Before the shift
Reproductive years
Cycles are generally more predictable and hormones follow a more consistent monthly pattern.
Perimenopause + menopause care
Women's health.
Personalized hormone therapy for perimenopause and menopause, prescribed online by licensed providers. Your plan is built around your history, symptoms, and changing needs.
Understanding the transition
Perimenopause is the transition. Menopause is a point in time.
Symptoms may begin years before periods stop. The pattern, intensity, and treatment needs can change throughout the transition.
The transition
Perimenopause
Estrogen and progesterone fluctuate. Symptoms can appear while periods continue and cycles become less predictable.
12 months
Menopause
Reached after twelve consecutive months without a menstrual period.
The years after
Postmenopause
Some symptoms improve while vaginal, urinary, bone, and cardiovascular considerations remain important.
Treatments.
Three treatment types, each with a different role. Your provider determines which option—or combination—fits your history.
EstradiolRx
Estrogen · patch, gel, tablet, or vaginal cream
Starting at $69 / month
4 formats
- The estrogen that declines through perimenopause and menopause, replaced in the form that suits you.
- Choose a transdermal patch, daily gel, oral tablet, or vaginal cream with your provider.
- Prescribed only when a licensed provider determines it fits your health history.
ProgesteroneRx
Micronized progesterone
Starting at $49 / month
Oral capsule
- Often prescribed alongside estrogen to keep a hormone therapy protocol balanced.
- Taken as directed by your provider, on a monthly or quarterly supply.
- Reviewed and dosed by a licensed provider before it ships.
Biest 50:50Rx
Bi-estrogen topical cream
Starting at $139 / month
Topical cream
- A compounded 50:50 blend of estradiol and estriol, applied as a topical cream.
- Available on its own or combined with progesterone.
- Compounded by a licensed U.S. pharmacy to your prescription.
Treatments
Different roles. One clinician-guided plan.
Choose the treatment you want to pursue, then compare formats, pricing, and the role each option may play in your care.
Estrogen replacement
Estradiol
Estrogen therapy available in systemic and local formats to fit different needs and routines.
PatchGelTabletVaginal creamStarting at $69 / month
Worth discussing when: symptoms include hot flashes, sleep disruption, or vaginal discomfort.
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Protocol balance
Progesterone
May be included with systemic estrogen based on your anatomy, history, and complete treatment plan.
Oral capsuleOften taken eveningsIndividualized doseStarting at $49 / month
Worth discussing when: progesterone may be needed as part of a complete estrogen plan.
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Compounded bi-estrogen
Biest 50:50
Estradiol and estriol combined in a customized topical cream prepared to an individual prescription.
Topical creamEstradiol + estriolCustomized strengthStarting at $139 / month
Worth discussing when: an individualized compounded topical option is being considered.
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View full treatment comparison
| Treatment | Primary role | Form | What distinguishes it |
|---|---|---|---|
| Estradiol | Estrogen replacement | Patch, gel, tablet, vaginal cream | Systemic and local options |
| Progesterone | May balance an estrogen protocol | Oral capsule | Selected as part of the complete plan |
| Biest 50:50 | Estradiol + estriol | Topical cream | Customized compounded formula |
Prices shown are starting prices and vary by prescribed form and supply. A licensed provider determines whether hormone therapy—and which option—is appropriate.
Your first step
Choose the treatment you're interested in. A licensed provider confirms whether it's appropriate for you.
Common questions
Before your visit.
How do I choose a treatment?
Choose the treatment you're interested in before starting your intake. A licensed provider reviews your selection and health history, and prescribes only if it's medically appropriate for you.
Can symptoms begin while I still have periods?
Yes. Perimenopause can begin before periods stop, and cycles may become irregular as hormone levels fluctuate.
Why might progesterone be prescribed with estrogen?
For some patients with a uterus, progesterone may be included with systemic estrogen as part of a balanced protocol. Your provider determines what your specific plan requires.
What is the difference between systemic and local estrogen?
Systemic forms circulate through the body and may be used for broader menopause symptoms. Local vaginal estrogen is applied where symptoms occur and is generally considered for vaginal or urinary symptoms. Your provider recommends the appropriate route.
Are compounded hormone medications FDA-approved?
Compounded medications are prepared by licensed compounding pharmacies for an individual prescription and are not FDA-approved. A provider may prescribe one when clinically appropriate.
Where is treatment available?
Availability varies by state and is confirmed during your intake.
Care built around what changed—and what you need next.
A licensed provider reviews every intake. If treatment is not appropriate, you pay nothing.
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