs?

Yes. Please send any recent labs before your visit. Shelley will review what is available and recommend only what is clinically useful. If additional labs are needed, we will discuss the reason and anticipated cost before ordering.

How do prescriptions work?

Prescriptions are sent electronically through our EHR Tebra when clinically appropriate after your evaluation. Medication costs are separate from visit fees and depend on the pharmacy, medication, insurance coverage, and available cash-pay pricing.

What should I do before my first visit?

Please complete your intake forms before your appointment and upload any recent labs, imaging, medication lists, supplements, surgical history, menstrual history, and relevant medical records. It’s also helpful to think through your main symptoms, goals, and what you most want addressed during the visit.

Visit Logistics & Scope of Care

Does Buoy provide TRT for male patients?

No, we do not prescribe testosterone replacement therapy for male patients. If testosterone treatment is indicated for women in menopause, it is prescribed at a much lower dose for Hypoactive sexual desire disorder (HSDD).

What makes Buoy Healthcare Group different?

While we respect many types of private practices, Buoy Healthcare Group is not an IV lounge, medspa, or trend-based hormone clinic. We are a small private medical practice designed to provide direct, personalized, concierge-style care for women in midlife. Our focus is evidence-based hormone care, metabolic health, nutrition, and the real-life stress load that affects how women feel in their bodies. Our goal is to help you connect the dots so your care feels clear, curated, and complete.

Do you offer in-person visits?

Yes, we offer 60 minute in-person new patient initial consultation visits and 45 minute follow-up visits.

Is care available virtually?

Yes. Buoy Healthcare Group currently offers virtual visits for patients in Washington state only. Patients must be physically located in Washington at the time of care. Many appointments can be completed remotely, depending on your symptoms, goals, and clinical needs. When Buoy Healthcare Group expands care to additional states, we will update our website with that information.

Do you accept insurance or provide superbills?

Buoy Healthcare Group is a small, private practice designed to provide direct, personalized, concierge-style care. We do not contract with insurance companies and we do not bill insurance directly. This out-of-network model allows us to provide care in a way that is more personal, flexible, and clinically thoughtful. It gives us the ability to spend more time with our patients, offer a wider range of services, maintain a sustainable caseload, and create treatment plans based on your individual needs rather than insurance limitations. Our goal is to be transparent from the beginning. There are no unexpected copays, insurance denials, or surprise bills from our practice. When labs are recommended, anticipated costs will be reviewed before ordering, and your lab plan will be tailored collaboratively so expenses are clear upfront. Buoy Healthcare Group accepts payment by credit card. We do not accept cash payments. For your convenience, eligible HSA and benefit cards may also be used for payment, depending on your plan. For eligible medical visits and services, Buoy Healthcare Group can provide a superbill that you may submit to your insurance company for possible out-of-network reimbursement. Reimbursement is not guaranteed and varies by insurance provider and plan. We recommend contacting your insurance company directly to ask about your out-of-network benefits. Please note that Buoy Healthcare Group providers have opted out of Medicare and Medicaid. This means we do not bill Medicare, Medicaid, or Medicare Advantage plans, and services provided by Buoy Healthcare Group cannot be submitted to Medicare or Medicaid for reimbursement. Patients are responsible for the full cost of care at the time of service.

What is your cancellation policy?

Please cancel or reschedule at least 24 hours before your appointment. Appointments canceled with less than 24 hours’ notice will be charged the full visit fee. Your appointment time is reserved specifically for you, and late arrivals may shorten the time available for your visit.

Do I still need an OB-GYN provider?

Yes. Buoy Healthcare Group is not a replacement for primary care, routine gynecology, preventive care, Pap smears, mammograms, urgent care, or emergency care. We provide midlife-focused care and are happy to coordinate with your PCP, OB-GYN, and other specialists.

Who may not be a good fit for Buoy Healthcare Group?

Buoy Healthcare Group is not appropriate for medical emergencies, chest pain, stroke-like symptoms, severe psychiatric crisis, pregnancy care, or complex uncontrolled medical conditions that require primary management. If your needs fall outside our scope, we will help guide you toward the appropriate level of care.

Do you treat anxiety or depression?

Mood changes are common in midlife and are considered as part of your overall care. Buoy Healthcare Group can evaluate how hormone changes, sleep, stress, nutrition, and medical factors may be contributing. We are not a crisis service or a replacement for psychiatric care, and we will refer when a higher level of mental health support is needed.

Clinical Approach

What does Dr. Davidson specialize in?

Dr. Davidson specializes in physician-led, interdisciplinary care for musculoskeletal health, mobility, recovery, stress physiology, inflammation, and long-term physical function. His background in orthopedic surgery, musculoskeletal oncology, and epidemiology allows him to evaluate pain and performance through both a structural and whole-person lens. Patients often seek this care when they want careful clinical judgment, not a rushed or fragmented plan.

