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- Comparison Table
- How We Chose
- What to Look For
- What Is HRT and How Does It Help?
Getting the menopause care you need isnt always as straightforward as it should be. Due to a lack of research and attention historically paid to women's health, many doctors haven't received adequate training and don't feel properly equipped to treat menopause symptoms, says Melissa Loseke-Albett, DO, a medical advisor for Joi + Blokes online health platform who practices in Omaha, Nebraska. So telemedicine services uniquely designed to do so began springing up. Today, there are many online options available for people who not only want HRT but also need extra support to help them through this life transition.
We carefully researched where to buy HRT online to find the most straightforward yet comprehensive services. We prioritized those with consistently excellent customer reviews and those that are well regarded by experts in the field. Finally, we spoke with three doctors who work in telemedicine to learn what makes a truly stellar service, which helped us round out this list.
When To Consult Your Doctor
HRT in any form requires a prescription and a doctor's evaluation before you can purchase it online. But an initial assessment shouldnt be the final step.
We typically recommend a follow-up check-in and lab test about six weeks after starting the treatment to make sure that its working well with your body, says Dr. Loseke-Albett. After that, we carry out check-ins every three months or so to assess how symptoms are progressing, any side effects from the medication, and adjustments needed in dosage. Ongoing oversight from providers is important, as menopause symptoms and needs may change over time, and with that comes continued evaluation of treatment plans.
Best Clinician Support
Winona
Pros
- Unlimited messaging with clinician
- Pay-per-month pricing
- Many resources for perimenopause and menopause support
- Hormone-free treatments available
Cons
- Uses compounded treatments
- Unavailable in 13 states
Key Specs
- Insurance accepted: Yes
- Membership fee: No
- Telehealth with prescription: Yes
- Types of HRT available: Estrogen cream, tablet, or patch; progesterone capsule or cream; combination estrogen and progesterone cream; DHEA tablets
- HSA/FSA-eligible: Yes
During your perimenopause journey, youre going to have questions. At Winona, you can skip Dr. Google and go straight to the experts. Thats because Winona offers unlimited messaging with your clinician. After taking a brief quiz designed to pinpoint your needs and understand your medical history, youll be connected with a clinician who will create a personalized treatment plan for you. Once your plan is in place, you can chat with your clinician via the patient portal 24/7 at no extra cost. The portal is also where you can view your treatment plan and access monthly live Q&As with physicians.
The initial appointment is free, and there are no subscription fees; you simply pay the monthly cost of your prescription, which starts at $27. If your provider determines that you can safely benefit from treatment, theyll submit your prescription through the patient portal, and it will be shipped free and discreetly to the address you specify. Winona is in network with some private and employer insurance plans. If your plan isnt in network, you can use a healthcare savings account (HSA) or flexible spending account (FSA) at checkout.
Best for Perimenopause
Alloy
Pros
- Specifically treats perimenopause symptoms
- Holistic approach to treatment
- Clinicians are peri- and menopause experts
- 24/7 ongoing support
- Community support groups and webinars
Cons
- Does not accept insurance
- No lab work requested
Key Specs
- Insurance accepted: No
- Membership fee: $49 for an initial consultation; prescriptions start at $90 per three-month supply
- Telehealth with prescription: Yes
- Types of HRT available: Estrogen and progesterone pills, patches, vaginal creams, or gels; low-dose birth control for perimenopause
- HSA/FSA-eligible: Yes
Unlike similar telemedicine services, Alloy has a dedicated landing page for perimenopause outlining the symptoms you can experience and options for treating them. When you click Start Now, you reach a short questionnaire designed to help your clinician learn about you and your symptoms. During your appointment, your provider will discuss treatment options (they can prescribe hormonal and nonhormonal medications, including those for hair and weight loss, as well as sexual, gut, and skin health). Meds are sent with free shipping right to your door.
Alloy isnt covered by insurance, but the initial consultation ($49) and prescription costs (starting at $90 per three-month supply) are relatively low compared with similar services that dont accept insurance. The only thing that gives us pause is Alloys lack of reliance on lab work. The clinicians dont send you for blood work, nor do they ask you for recent blood work. This puts the responsibility of prescription safety and accuracy more on the patient.
