Menopause Health with Modernized Menopause
Awad Medical Aesthetics & Wellness has revolutionized women's wellness with MODERNIZED MENOPAUSE. Offering highly effective treatments that are minimally invasive and positively impacts women's health. We offer full menopause services virtually (and in person for those local to us - but it's not necessary to be seen in person): assessments, laboratory services, prescription and non-prescription treatments.
New Launch
Modernized Menopause Provides Virtual Support to Ontario, Canada Residents
Services are provided virtually by our Nurse Practitioner who is trained and certified in primary care and specializes menopause care.
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Services are offered to biological born women, with ovaries, ages 35 to 65.
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Must be an Ontario resident.
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No family practitioner (doctor or nurse practitioner) needed, as no referral is needed. Although we suggest everyone have a family practitioner for overall health care needs.
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Prescriptions are covered by your 3rd party insurance. OHIP covers any blood work or other tests. For those that do not have either a drug plan or valid OHIP card, you will pay for your services according to the fees set by the pharmacy or laboratory.
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Your online intake includes: a client fillable form, form review by the NP, a virtual follow up appointment, treatment recommendations, additional testing if needed, prescription, education and a follow up plan.
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NP virtual consultation fees are not covered under OHIP billables therefore see our set fees for intake (below), consultations and follow up care.
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Book an online intake. Or call to book 519-792-0306
Investment: $125
Fee applies at time of booking
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Complete the medical intake form. Mandatory form fields filled in advance to help expedite your treatment plan.
You will have the opportunity to review your details with the NP and provide additional information if needed.
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Within 72 hours your intake form completion, your form will be reviewed and a clinic member will reach out.
Verify the email for your account for communication.
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Next, receive a virtual booking (telephone or video) to discuss your entire plan and next steps.
No fee. Included in your initial intake.
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Follow ups, prescription renewals, and support at intervals determined by your Nurse Practitioner.
Investment: $35
*3 month follow up required after initial visit and includes prescription refill. Prescription refills $35. Follow up requests $35
About Us
It is an inevitable reality that most women will eventually reach menopause at certain ages. While this may seem daunting, menopause is a natural phase that all women who live to a certain age will encounter. The outdated notion of resigning to menopause as an unavoidable part of life no longer holds true. Recent advancements in medical research have revolutionized the understanding of menopause, offering safe, effective, and innovative treatment options.
Gone are the days when women had to endure negative side effects without recourse. New evidence has emerged, providing valuable guidance on managing menopausal symptoms. These symptoms can now be addressed through tailored treatment options. It is essential to recognize that menopause impacts various aspects of a woman's health, including cardiovascular well-being, vulvar health, bladder function, bone density, sexual functioning and mental wellness.
At Modernized Menopause, a branch of Awad Medical Aesthetics & Wellness, we specialize in providing comprehensive treatment for menopausal symptoms for females 35-65. Our services offer convenient online access to on-demand treatment, designed to enhance the quality of life for women and alleviate the multitude of health challenges commonly associated with the menopausal transition.
Our Features
Functionality You Will Love
Understanding Menopause
Modernized Menopause
Menopause has recently evolved which makes us happy to be able to bring you: Modernized Menopause
Why did we develop this arm of our practice?
We saw a need: many women have been denied treatment for menopause symptoms. Why? While we cannot fully answer that question, we do have some information to help with this. One reason may be that not many health care providers receive menopause treatment education in their basic degree program and even into specialities such as OBGYNs. Menopause treatment has been lacking, with only 4% of women receiving treatment, something we hope to increase by improving access to care.
Our Nurse Practitioner engaged in additional training with the Menopause Society and attending other certified trainings to gain additional knowledge in order to provide you this care. By staying up to date through targeted learning sessions, our Nurse Practitioner can deliver you the most reliable and up-to-date care – something she is highly interested and invested in!
Background data: Historically there was a research study called the Women’s Health Initiative, which in 2002 was stopped due to unfavourable outcomes in which hormone treatments were being studied for menopause treatment. In short, the study was determined more recently to be flawed, and new evidence has been released to explain what treatments are effective and safe. This being new information, it has likely not been adapted into healthcare provider’s care because they have not updated their education in this area of practice. Why are they not up to date? Well, it takes a lot of dedication and time to uptrain, and we are sure some personal reasons exist. Practitioners are very busy in their current work and just trying to keep up with the basic duty of care is challenging. Besides, this old information may still linger and make practitioners cautious to treat and prescribe as the new recommendations suggest.
To get into modern day menopause and treatment options, let’s start with the basics: definitions, stages and symptoms.
