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Menopause Care Without the Standard Template
Menopause is personal. For some women the transition is subtle. For others, sleep, hot flashes, vaginal symptoms, mood, body composition, or sexual health can change dramatically. Your care should reflect your experience, your history, and what matters to you.
Your Experience Is Personal
Menopause is defined after 12 consecutive months without a menstrual period when another cause is not responsible. The experience varies. Some women have few symptoms, while others experience hot flashes, night sweats, sleep disruption, mood changes, vaginal or urinary symptoms, sexual concerns, or changes in body composition.
Your provider reviews the timing and pattern of symptoms, bleeding history, medications, health risks, screening history, and other conditions that may produce similar symptoms. Testing is selected for the clinical question rather than ordered as a generic panel.
Evaluation Before Treatment
Treatment Options
Depending on your symptoms and history, the discussion may include:
- Hormone therapy
- Nonhormone prescription options
- Vaginal treatment
- Sleep or lifestyle support
- Coordination with other clinicians
No single plan is right for everyone.
Review Over Time
Follow-up is used to assess symptom response, side effects, adherence, and relevant clinical or laboratory findings.
Review Over Time
The plan should be reassessed as symptoms, goals, health history, and evidence change
Follow-up covers
Benefit, side effects, new contraindications, dose, route, and whether treatment should continue
Provider Identity

Melissa Markel, FNP-C, ABAAHP, FAAMFM
Florida license: APRN11019655
Melissa is a board certified functional medicine nurse practitioner. She specializes in male and female hormone replacement, medical weight optimization, and longevity medicine.
Telehealth Designed Around Your Life in Miami, Florida
Umber Health was designed for adults who value discretion, time, and close attention. Private virtual visits bring that experience to eligible adults in Miami and throughout Florida. Umber Health does not operate a walk-in or patient-facing physical clinic.
Frequently asked questions
Do I need testing to confirm menopause?
Not always. The need for testing depends on age, menstrual history, symptoms, medications, and other clinical factors.
Is hormone therapy the only option?
No. Hormone and nonhormone options are available. The choice depends on the symptoms being treated, personal risks, preferences, and goals.
Can menopause care be handled by telehealth?
Much of the history, counseling, treatment planning, and follow-up can be virtual. Your provider will explain when an in-person examination or referral is needed.
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