I tested 7 online HRT Clinics: My Top Choice for 2026

I've been on Hormone Replacement Therapy since 2019.

2025 was the year menopause finally broke the internet. When I launched my HRT blog and YouTube channel back in 2024, I had no idea we were on the verge of such a massive cultural shift. But for those of us 36 and older, this ‘growth spurt’ in conversation has been a lifeline. It’s finally time we had the resources and transparency we deserve

I've spent the past two years becoming a patient of many of the most popular and well-known online HRT Clinics. It's my privilege to share with you my top choice based on the companies I've tried so far.

At a Glance: The 2026 HRT Comparison Table

I am HRT patient reviewer. I paid for my Hormone Replacement Therapy out of pocket using my HSA credit card or my Medical and Prescription Insurance when I could. The costs below represent what the online HRT Clinic charged me or what I was charged by my pharmacy when I used my employer provider prescription insurance.

HRT Online Clinic	Monthly Price	HRT Insurance Accepted	HRT Formulation Typically Prescribed	Comments
Winona	$89	X	Topical Cream	No Consult Required
Joi Women's Wellness	$233	X	Patch + Pills	$150 Labs required initially
Alloy	$75	X	Patch + Pills	No Consult Required
Midi Health	$39/mo+$250 Consult Fee	Yes	Patch + Pills	30 Minute Consultation included
MyMenopauseRX	$39/mo+$99 Consult Fee	Yes	Patch + Pills	20 Minute Consultation Included
Inner Balance 2026 Top Choice	$150/first year monthly avg.	X	*New Vaginal Delivery Cream	New to Market Product, best for Sleep Improvement, Free consults as needed
Effecty	$140	X	Patch + Pills	Consult Optional at no cost

Disclaimer: I am a patient sharing my personal experience. This is not medical advice. Always consult with a licensed healthcare professional before starting HRT.

Best online Bioidentical Hormone Replacement Therapy

What makes an HRT product or formulation bioidentical or not is the ingredients. If your Hormone Replacement is made up of Estradiol and/or Progesterone, then it's bioidentical. These products can be pills, creams, gels, patches or injections.

Bioidentical HRT may come from a local pharmacy or it may come from a compound pharmacy. It may be FDA approved and it may not be. Bioidentical has become a huge marketing term to entice and help women feel comfortable about taking Hormone Replacement Therapy. Bioidentical hormones are processed hormones designed to mimic the hormones made by your body’s glands.

Any HRT product consisting of Progesterone or Estradiol are bioidentical, no matter where it comes from.

HRT Consultation, what to expect

To this day, this question, "Will I actually meet with a clinician?" is the most popular YouTube Short Video I've posted. Two of the providers on the chart above afford you a 20-minute or 30-minute consultation before you are prescribed any medications, if necessary. If you have lots of questions or really want to talk through how Hormone Replacement is prescribed and what you can expect, either of these two will satisfy your needs.

Both MyMenopauseRx and Midi Health, operate much like a traditional doctor's office. You make an appointment. They take your medical insurance information and submit the bill on your behalf for payment. If the appointment is not 100% covered, they'll bill you for your portion of the bill. If you find either of these two providers don't take your medical insurance, you can take advantage of their self-pay consultation. Cost is noted in the chart.

Should they decide you are qualified for an HRT medication prescription, then they send your prescriptions to the pharmacy of your choice. When you pick of your medications, you can use your prescription insurance or a GoodRx Coupon Code.

Joi Women's Wellness also offers a 30-minute consultation. The cost of the consultation is included in the $150 lab fees. Once labs are returned, they send you a link to schedule an on-line appointment to discuss your levels and any medications that might be prescribed. Joi partners with a compound pharmacy for prescriptions so you can't use prescription insurance for their meds.

Midi Health and MyMenopauseRx both offer 30 or 20-minute consultations to discuss Hormone Replacement Therapy.

Is Online HRT Covered by Insurance? 2026 Telehealth Coverage Guide

Any Hormone Replacement medication that has been approved by the FDA, including the formulation, the ingredients and the exact dose will be covered by prescription insurance. Midi Health and MyMenopauseRx only prescribe medications that are FDA approved and can be picked up at your local pharmacy.

All five of the others work with Compound pharmacies and will prescribe Hormone Replacement medications that are compounded, meaning custom created and dosed specifically for you. Due to this customization, these medications are not FDA approved and therefore won't be covered by prescription insurance.

But understand, my friend, the ingredients in 100% of the cases of the other five clinics are FDA approved, it's just the formulation, the ratio of estrogen to progesterone, it's delivery method or the custom dose that prevents it from being FDA approved.

You need not be concerned about these medications. For me, as a matter of fact, knowing that they are custom created in ratios and dosages that are specific to my needs, feels like a step up from the age-old HRT standard dose formulations that many clinics offer.

Most online HRT Clinics don't require Blood work or labs to get started.

Is Hormone Testing for Menopause Required to Start HRT?

The only online HRT provider in the chart that 'requires' Hormone Level Testing prior to seeing a doctor is Joi Women's Wellness. They charge $150 which includes the basic Hormone lab panel and a 30-minute follow-up consultation to discuss those labs.

All of of the other online clinics on the list practice what they call, "Evidence Based Medicine" meaning if the medication makes you feel better then it's working and labs are not needed to validate its effectiveness.

The one thing to understand about Hormone levels is that they fluctuate through-out the day. You level at 8:00AM will be different than your levels at noon and even different than your levels at 6:00PM. Hormone level tests are a snapshot of your level at that moment in time and doesn't necessarily representative the full picture. Many clinics feel testing is not needed and therefore don't ask you spend your hard earned money on testing.

I tested 7 online HRT Clinics: My Top Choice for 2026

My Top Choice for 2026 after trying all seven of these Clinics, is Inner Balance. It's my current HRT regimen.

It was created by Dr. Sarah Daccarett, Founder and CEO of Inner Balance. This cream is different. Unlike topical creams that you rub on your thighs or inner arms, the Oestra Cream by Inner Balance is delivered vaginally with your fingers or a disposable applicator, which according to Dr. Sarah mimics more like how we got our hormones when we were in our 20's. No night-sweats, hot flashes or brain fog and the one big difference I notice with Oestra is my sleep. I go to sleep faster and stay asleep longer on this HRT, more so than any of the others. Also, I only need the one product where as with the other HRT regimens I was prescribed two or three products all with different schedules.

It is a bit more expensive for the first six-months at $199 per month, but then on month seven its decreased to $99 per month which is right in line with many of the others on the chart. You'll have total access to Inner Balance clinicians for free and if they need to tweak your dose, they'll do that as often as needed until it's just right for you.

Use PEGGY10 for 10% off First Order of Oestra by Inner Balance

Each bottle of Oestra has enough cream for 3 months.