Menopause Defined
Perimenopause is defined as the time leading up to menopause and is further defined as fluctuations in your menstrual cycle, as well as hormone levels. Fluctuation in hormones can lead to some of the symptoms commonly associated with perimenopause. While this is a gradual change and can happen over several years typically 7 on average for most women it can be as long as 14 years for some.
Menopause is a day in which a woman has had no menstrual period for a period of 12 months. One day - that's it! Yet there is a term that we refer to: the menopause transition to further define the process which includes: perimenopause, menopause and post menopause in which women (someone with ovaries) experiences related to hormone changes.
The average age in Canada is 51 for this stage. Therefore, the status of your menstrual cycle is what determines if you are officially menopausal.
Post menopause then, is everyday past menopause and you remain in post menopause the rest of your life.
All together, the menopause transition includes all phases of menopause.
The most common symptoms of the menopause transition can include but are not limited to:
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Hot flashes and or night sweats
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Insomnia
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Breast tenderness
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Muscle and/or joint pain
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Changes in your sex drive (libido)
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Rapid heartbeat
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Thinning hair
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Mood changes
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Vaginal dryness/itchiness
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Increased bladder issues (leakage)
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Urinary Tract Infections
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Dry skin
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Insomnia
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Mood changes
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Painful vaginal intercourse
A common term for some of the symptoms above is GSM, the Genitourinary Syndrome of Menopause. It’s actually quite an alarming statistic, with over 80% of women experiencing these symptoms and only 7% of women ever mention them in a healthcare visit. We aim for 100% of these issues being discussed in our assessments.
Let’s talk modernized menopause
Pro-information vs. Mis-information
This modern information is to educate you briefly about the menopause transition so you can have the best and most accurate and up-to-date information to better understand what menopause is really all about and what type of treatment options you can reliably and safely utilize to help improve your symptoms and overall health status.
One of the most common misconceptions of menopause is that of the definition. Another major misconception is that therapy, especially hormone replacement therapy, is not safe – YET IT IS an acceptable and effective option for many women, despite ‘old and outdated’ education.
And another myth is that around testing and what is really validated or needed.
Bottom line: Women no longer need to be told that this is a natural transition, and nothing can be done. Modernized menopause concepts are here - help does exist, thankfully!
What about testing for “menopause”? Let’s skip misleading tests!
We follow the modernized menopause facts: testing is NOT REQUIRED to determine prescriptive hormone replacement therapy options (Position Statement: The North American Menopause Society,)
If you’re not experiencing any menopause symptoms, there is no need to test for them. However, if you are having symptoms, the best course of action is to discuss with your healthcare professional. Menopause treatment can be initiated without any tests for certain symptoms. A healthcare practitioner can figure out if there are any other conditions that may be causing symptoms and if testing is needed to rule out other causes. Some examples include thyroid disorders, or iron deficiencies, may mimic perimenopausal symptoms. Bloodwork will provide a more precise measurement of hormone levels and can determine if you have any underlying conditions, along with identifying risk factors or markers which may guide treatment and the best course of action for treatment. Testing can include, but not be limited to:
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Thyroid function
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Anemia
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Vitamin deficiencies
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Diabetes
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Cholesterol
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Kidney function
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Liver function
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Electrolytes
From testing, this data is used to determine a risk-vs-benefit analysis along with your personal health information to determine candidacy for various treatments which included shared decision making with you, the client!
We want to be a little clearer about testing. We offer covered testing, as long as you have a valid OHIP (Ontario Health Insurance Plan for Ontario, Canada residents) card, your tests are covered with some exceptions such as Vitamin D (sometimes a charge of $45) if it’s a non-insured benefit under the provincial healthcare plan. Unfortunately some bloodwork isn’t always covered in Ontario, but the majority that we need for menopausal testing are.
NO NO NO
Additionally, there is no need to spend money on pricey at-home or alternative tests that may cause you unnecessary stress with misleading results. Some of those to name a few are: The Dutch Test or Saliva Testing. Those tests are not evidence based or valid test and are not an accurate science. Those tests cost you unnecessary money considering don’t really determine much. You should instead see a certified and reputable health care provider for reliable advice and undergo a personalized assessment to get to the bottom of what’s causing your symptoms and a clearer picture of your overall health. That’s what we cover in our initial intake with clients.
Services
We offer a wide array of innovative services for women throughout their life stages!
