Independent rankings of every major online HRT and TRT provider.

August 2026 · Updated monthly

Find your all-in online HRT price in 30 seconds

Cheapest with the medication included is $54 per 28 days at Winona. We track 10 platforms and grade each one A to F on what it tells you before you hand over an email address.

Prices verified August 202610 platforms graded A to FRanked by score, not payment

All-in monthly price finder

  1. 1Winona8.4/10 · VerifiedB$54 per 28 days
  2. 2Hers Menopause7.4/10 · on a 12-month plan · ReportedD$79/mo
  3. 3Gala Health7.2/10 · VerifiedC$86/mo

Prices above include the medication. 1 more platform charges for care separately from the medication, so its number is not comparable: Hone Health $155/mo. 3 charge per visit with no subscription: Midi Health $150 per visit, Sesame Care $99 per visit, Wisp $99 per visit. See every price.

Patch Rx
+184%

since 2018 (Truveta)

Tracked
10

platforms reviewed

Updated
Monthly

pricing + formulary

Featured picks · Verified August 2026

One best-overall pick. A shortlist for everyone else.

Each pick is derived from the same data as the full ranking (score, verified price, insurance status, transparency grade) and every one appears in the table below at its score-earned position. Read the methodology.

Best overall · 2026

Winona logoWinona

8.4 / 10TransparencyB

Compounded bioidentical HRT with $0 consults and product-only pricing. The highest-scored provider in the women's wing. $0 consult + product-only pricing + largest HRT-specific review base.

Total first-month cost

From $54

Verified

Medication, consults, follow-ups, and shipping included

  • True $0 consult, product-only pricing with care and shipping included [Verified July 2026, bywinona.com/product]
  • Full product menu priced publicly: estrogen tablets from $54 per 28 days, estrogen body cream $89 per 28 days, estrogen+progesterone dual cream $89 per 28 days, patch $149 per 28 days, progesterone capsules $39 per 28 days, vaginal estrogen cream $89 per 28 days, DHEA $27/3-mo [Verified July 2026]
  • ~6,000 Trustpilot reviews at ~4.7/5, the largest HRT-specific review base in the set [Reported]

Best insurance route

Midi Health logoMidi Health

Total first-month cost

Not verifiable

Not verifiable

No complete pre-intake total is currently published

7.7 / 10TransparencyB

The highest-scored provider that bills insurance. Women with a commercial PPO plan who want menopause care billed through insurance rather than paid as a cash membership.

Best budget entry

Sesame Care logoSesame Care

Total first-month cost

$99-$125 + medication

Reported

Video visit plus the pharmacy price or insurance copay

7.6 / 10TransparencyB

Lowest verified cash entry among providers scoring 7.5+: $99 per visit. Membership-fee "prices" don't qualify: a fee isn't a treatment price. Consult: About $99 to $125 per menopause video visit [Reported; not displayed in our July verification pass]. Exact clinician pricing is shown at booking; medication is separate. Optional Sesame Plus is $10.99/mo or $99/year with $10 off visits [Verified July 2026]. A separate reported menopause subscription price was not verified and is not used as our price anchor..

Best transparency

Wisp logoWisp

Total first-month cost

$99 plus your pharmacy's price for the medication

Verified

The $99 Menopause Consult does not include hormones. Wisp sends the prescription to your local pharmacy and you pay that pharmacy separately, using insurance or the Wisp Discount Card. The all-in first month is therefore not computable from published information.

7.3 / 10TransparencyB

Transparency Grade B, the strongest grade-and-score combination among providers not already featured above. The only provider in this wing that sends FDA-approved hormones to your own pharmacy, where insurance or a discount card can be applied to the drug cost.

Disclosure: some picks above are affiliate partners. We earn a commission when readers sign up through those links, at no extra cost. Scores and picks are set by methodology before affiliate status is considered; and the score never moves for payment. How we score · Affiliate disclosure.

Iacob Pastina, Independent Researcher & Publisher

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The Rankings

All 7 women's HRT platforms, scored.

Sorted by editorial score. Affiliate status never moves rank, only tie-breaks within a score band. How we score.

#ProviderScoreStarts atGrade
1Winona logoWinonaReview8.4$54 per 28 daysBVisit
2Midi Health logoMidi HealthReview7.7$150 per visitBVisit
3Sesame Care logoSesame CareReview7.6$99 per visitBVisit

Methodology: scores combine cost (25%), formulary breadth (20%), clinical depth (20%), patient experience (20%), and transparency (15%). Affiliate status is excluded from score computation. Full methodology. Looking for men's hormone care? The TRT wing: 4 clinics, same methodology.

