How to Start Hormone Replacement Therapy in 2025
- Peggy B. - Experienced HRT Patient Reviewer
- Aug 29
- 6 min read
Updated: Oct 5
Sometimes, we just don't know where to start? Specifically for Hormone Replacement Therapy, the options and choices can feel daunting. Let this blog be your guide for the top online companies and providers to consider, if HRT is on your list for 2025.
Hormone Imbalance
It seems like at least once a week, I have someone ask, "How do I know if I have a hormone imbalance?" Believe me, when your hormones are out of whack, you know it. Symptoms will include things like:
Night Sweats
Hot Flashes
Moodiness
Sleeplessness
Brain Fog
Heart Palpitations
Weight Gain
Hair Loss
If you are anywhere north of age 35 and have experienced any or some of these symptoms, then you are likely in some phase of Perimenopause or Menopause. Perimenopause can last up to ten years and are the years leading up to your last menstrual cycle. Once you have gone twelve plus months without a period, you are technically in menopause and the next day, you are post-menopause.
Does Insurance cover Hormone Replacement Therapy
If you have medical and prescription insurance and you visit a doctor who takes your insurance and then also prescribes medications that are FDA approved ingredients and dosages, then yes, it's highly likely that you can utilize your insurance for HRT.
Hormone Replacement medications that are custom dosed by a compound pharmacy whether they are FDA approved ingredients or not, will not likely be covered. When the time comes to speak to a medical professional about HRT, you'll want to ensure you visit with a doc and a practice that understands which Hormone Replacement Meds are FDA approved. They know which creams, patches or pills are FDA approved and can be picked up at your local pharmacy using your prescription insurance.
The last time I picked up three months worth of medications at my local CVS, it averaged out to $36 per month. My prescriptions consisted of a estradiol patch, progesterone tablet and then vaginal estradiol cream.
But, there is also a place for custom doses and compounded meds. Hormone Replacement medications that are made by a compound pharmacy are usually a custom dose or a custom blend of ingredients, like progesterone plus estrogen in one cream or troche.
Many of my favorite online Hormone Replacement providers have a simple business model that doesn't include medical and prescription insurance. More of a self-pay discounted price. They price their meds to be competitive. And personally, sometimes I find it's just easier to purchase prescriptions outside my insurance plan. I typically use my HSA card to purchase all my HRT medications.
Will my Insurance cover Hormone Testing?
Maybe. This one is a little more difficult to give a definite answer. Your GYN can order hormone tests and code it in a way that will likely be covered by insurance. but here's the thing . . many GYN's don't know much about hormone replacement or how to read hormone tests once they are returned.
There is where the specialty, online telemedicine providers really excel. For example, I've been a patient of Joi Women's Wellness over the years and they offer a battery of hormone tests for as little as $59, using this link. There are "standard ranges" that the results will show, and then there are the optimum results to feel your best. The acceptable numbers can be quite different. For example, the last time I met with a Joi clinician, they suggested we look a bit deeper into my thyroid numbers and my testosterone. But had we only focused on the LabCorp standard "ranges," I would have never known that there could be some issues that needed further testing.
If you are starting to feel really crappy, getting tested to see not just your hormones, but other biomarkers can be a huge eye opening event.
Then there are biomarkers like blood glucose levels that can impact lots of other areas of your body. This one biomarker can impact whether you are in diabetes and could be part of the reason why you have gained weight or can't lose weight.
Some doctors will tell you that they use evidence based medicine, meaning it's how you feel once you start taking HRT that determines if the meds are right and are working. Some docs will order blood work and some won't require or ask you do this. Both of these models of practice have their value in Hormone Replacement Therapy.
How to start Hormones
Personally, I like to get my HRT from a online, telemedicine providers. See this link to find the ones that I've been a patient and read the many blogs about my experiences and what each one cost me out of pocket.
Some take insurance and some do not. Some require testing and some do not. Some only prescribe FDA approved meds and some only prescribe compound custom meds. Some offer both. It can be quite confusing.
Visit the Trusted Providers page of my website to further dive into what each offers and which one might be the best for you.
Trusted Online HRT Providers
I'm going to give you a quick run down of the ones I've tried and a bit about each. I'm just going to provide the high-level details that sets each one apart, but if you want more details, visit my website, Hormone Therapy Hub.
Joi Women's Wellness - Requires hormone testing - this link will give you up to 50% labs which includes your first 30-minute consultation once labs are back. You can not use insurance to pay for labs. They offer FDA approved and compond meds, so you have options.
Winona - Simple to start. I spent about $75 per month for compounded estradiol/progesterone cream. No cost to create an account. No consultation visit required. Since they sell compound only, they don't accept insurance.
Mid Health - They do take some major insurance, however, they didn't take mine. I paid $250 out of pocket for a 30 minute visit and then was able to get prescriptions for meds that I could pick up at my local CVS. Follow up consultations are expected every three months, they are $150 for a 15 minute meeting to review meds and how you are doing.
MyMenopauseRx - this is a brick and mortar doctor's office in Illinois, that also offers telehealth visits in most states. They take insurance and only write prescriptions for FDA approved meds that can be picked up at local pharmacy. First 20 minute consultation if you self pay is $99 with each follow up being the same price.
Alloy - this one is similar to Winona, but you have to pay $50 to create an account to even get started. I do like their skin care, but some can't get over the fee to create an online account. No consultation required.
Inner Balance - I just recently started using their Oestra cream. I have found it great for sleep. It's a subscription based HRT provider, the cost remains the same no matter if you are dosed one or two pumps. It's a vaginal delivery which I suspect works best for me, based on my experience at 90 days. Topical creams that I rubbed on my forearms, didn't absorb and couldn't be detected in my bloodwork. Patches were better, but my sleep still suffered. It was when I then tried Oestra, that I may have found the perfect HRT for me.
How to Start Hormone Replacement Therapy in 2025
Whether you are leaning toward getting your medications from your GYN, if they are onboard or whether you want to try a specialist that practices as telehealth, online you have lots of options. And I've tried many of them, so there is a ton of information in my blog posts around my personal experience and how much I paid out of pocket for the different providers.
It's great that in 2025 that we have so many options. A few years we didn't. If you happened to be a patient of a doctor who didn't understand HRT or refused to prescribe it, you were out of luck. Today, even if your doc isn't on board, you have other doctor specialists that you can visit to advocate for the care you want and deserve.
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