Menopause Hormone Replacement Therapy
For women ages 35 to 65 we offer specialized hormone (and non-hormone) treatments. Services offered by our Nurse Practitioner, a certified expert in menopause health (among other specialties). Our clinics are supported by nursing associates that are regulated and trained in women's wellness. We offer ONLINE services for hormone replacement therapy. No need to be seen in person for this. We also offer in-clinic women's wellness services in the area of Tecumseh, Ontario, just outside of Windsor, Ontario.
NO REFERRAL NEEDED
IT'S OK to have a primary care provider. We do not take over that role. We act like a specialist only YOU get to choose us (no referral necessary).
PRESCRIPTIONS ARE COVERED
We provide prescriptions that are covered under your 3rd party insurance benefits, if you have them. Prescriptions come from your preferred pharmacy - just like regular drugs. We do from time to time offer compounded options in which we use a compounding pharmacy and some fees may apply but we always work with you to have the most affordable and effective treatments.
Menopause is a transition and is really about hormone fluctuations. Some symptoms can be treated by replacing hormones that are declining. Taking prescriptive hormones can help these fluctuations and help relieve symptoms. Medication options come in different forms (topical patch, pill, cream) to accommodate various needs.
For those who have allergies, or cannot take hormonal options, non-hormonal treatment recommendations are available to treat specific symptoms which can help alleviate discomfort.
Vitamins and supplements can also help your general well-being by contributing to areas like energy levels and sleep.
NO UNNECESSARY TESTS
It's not necessary or helpful to have insignificant tests i.e.: Dutch Test, Saliva Testing ...
See our section on testing. In short - no fees for testing as anything we need to investigate is covered with your OHIP card.
Treatment for menopause symptoms can differ depending on the severity of symptoms along with one's individual lifestyle and health needs.
WE WILL UTILIZE EVIDENCE
that exists so we can safely prescribe hormones for treatment.
BEEN TOLD YOU CANNOT HAE HORMONE REPLACEMENT THERAPY? THERE ARE INNOVATIVE OPTIONS FOR YOU
There are non-hormone prescription options that are NEW as well. We pride ourselves in using the latest information (evidence) available to support your care plan!
Connect with our healthcare practitioner who who is certified in menopause symptom management to discuss what treatment options might be right for your symptoms and lifestyle.
In-clinic wellness exams
For in person clients at our Tecumseh, Ontario clinic location, we do offer female pelvic floor assessments, pap smears and other wellness examinations.
Did you know?
Not everyone should perform Kegels
Even when people do Kegels they often do them incorrectly!
Before engaging in these well-known often poorly completed pelvic floor exercises it’s best to have a pelvic floor assessment to assess for hypertonic muscles (overactive). It’s best to understand the dysfunction can be caused by a number of different reasons, and should be discussed with an assessed by a healthcare, healthcare professional, prior to self diagnosing and self treating.
Sometimes Kegels can cause more harm than good. Has your practitioner ever checked your pelvic floor for hypertonicity?
If you are doing Kegels constantly, you also run the risk of developing hypertonic muscles in the pelvic floor. This itself is a pelvic floor dysfunction and can result in painful sexual intercourse, urinary urgency, constipation and for some urinary incontinence.
Our healthcare professionals can give you expert guidance on your pelvic floor needs.
In Ontario, Canada it is recommended to have a pap smear starting at age 21 if you have been sexually active to age 70 at least every 3 years, and you may stop at age 70 if adequate and negative screening in the past 10 years or 3 annual negative test results. Aside from regular testing, pap smears should occur depending on your personal risk factors as advised by your most responsible health care practitioner.
HPV TESTING
NEW at our partnered laboratory
LIFE LABS
At-Home Collection Kit
Convenient & Fast Online Ordering
Order the test from the comfort of your home. Request form provided with no visit to your doctor required.
Self Collect Easily, Delivered to Your Door
With a small swab and easy-to-follow instructions, you can collect your sample when and where it works best for you.
Immediate, Secure Results Access
When your results are ready, you will receive a notification to access your results over our secure platform.
$129.00 fee to lab Cervical Health (HPV) Kit (oraclecloud.com)
Or in our Office
Order through your healthcare provider (we can do this for you)
Visit your health care provider to find out if HPV testing is right for you.
Book a clinic visit.
Your health care provider will collect your sample during your initial or subsequent visit.
Results via your health care provider
When your results are ready, your health care provider will review and discuss them with you.
$95.00 fee to lab + $55 fee to Awad Medical
This is not the only women's health care issue that should be discussed with a health care professional, we are only outlining the services we offer.