Who is a good fit for Dr. Davidson’s services?

Dr. Davidson’s services are a good fit for patients who want a deeper understanding of pain, injury recovery, mobility changes, fatigue, stress load, post-oncology recovery, or declining physical capacity. Many are active adults, midlife patients, executives, or people recovering from surgery or serious illness. His care is best suited for those who value thoughtful assessment, evidence-informed recommendations, and individualized planning.

Is this orthopedic care, longevity medicine, or integrative medicine?

Dr. Davidson’s work is best described as physician-led interdisciplinary medicine. He uses orthopedic expertise to understand structure, movement, pain patterns, and function, while also considering nervous system load, inflammation, metabolic health, recovery capacity, and lifestyle factors. This is not trend-driven longevity care. The goal is a more complete understanding of what is limiting health, mobility, and quality of life.

Do I need to have an injury to see Dr. Davidson?

No. Many patients see Dr. Davidson because they want to stay active, improve mobility, prevent decline, recover more effectively, or understand physical changes they are noticing in midlife and beyond. An injury, surgery, or pain concern can be part of the visit, but it is not required. Care can also focus on strength, recovery, function, and long-term physical health.

Musculoskeletal Health, Pain & Recovery

What types of musculoskeletal concerns does he evaluate?

Dr. Davidson evaluates concerns involving joints, spine, muscles, mobility, strength, prior injuries, post-surgical recovery, activity limitations, and changes in physical performance. His orthopedic background allows for a high level of clinical judgment while also considering the broader factors that affect healing and function, including sleep, conditioning, inflammation, stress physiology, and recovery capacity.

Is Dr. Davidson a pain medicine doctor?

No. Dr. Davidson is not a pain medicine physician, and his practice is not focused on prescribing pain medications or managing chronic opioid therapy. His work focuses on understanding what may be contributing to pain, reduced mobility, or poor recovery, then building a plan that supports function, resilience, and quality of life. When pain procedures or medication-based care are needed, he may recommend the appropriate specialist.

What is included in injury recovery and return-to-activity planning?

Return-to-activity planning may include a review of your injury history, current symptoms, activity goals, orthopedic considerations, recovery timeline, and outside care such as physical therapy, imaging, or specialist input. Dr. Davidson also considers sleep, stress, inflammation, conditioning, and nervous system load because these factors often influence healing, performance, and confidence when returning to activity.

Can Dr. Davidson help after orthopedic surgery?

Yes. Dr. Davidson can help patients think through recovery after orthopedic surgery, including mobility, strength, activity progression, pain patterns, recovery expectations, and coordination with rehabilitation or specialty teams. This care does not replace the operating surgeon. It can help patients build a more complete recovery strategy, especially when healing, conditioning, confidence, or return-to-activity feels more complex than expected.

Stress Physiology, Inflammation & Adjunctive Therapies

What is nervous system regulation?

Nervous system regulation refers to the body’s ability to shift between stress, alertness, recovery, rest, and repair. When the nervous system is under chronic strain, patients may notice poor sleep, fatigue, anxiety, muscle tension, heightened pain sensitivity, slower recovery, or reduced resilience. Dr. Davidson helps patients understand this physiology and develop practical tools to support steadier recovery and performance.

How does stress physiology affect pain and recovery?

Chronic stress can affect muscle tension, inflammation, sleep quality, hormone signaling, pain sensitivity, immune function, and recovery capacity. For many high-performing people, the body adapts to long-term stress until symptoms become harder to ignore. Addressing stress physiology does not mean symptoms are imagined. It means the nervous system is part of the biology of healing, pain, and physical resilience.

How are inflammation and metabolic health connected to mobility and pain?

Inflammation and metabolic health can influence pain, stiffness, energy, tissue repair, exercise tolerance, and long-term risk. Patients with insulin resistance, poor sleep, chronic stress, deconditioning, or persistent inflammation may notice slower healing or more frequent flares. Dr. Davidson looks at these connections so the plan supports not only symptom relief, but also stronger recovery capacity and long-term function.

What are adjunctive therapies?

Adjunctive therapies are supportive tools that may be used alongside a broader medical plan when clinically appropriate. These may include selected advanced diagnostics, technology-supported tools, medications, breathwork, recovery metrics, or nervous system support. Dr. Davidson uses these options carefully, with attention to safety, evidence, quality, monitoring needs, and the patient’s goals rather than offering treatment for its own sake.

Does Dr. Davidson offer peptide therapy?