Best for Preventive Care
Hone
Pros
- Focus on preventive care, with advanced labs and longevity treatments
- Personalized, holistic treatments
- Extensive lab testing
- Ongoing monitoring
Cons
- Basic membership does not include hormone therapy
- Users report poor customer service
Key Specs
- Insurance accepted: No
- Membership fee: $25 per month for basic; $155 per month for premium
- Telehealth with prescription: Yes
- Types of HRT available: Estradiol cream or patch, progesterone cream or patch, combination estradiol and estriol cream, DHA cream, testosterone injections or cream
- HSA/FSA-eligible: Yes
Unlike other telemedicine services that offer HRT, Hone has its patients undergo a comprehensive lab test ($65) before providing treatment. Once those labs are in, you have a 30- to 45-minute consultation with a clinician who will go over your results, medical history, symptoms, and concerns. Then theyll outline a customized treatment plan for you.
Note: If youre specifically looking for HRT, youll need to purchase the Premium plan ($155 per month). HRT options include progesterone, estradiol, and testosterone.
The Basic plan ($25 per month) doesnt include the price of medications or the initial lab test. But it does give you access to other medications, such as metformin, nicotinamide adenine dinucleotide, and GLP-1 agonists, so if youre looking for a more comprehensive treatment plan, this one may fit the bill.
Best Without Insurance
Sesame
Pros
- Affordable without insurance
- Full-service telemedicine platform
- Unlimited messaging with providers
- Fast scheduling and same-day prescriptions
- Range of medications available, including selective serotonin reuptake inhibitors
Cons
- Insurance not accepted
- May not be able to see the same provider each time
Key Specs
- Insurance accepted: No
- Membership fee: $59 per month for labs and ongoing support via video calls and messaging (prescription cost not included)
- Telehealth with prescription: Yes
- Types of HRT available: Estradiol, progesterone, estrogen/progestin, and DHEA, all in tablet form
- HSA/FSA-eligible: Yes
If you dont have insurance, it may seem cost-prohibitive to get specialized prescriptions such as HRT, but Sesame is bridging the affordability gap. The service offers telemedicine for a wide range of needs, including online therapy, urgent care, and various womens health concerns, including menopause, but it does not work with insurance. The menopause program, which includes lab work, unlimited messaging with providers, and ongoing care via telehealth appointments, costs $59 a month. When you factor in the ongoing care and prescription deals (you get a savings card that can lower the cost to below copay rates), this represents a good value for those who are uninsured or underinsured.
We love that you can schedule an appointment on the same day you complete a simple questionnaire to help determine a personalized treatment plan. Our research has found that Sesames clinicians are attentive; however, its not always possible to rebook with your preferred provider. Also, while we appreciate that you can often make same-day appointments, we found that patients sometimes feel like their visit is rushed.
Best With Insurance
Midi
Pros
- Covered by most major insurance providers
- No membership or subscription fees
- Wide variety of medication forms
- Holistic approach to care
- Hormonal and nonhormonal prescriptions available
- Clinicians are experts in midlife womens health
Cons
- Not covered by Medicare and Medicaid
- No initial lab work requested
Key Specs
- Insurance accepted: Yes
- Membership fee: No; $250 for the first visit, $150 for follow-ups
- Telehealth with prescription: Yes
- Types of HRT available: Estrogen patch, cream, vaginal ring, gel, or pill; testosterone cream; DHEA/estradiol cream; progesterone pill, patch, IUD, or vaginal suppository
- HSA/FSA-eligible: Yes
Treating the mosaic of symptoms that can result from midlife hormone changes can involve visits to multiple doctors and specialists. Midi aims to reduce those visits by giving you access to numerous specialists from the comfort of your home. And its all covered by insurance no membership fees of any kind. If your insurance provider is accepted (most major ones are), youll likely just pay a copay; the most youll pay is a $250 deductible for your initial consultation. And you can pay with your HSA or FSA account.