Technology Based Treatments
In recent years, it seems that radiofrequency technology has taken center stage when it comes to skin care, but as science has continued to evolve, the role of radiofrequency devices for treating an array of non skin-related conditions has also began rising to prevalence. You’ve probably seen videos of radiofrequency-based devices that tone the muscles in the abdomen, buttocks, face and more, but just recently, a new type of radiofrequency device has entered the market, this time for strengthening the pelvic floor muscles.
Abdominal Tone
Diastasis Recti
For those issues, we offer: EmpowerRF which features several key technologies like Tone, which restores the strength of the abdomen muscles through electrical muscle stimulation (EMS). This technology is excellent for those in the post partum stages, suffering from diastasis recti, or those who just want to sculpt their abdominal muscles. It works by emitting, electronic muscle stimulation, pulses to stimulate involuntary muscle contractions. These hand free applicators restore the strength of the muscle without pain or downtime.
Vaginal & Bladder Treatment Options: Non-surgical
Getting more specific to the vagina and bladder we also offer, Plus90, a safe, effective treatment for feminine health and wellness that offers immediate results to remodel the tissue in the vaginal area. The treatment is intended and approved for muscle stimulation, relaxation, pain reduction, fractional resurfacing, improvement of blood circulation, and for the treatment of the symptoms of Genitourinary Syndrome of Menopause.
And let's amp it up a bit with Morpheus8V, a treatment that works by utilizing a specialized micro-needling handpiece. Morpheus8V uses micro-needling to rejuvenate the vaginal skin and tissue while also delivering radiofrequency energy to the deeper layers of tissue. In addition to triggering the body’s healing process, this stimulates the increased production of collagen, which is an essential protein for the health and structure of the skin.
The combination of micro-needling and radiofrequency energy allows Morpheus8V to completely rejuvenate the vaginal and vulvar tissue and skin.
And last but not least, VTone which is an intravaginal technology that uses EMS to tighten and tone the pelvic floor. VTone is quick and painless procedure – completed in 15-30 minutes, without anesthesia, surgery or downtime. Clients report increased urinary control, reduced bladder leakage, and improved sexual sensation after a VTone series. Results are cumulative, with most patients realizing optimal strengthening and narrowing of the vaginal canal in 1-2 weeks after their final treatment.
These technologies allow women the opportunity to manage their urinary leakage with an easy, Health Canada cleared procedure, and to avoid bladder mesh surgery with all of the potential surgical complications including from mesh erosion, scarring and painful intercourse for both partners.
Non-surgical, no downtime help!
Check out our women's wellness page for more details about technology treatments to support women's health care needs. Or contact us directly to learn more. These services include a free consultation.
About Me.
More About Medications, and Alterntives : Modernized Menopause
Hormone therapies are what we refer to as the prescription drugs used most often to treat hot flashes and genitourinary syndrome of menopause (GSM), which includes vaginal dryness, after menopause. For hot flashes, hormones are commonly given in pill form, patches applied to the body, sprays, gels, or a vaginal ring that deliver hormones throughout the body—known as “systemic” therapy. For the GSM - genitourinary symptoms, hormones are given in creams, pills, or rings that are inserted into the vagina.
Systemic (into the body) hormones include estrogens—either the same or similar to the estrogens the body produces naturally—and progestogens, which include progesterone—the progestogen the body produces naturally—or a similar compound. Another approach to systemic hormone therapy is a pill that combines conjugated estrogens (those in the brand Premarin) and a compound known as a “SERM” (selective estrogen receptor modulator) that protects the uterus but is not a progestogen. Women who have had a surgical hysterectomy (had their uterus or ovaries removed) can use estrogen alone to control their hot flashes. Women who still have a uterus must use a progestogen in addition to estrogen or the estrogen-SERM combination to protect against uterine cancer. Systemic hormones are very effective for hot flashes and have other benefits. Systemic hormones are used on label for bone health as well. They also carry some risks, such as blood clots and breast cancer. Risk needs to be individualized into your care plan.
Vaginal estrogen therapy for the GSM is administered in the vagina and is effective for both moisturizing and rebuilding tissue. Very little goes into blood circulation, so the risks are far lower. This can be effective for some that have had certain cancers as well and best discussed in full with your practitioner to determine if you are a true candidate.
You should discuss your individual risks and preferences with your healthcare team to determine whether hormone therapy or alternatives, including Health Canada approved nonhormonal therapies, are right for you.