Dr. Davidson may prescribe peptides when clinically appropriate for an individual patient. This decision follows a careful medical review that considers the available evidence, safety, product quality, monitoring needs, and whether the treatment makes sense for that person’s health history and goals. The focus is responsible, physician-guided care, not shortcuts, trends, or unsupported protocols.

What makes this different from a typical wellness or longevity clinic?

This care is grounded in extensive medical training, orthopedic expertise, epidemiology, and careful clinical judgment. Dr. Davidson does not start with trends, exhaustive protocols, or one-size-fits-all treatments. He starts by understanding how you move, how you recover, what you have been through, what you want to return to, and what may be limiting your health over time.

Active Aging & Post-Oncology Recovery

What does active aging mean in this practice?

Active aging means preserving the strength, mobility, independence, clarity, and confidence to keep participating in the life you want. At Buoy Healthcare Group, this may include functional health planning, injury prevention, recovery strategy, metabolic resilience, nervous system balance, and long-term physical capacity. The focus is not simply aging longer, but remaining capable, active, and engaged through midlife and beyond.oh

Can Dr. Davidson help with post-oncology recovery?

Yes. With his background in musculoskeletal oncology, Dr. Davidson supports patients rebuilding after cancer treatment, surgery, chemotherapy, radiation, endocrine therapy, immunotherapy, or serious illness. Care may focus on strength, mobility, fatigue, bone health, pain, deconditioning, recovery capacity, and return to activity. He approaches post-oncology recovery with quality of life, safety, and coordination at the center of care.

Is post-oncology survivorship care only for people recently out of treatment?

No. Patients may benefit from post-oncology survivorship support months or years after treatment, especially when they notice changes in strength, mobility, fatigue, pain, bone health, confidence, or activity tolerance. Survivorship care looks beyond disease monitoring alone. It helps patients rebuild physical capacity, restore trust in their bodies, and support the quality of life they want after cancer treatment.

Care Coordination & Visit Logistics

Will Dr. Davidson coordinate with my other physicians?

When appropriate, yes. Dr. Davidson’s care is designed to complement, not replace, your existing medical team. This may include coordination with primary care, oncology, orthopedics, physical therapy, rehabilitation, nutrition, mental health, or other specialists. He also works closely with Buoy Healthcare Group co-founder Shelley Kemmerer, PA-C, MCHS, when interdisciplinary care supports a safer or more complete plan.

Is this care evidence-based?

Yes. Dr. Davidson’s background as a trained epidemiologist informs how he evaluates evidence, risk, benefit, and clinical decision-making. His approach combines medical expertise with individualized care, recognizing that the best plan should be grounded in science and tailored to the person in front of him. Evidence matters, and so do your goals, history, values, and clinical context.

What should I expect from an initial visit?

An initial visit is designed to understand your health story, current concerns, goals, prior injuries or treatments, activity level, recovery patterns, and the factors affecting your function. From there, Dr. Davidson develops a personalized framework that may include medical recommendations, lifestyle strategies, referrals, adjunctive therapies, and follow-up planning. The visit is built for depth, not rushed decision-making.

Is this a replacement for primary care?

No. Dr. Davidson’s services are not a replacement for primary care, oncology care, orthopedic surgery, emergency care, or specialist management when those are needed. His work is complementary and focused on helping patients better understand and improve function, recovery, resilience, and whole-person health. Patients should continue routine preventive care and appropriate specialty follow-up.

Do I need labs, imaging, or wearable data before my visit?

Not necessarily. Prior labs, imaging reports, surgical notes, oncology treatment summaries, physical therapy notes, or wearable data can be helpful, but they are not required to begin. Dr. Davidson can review what is relevant and determine whether additional information would meaningfully support your care plan. Testing is considered in context, not ordered simply to create more data.

Is this care appropriate for high-performing professionals or executives?

Yes. Many high-performing professionals are used to operating at a high level while quietly absorbing chronic stress, pain, poor sleep, reduced energy, or slower recovery. Dr. Davidson helps patients understand the physical cost of sustained output and build a more sustainable framework for performance, recovery, mobility, resilience, and long-term health.

Why does this approach appeal to patients in midlife?

Midlife is often when small signals become harder to ignore, including slower recovery, increased joint pain, reduced strength, disrupted sleep, high stress load, metabolic changes, and new limits in activity. Dr. Davidson helps patients take these changes seriously before they become larger barriers to health, mobility, and quality of life.

How do I know which service is right for me?

You do not need to know exactly which service category fits before scheduling. Many patients have overlapping concerns, such as injury recovery, stress physiology, inflammation, reduced mobility, post-oncology recovery, or long-term health goals. The initial visit helps clarify what is most important, what may be connected, and what type of plan will be most useful.