Midi supports its patients with the help of a multidisciplinary care team, including dermatologists, naturopaths, clotting experts, and gynecologists well versed in hormone therapy. If youre recovering from breast cancer, for example, they have specialists who can create a safe and effective treatment plan for you. Not many telehealth services offering HRT can say that.
No labs are required to make an appointment with a clinician; you just fill out a survey about your medical history and symptoms. During your consultation, your clinician will determine if you require lab tests to proceed with your treatment plan. You can have prescriptions sent to your local pharmacy or even a mail-order pharmacy. After you begin taking medication, you can have virtual follow-ups with your clinician as often as you need to track your progress and adjust dosages. Out-of-pocket costs can vary if you dont have insurance; however, the initial consultation is $250.
Best for Fast Shipping
Wisp
Pros
- Same-day appointments
- Affordable plan for those without insurance
- Various forms of HRT
- Free shipping for medications or same-day pickup
- Other sexual health meds available (via different plans)
- Regular discounts
Cons
- Must be at least 40 to receive HRT, unless youve had a hysterectomy
- Insurance not accepted
Key Specs
- Insurance accepted: No
- Membership fee: $99 for the initial consult and three months access to care team
- Telehealth with prescription: Yes
- Types of HRT available: Estradiol patch, gel, or tablets; estradiol/norethindrone tablets; progesterone capsules or tablets
- HSA/FSA-eligible: Yes
When youre struggling with hormone-related symptoms, receiving fast relief is key. Wisp offers same-day appointments and fast, free shipping for medications (or pickup at your local pharmacy, often within 24 hours). In some cases, you may not even need to have a video consult with a provider; you can simply answer questions about your medical history and symptoms via messaging on the website to receive your prescription. What could be easier?
Aside from hormone therapy, Wisp is a one-stop shop for sexual and reproductive health. You can get STI testing and treatments, birth control prescriptions, and intimacy products such as vaginal lubricant. Subscription prices vary by product and treatment program. The menopause program is a one-time fee of $99, which includes an initial consultation and three months access to a care team (medication costs are separate, and insurance may apply).
We love the comprehensive approach to treatment but wish the HRT treatments were more inclusive. By only providing HRT care to people over 40 (unless youve had a hysterectomy), the current plan feels exclusive of those who may be dealing with hormone fluctuations at an earlier age.
Best for Holistic Care
PlushCare
Pros
- Can see providers to address all kinds of health needs
- 30-day free membership
- Most major insurance providers accepted
- Discounts on labs and prescriptions (with card)
- Free family memberships
- Telehealth treatment for a wide range of concerns
Cons
- Clinicians arent necessarily HRT experts
- Clinician availability is limited, depending on your state
Key Specs
- Insurance accepted: Yes
- Membership fee: $19.99 per month with insurance; $19.99 per month plus $129 per visit without insurance
- Telehealth with prescription: Yes
- Types of HRT available: Estrogen and progesterone pills, patches, vaginal creams, gels, or rings
- HSA/FSA-eligible: Yes
Thanks to telehealth services like PlushCare, there are so many health-related concerns you can address from home. Aside from offering HRT, PlushCare has a comprehensive care system in place for everything from mental health support to urgent care to weight loss prescriptions. Its membership makes it easy to get your entire family the healthcare they need, all in one place.
Membership costs $19.99 per month (the first month is free) or $99 per year. That said, the benefit is mainly for those with insurance; without insurance, each visit is $129. You can also add up to five family members to your plan. You can book a same-day appointment and choose from a list of available practitioners (their profiles and patient ratings are available). Unlike other services on this list, there is no medical background questionnaire to fill out. While that certainly gets you on the books with a clinician faster, it may mean your appointment wont be as comprehensive.
If your doctor thinks HRT will work for you, theyll prescribe it and have it sent to your local pharmacy. Theres not much information about how clinicians treat perimenopause and menopause, other than the HRT landing page, which is basically just an FAQ outlining how HRT works. Based on that, we recommend PlushCare more as a one-stop health shop rather than a service that specializes in HRT.