Theres a BIG CRAZE and a lot more misinformation about Bioidentical Hormone Replacement Therapy (BHRT)
The term “bioidentical hormone therapy” is a marketing term for custom-compounded hormones. It really means hormones that have the same chemical and molecular structure as hormones that are produced in the body. Bioidentical hormones do not have to be custom-compounded (meaning custom mixed). We actually prescribe them but often people get confused over the term due to the marketing of them (commonly from other types of providers such as Naturopaths). There are many well-tested, FDA-approved and Health Canada approved hormone therapy products that meet this definition and are commercially available from retail pharmacies in a variety of doses that will allow you and your doctor to customize your therapy to meet your needs.
Custom-compounded hormones are not safer or more effective than approved bioidentical hormones. They are not tested for safety and effectiveness or to prove that the active ingredients are absorbed appropriately or provide predictable levels in blood and tissue. In fact, they may not even contain the prescribed amounts of hormones, and that can be dangerous. And recall, we don’t have to test for amounts of hormones for treatment (or adjusting treatment). We view the biggest risk with BHRT and a good example is: when your progesterone level is too low, you are not protected against endometrial (uterine) cancer. When estrogen levels are too high, there can be overstimulation of the endometrium and breast tissue, putting you at risk of endometrial cancer and possibly breast cancer. Something we are not willing to risk without a major risk benefit and we don’t have to because there are many formulations of “regularly prescribed hormones’ on the market that are also covered under your, the majority, of drug plans.
While not everyone is a candidate for hormone treatment – there are several other non-hormone treatment options that are just as effective for some symptoms of menopause. We want to dispel one very important issue: That women with a history of cancer (i.e.: breast or other) very well may have an option of hormone treatment for certain symptoms. We don’t want you to go down the rabbit hole, so will slightly describe these for your peace of mind. Afterall, you want to know that reasonable alternative does exist.
Alternatives, Non-Hormone and Other Therapies
Hyaluronic acid, something we familiar with for facial moisturizing – can be used as a non-hormone treatment option intra and extra-vaginally in specialized formulations for vaginal dryness and itching. Who would have thought? Not to be confused with actual vaginal lubricants, another type of product that can help with dryness alongside penetrative sexual activities for comfort. These items can be found on the pharmacy shelf or discussed with your pharmacist at your next pharmacy visit – no prescription required! We can also help you navigate these items.
Have you heard about pelvic floor therapy? Well, you automatically might think ‘Kegels’ but we first must determine that you don’t have hypertonic (too strong) pelvic floor muscles before we can even recommend Kegels, if necessary. Also, often misinformed is how to perform these exercises properly. What if your pelvic floor muscles are too weak for you to rehabilitate on your own? We do have Electronic Muscle Stimulation devices we can recommend. The same goes for vaginal dryness, bladder control issues, weakened abdominal muscles and other vaginal concerns. Our Nurse Practitioner is trained in all these things, so just ask! See? We have really come a long way with Modernized Menopause.
There are so many other options for treatment of the syndromes associated with menopause that we briefly want to let you know of other modalities of treatment exist such as: mindfulness or CBT (cognitive behavioural therapy) too! We are excited to know that even with all these options, more research will come and hopefully give us more options to treat menopause in an even more modernized way! We strive to stay up to date with all of the latest evidence and trends and are here to approved, disapprove, debunk and treat as necessary!
We are Modernized Menopause and here to have an open conversation about what is right for you. With evidence informed decision making guiding your personalized treatment plan!
References:
Menopause Society North American Menopause Society (NAMS) - Focused on Providing Physicians, Practitioners & Women Menopause Information, Help & Treatment Insights
North American Menopause Society Position Statement on hormone therapy nams-2022-hormone-therapy-position-statement.pdf (menopause.org)
About
Catherine (Cathy) Awad, MN, NP-PHC
Cathy Awad is an advanced practice Nurse Practitioner who holds a Master's Degree in Primary Health Care (and other provincial and state licenses). Her practice primarily involves advanced medical aesthetics, primary care and women's health. She carries specialized certifications in menopause health and services the unique needs of women's wellness in a new yet passionate approach to holistic pro-aging.
Her philosophy is to age gracefully and turn back the time on youthfulness, within reason. Always curating realistic, natural and beautiful results for clients based on their personal goals.
For clients in the menopause transition, she provides the most up-to-date information on treatments. Whether it's technology-based, hormone or non-hormonal therapies; she extends treatment plans to include adjuncts and alternatives that are innovative and evidence-based.
Offering services to Ontario, Canada residents both in person and online she guides clients through individual treatment plans. Cathy is fully committed to supporting the client through the journey they choose, being honest, professional and supportive.
Contact
If you are looking for help and support - we are here!
tele: 519-792-0306