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No spam. We never sell your email. Editorial policy.

HRT Picks compares prices and disclosure practices; it is not a medical provider and nothing here is medical advice. Talk to a licensed clinician.

Compare providers side by side

Pick any 2 to 4 providers and line up their prices, fees, formats, and transparency grades in one table.

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The state of HRT, June 2026

The FDA hasn't declared a shortage. Women still can't fill their patches.

In November 2025 the FDA began removing its strongest warnings (the black-box labels for cardiovascular disease, breast cancer, and dementia) from menopausal hormone therapy products. Labeling changes were approved in February 2026, and demand jumped.

By February 2026, about 5% of women aged 45-54 (one in twenty) had an estrogen-based HRT prescription, per Truveta's analysis of 130M+ patient records. Truveta measures the rise from a 2018 baseline: estrogen-patch prescriptions are up 184% since 2018, including a 25.7% jump in just July 2025 to February 2026. (Reuters characterized the recent climb as a rough doubling since 2023.)

Multiple estradiol transdermal products from Amneal, Zydus, Sandoz, Noven and Viatris now have doses on the ASHP shortage list, which began tracking estrogen patches in January 2026 (more than a dozen brands and dosages by May). Amneal's Dotti, one of the most-prescribed patches, is among them. Anonymous industry sources told Reuters the squeeze could last up to three years, but that's a worst case; named menopause experts are more measured, with Mayo Clinic's Dr. Stephanie Faubion expecting supply to improve by the end of 2026.

Here's the gap: the FDA has not added estradiol patches to its own shortage database (Commissioner Marty Makary calls supply "tight but keeping up… something to manage") even as ASHP, which logs shortages from front-line pharmacist and patient reports, lists more than a dozen patch products as short. That distance between what the regulator has formally declared and what women hit at the pharmacy counter is the structural reality of this market right now. See our full estrogen-patch shortage status and alternatives →

Several DTC telehealth platforms have stepped in, and many can prescribe non-patch estrogen (gel, cream, spray, oral or a vaginal ring) when your patch is unavailable. We've ranked the 7 platforms women are actually choosing between (by cost, formulary, and clinical depth) so you can pick one and move on.

Sources: FDA labeling-change records (Feb 2026); NBC News (May 10, 2026) and NBC News / Reuters (Apr 9, 2026); Truveta (Apr 9, 2026); ASHP Drug Shortages list (estradiol transdermal system); and AARP (Mar 13, 2026).

Most-compared providers
What the clinicians say

Independent Clinical Perspective

What the clinicians say about HRT

Verbatim, independently sourced statements from named physicians and medical bodies: real clinicians quoted with their sources, not a single paid reviewer. General clinical context, not an endorsement of any provider.

Tragically, tens of millions of women have been denied the life-changing and long-term health benefits of hormone replacement therapy because of a medical dogma rooted in a distortion of risk. For too long, issues of women's health have been underrecognized. Women and their physicians should make decisions based on data, not fear.
Marty Makary, MD, MPH, FDA Commissioner
U.S. Food and Drug Administration
Announcing the FDA's removal of the broad 'black box' warnings from menopausal hormone therapy products.
We agree with the FDA's decision to remove the boxed warning on low-dose vaginal estrogen therapies used to treat genitourinary symptoms associated with menopause. The boxed warning may have been a deterrent to the use of the low-dose vaginal estrogen, which is a safe and effective therapy for a condition that affects most menopausal women. Systemic estrogen still comes with potential risks in certain individuals that should be reviewed in detail with women initiating therapy.
The Menopause Society, Official statement (formerly the North American Menopause Society)
The Menopause Society
The specialty society's same-day response to the FDA announcement, agreeing on vaginal estrogen while keeping the nuance on systemic hormone therapy.
The WHI findings should never be used as a reason to deny hormone therapy to women in early menopause with bothersome menopausal symptoms. Many women are good candidates for treatment and, in shared decision making with their clinicians, should be able to receive appropriate and personalized healthcare for their needs.
JoAnn Manson, MD, Chief of Preventive Medicine; first author, 2024 JAMA WHI review
Brigham and Women's Hospital
On the long-term Women's Health Initiative follow-up: risks are lower and the benefit-to-risk ratio more favorable for women who start HRT in early menopause.

