I want to be honest with you about something before you read any further. There are a lot of menopause telemedicine options available to you right now. Some of them are well-funded, well-marketed, and genuinely helping women who had no access to hormone care before. I am not here to dismiss that. What I am here to do is tell you clearly what my practice is and what it is not, so that you can decide whether it is the right fit for you rather than finding out after you have already started.
My practice is a one-physician practice. There is no rotating roster of nurse practitioners. There is no algorithm deciding your protocol. There is no intake form that generates a prescription. There is me. And the difference that makes is not subtle.
Women come to me in two ways. Some are referred by a patient who is already in my practice. Others have already tried hormone therapy elsewhere, whether through a platform or through a physician who prescribed a standard preparation, and it did not work for them. In both cases, they arrive knowing something is missing. My job is to find out what that is and fix it.
What access to your doctor actually means
Most women who come to me have already tried at least one platform or seen a physician who gave them a prescription and told them to follow up in three to six months. Not weeks. Months. If something felt off during that time, they waited. If they had a question, they left a message and hoped someone called back.
In my practice, my patients can message me directly. They can make an appointment whenever they need one. I typically respond within a few hours. If something is urgent, I will return a call, schedule a call, or make an appointment the same day. That is not a promise buried in fine print. It is how I practice. And it is something most patients tell me they have never experienced with a physician before, the realization that when they reach out, they will hear back from the doctor herself, not a portal message that could have been written by anyone.
Weekly titration and why it changes everything
The way most hormone prescriptions work is this: a physician prescribes a dose, tells you to use it, and asks you to follow up in three to six months. If something feels off in the meantime, you wait. That is not how hormones actually work in the body, and it is not how I practice.
I use a weekly titration method. After your first appointment, you titrate your dose incrementally each week, building gradually so your body has time to respond and adjust. You do not go from zero to a full dose and then wait months to assess the fallout. You increase carefully, week by week, and you know exactly what to expect and what to watch for at each step. Four weeks after your first appointment we have a follow-up visit to review your response and refine the protocol. In between, if anything feels off, you message me and I make the adjustment. That is it. No billing for every message. No waiting room. No appointment required for a simple dose question.
This approach is only possible because of the formulation I use. Hormones compounded in organic jojoba oil can be adjusted with a precision that a patch or a pill simply does not allow. If your dose needs to go up by a small increment, I can make that change immediately. There is no waiting for a new prescription to be manufactured, no waiting for a new patch to be mailed. The adjustment happens, and you feel it within days rather than weeks.
My patients become experts in their own hormones
I am going to be honest here: my patients probably know more about hormones than most of the physicians they have seen. I love that. I mean it sincerely. An educated patient is one of the most powerful forces in medicine, not because she challenges her doctors, but because she can advocate for herself, ask the right questions, and notice when something has shifted before it becomes a problem.
By the time my patients have been with me for a few months, they understand what each hormone is doing in their body, why it matters, what the research says about its risks and benefits, and what symptoms to watch for that might indicate their doses need adjusting. They understand what estradiol does and why estriol belongs alongside it. They understand what progesterone contributes that a synthetic progestin cannot. They understand why testosterone matters for their brain, their energy, and their bones, and not just their libido. They understand what DHEA adds and why thyroid is part of the picture. They are not passive recipients of a prescription. They are informed participants in their own care.
And then something remarkable happens. They talk to other women. They share what they have learned with friends, sisters, colleagues, and neighbors who are struggling with the same symptoms and have been told the same dismissive things. Women have always taught other women. We spread knowledge by sharing with one another, and hormone health is a conversation that is not happening nearly enough in our society. It is one of the reasons I give talks as often as I can. Getting this information out into the world, person to person, woman to woman, is one of the most important things I can do alongside the clinical work.
What I am and what I am not
I want to be clear about the scope of my practice because I think clarity here is a form of respect. I am a hormone specialist. I manage your estrogen, progesterone, testosterone, and DHEA. I evaluate and treat thyroid dysfunction when it is part of your hormonal picture, because thyroid and sex hormones are deeply interconnected and you cannot optimize one while ignoring the other.
I am not a replacement for your internist, your family doctor, or your gynecologist. I am not a functional medicine practice. I do not manage your cardiovascular disease, your diabetes, your cancer care, or your general preventive medicine. What I do, I do with full depth and attention. What falls outside that scope, I will tell you clearly and refer you accordingly. A patient who understands exactly what her physician does and does not do is a patient who can build a complete care team, and that is exactly what I want for the women I work with.
What my pricing actually includes
One of the things that frustrates me most about what women encounter elsewhere is the lack of transparency about what they are actually paying for and what it costs when they need something. I have heard from patients who were surprised to find that a follow-up question required a new billable appointment. I have heard from patients who could not get a clear answer about what their monthly costs would actually total once medication was factored in.
My pricing is a single monthly fee. That fee includes your hormones and my time. It includes your follow-up visits. It includes the ability to reach out when you need to without worrying that contact equals a charge. You are not paying for a subscription to a platform. You are paying for a physician relationship, and that relationship includes everything a real physician relationship should include.
At approximately ten dollars a day, that covers your medication and the kind of extended, personalized, responsive clinical attention that women in this country have almost never had access to in the context of menopause care. I do not take insurance because insurance constrains what I can prescribe, how long I can spend with you, and how often I can see you. Removing that constraint is not a disadvantage. It is the entire point.
Who this practice is right for
My practice is right for you if you have already tried the standard approach and it did not work. If you have been on a patch and still feel awful. If you have had questions that went unanswered or answers that felt generic. If you want to understand what is happening in your body rather than just receive a prescription. If you want a physician who will notice when something shifts, who you can actually reach, and who will make the adjustment rather than asking you to wait until your next scheduled visit in three to six months.
It is also right for you if you are new to hormone therapy and want to start with someone who will take the full picture seriously from the very beginning, who will teach you what you need to know, and who will be genuinely reachable as your body finds its balance.
Most of my patients have been searching for this kind of care for longer than they should have had to search. Most of them say, on their first call, that they cannot believe a physician is actually going to spend this much time with them. By their first follow-up, they usually say they cannot believe they waited as long as they did to find it.
If you are in California, Florida, New York, or Illinois and you are ready to find out whether this is the right fit for you, the discovery call is free, there is no pressure, and it is a real conversation with me, not a form submission.
Dr. Anat Sapan, MD, is a board-certified OB-GYN and menopause specialist practicing telemedicine in California, Florida, New York, and Illinois.
Anat Sapan MD
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