Comparison Table
How We Chose HRT Online Platforms
We researched more than 20 of the top telehealth services that offer HRT to find the best, safest ones available. When curating this list, we considered each services initial questionnaire, the clinician support offered, the communication methods, other health-related services and prescriptions, whether insurance is accepted, and the types of HRT offered, among other factors. We also explored each website to determine the ease of navigation and whether useful information on HRT was readily available.
Finally, we consulted with four doctors who familiar with HRT and telehealth to understand the key considerations when buying HRT online:
- Andrea Caamano, MD, director of medical affairs at Besins Healthcare, who practices in North Arlington, New Jersey
- Barbra Hanna, DO, an ob-gyn, a Menopause Societycertified practitioner, and co-founder of MyMenopauseRx, who practices in Winfield, Illinois
- Melissa Loseke-Albett, DO, medical advisor for Joi + Blokes online health platform, who practices in Omaha, Nebraska
- Pamela W. Smith, MD, MPH, chief education officer at MDLifespan, who practices in Michigan and Florida
What to Look for When Buying HRT
When considering where to buy HRT online through a telehealth service, make sure that youre purchasing from a safe and reputable source. Get HRT from a telemedicine company that uses technology to practice medicine, not just sell you a prescription, says Dr. Hanna. Here are some other key factors to look for when buying HRT online:
- An Individualized Plan No one seeking HRT has the same medical history or needs, so a telehealth service that provides it should offer the opportunity to speak with a knowledgeable clinician who can make personalized recommendations to help address symptoms. Any reputable telehealth provider should offer an individualized plan. There is nothing in medicine that is one size fits all, and HRT is not an exception, says Dr. Caamano.
- Transparent PricingA telehealth service shouldnt make it challenging to find their price model for memberships and prescriptions. If the website isnt up front about its costs, there may be other important information theyre also keeping from you.
- Expert Providers and Follow-Up AppointmentsWhen taking HRT, youll want to have access to a provider who has a deep understanding of how it works and what you may be experiencing. Hanna suggests looking for physicians and practitioners certified by the American Menopause Society. You should have access to a provider as long as youre taking HRT for any questions or concerns that may arise. If a service simply offers automatic refills without the option to consult a provider, thats a red flag.
- Lab Monitoring Hormones are forever fluctuating, especially when youre in perimenopause or approaching menopause. Since dosages of HRT should complement your unique hormone levels, its vital for your doctor to regularly monitor them so they can adjust amounts and even types of HRT as needed. Estradiol and testosterone should be checked 6 to 12 weeks after the start of therapy or after dose changes, explains Caamano.
What Is HRT and How Does It Help?
Who Should Not Take HRT and Why?
HRT comes with some risks that depend on a persons medical history. For example, a history of breast cancer might impact ones ability to take HRT or certain varieties of it.
Individuals who have known or suspected estrogen-sensitive breast cancer or endometrial cancer should consult their doctor before taking HRT, says Loseke-Albett. History of breast cancer is not an absolute contraindication, but should be discussed with an oncologist prior to any HRT." She goes on to note some other significant contraindications: "Undiagnosed or unexplained vaginal bleeding; active venous thromboembolism such as deep vein thrombosis or pulmonary embolism; known clotting disorders; active or recent stroke, myocardial infarction, or heart attack; and active liver disease or severe liver dysfunction.
What Are the Potential Side Effects of HRT?
The most common side effects of HRT include the following:
- Headache
- Nausea
- Weight changes
- Vaginal bleeding
- Breast tenderness
- Mood swings
- Insomnia
- Muscle and joint pain
- Blood clots
- Allergic reaction
- Certain forms of cancer
If you experience any concerning symptoms, contact your doctor immediately. Its also a good idea to discuss any symptoms, concerning or not, with the clinician who prescribed the medication to see if you should adjust your dose.
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- Ongoing Individualized Hormone Therapy Appears to Have No Age Limit. Menopause.org. September 2024.