Quotes are general medical commentary about hormone therapy, independently sourced and not solicited by HRT Picks. They are not an endorsement of any provider. Our provider scores are set solely by our published methodology.

How we score providers

Scoring methodology

How we score, and why the grade is separate.

Every provider gets two independent readings: a 0-10 score on five fixed weights, and an A-F Transparency Grade for what it discloses before you hand over an email address. Affiliate status is excluded from both. Full methodology.

Cost

25%

Verified entry price and realistic first-year cost: anchor pricing and membership-plus-meds math counted at their real numbers, not the marketing ones.

Formulary

20%

Breadth of medications and modalities (patch, gel, spray, oral, cream, vaginal, injection) and FDA-approved vs compounded options.

Clinical depth

20%

Prescriber credentials, lab work, visit format (video vs text-only), and how much medicine actually happens between refills.

Patient experience

20%

Independent review base (Trustpilot, BBB, Reddit), complaint patterns, onboarding speed, and support quality. Unanswered BBB F caps the score at 7.0.

Transparency

15%

Honest marketing and disclosure practices inside the score, separate from (and in addition to) the A-F grade below.

The Transparency Grade, A-F

Not part of the 0-10 score. It's a separate axis grading what a provider tells you before intake, on five criteria:

  • Pricing disclosed before intake
  • Named clinicians with credentials
  • Published cancellation policy
  • Corporate disclosure (who runs it)
  • Third-party review accessibility

An unanswered BBB F rating or a corroborated billing-surprise pattern caps the grade at D regardless of disclosure.

Current spread (10 providers)

  • A0 providers
  • B4 providers
  • C4 providers
  • D2 providers
  • F0 providers
Common questions

FAQ

Frequently asked questions

What is the best online HRT provider in 2026?

Top-scored is Winona (8.4/10): compounded bioidentical HRT on a true $0-consult model from $54 per 28-day cycle, covering medication, consults, follow-ups and shipping, with ~6,000 Trustpilot reviews at ~4.7. For FDA-approved (not compounded) generics from named clinicians you can fill on your own insurance, Sesame Care (7.6/10) is the value alternative, though it is a general marketplace rather than a menopause specialist. Hone Health (7.5/10) is the labs-first option and the one whose pricing needs reading twice: women's Premium is $155/mo plus medication; Basic at $25/mo excludes hormones. Winona and Sesame Care are both affiliate partners, ranked at their earned scores, and affiliate status is excluded from the score entirely. Midi bills participating commercial insurance. Confirm your state, plan and cost sharing before booking.

How much does HRT cost online?

Verified August 2026: the cheapest all-in route on our women's wing is Winona at $54 per 28-day cycle with a $0 consult, which covers the medication, consults, follow-ups and shipping, on a 28-day billing cycle that puts 13.04 charges in a year rather than 12. Hone women's Premium is $155/mo plus medication and a $65 initial test; Basic at $25/mo excludes hormones. Watch the framing on every other headline number: Hone women's Premium is $155/mo before medication, Gala advertises $79/mo but bills $237 every 12 weeks, which works out to $85.82 a month, Sesame is a per-visit marketplace where FDA-approved generic estradiol goes to your own pharmacy (the exact drug price we could not verify this pass), and Wisp's $99 buys the consult alone with the hormones billed separately by your own pharmacy.

Is HRT covered by insurance?

Most commercial plans cover FDA-approved HRT medications (generic estradiol, micronized progesterone), often with step-therapy rules; compounded bioidentical HRT is almost never covered. None of the platforms we currently track bill commercial insurance directly. All of them are cash-pay, and several are HSA/FSA eligible. The way to use insurance on a cash-pay platform is to fill an FDA-approved prescription at your own pharmacy on your plan's formulary, which is exactly what Sesame's FDA-approved generics and Wisp's local-pharmacy routing are built for.

What is a Transparency Grade?

Our A-F grade for what a provider discloses BEFORE you hand over an email address, separate from the 0-10 quality score. Five criteria: pricing disclosed pre-intake, named clinicians with credentials, published cancellation policy, corporate disclosure, and third-party review accessibility. Current spread across the 10 providers we track: 4 B (Midi Health, Winona, Sesame Care, Wisp), 4 C (Hone Health, Gala Health, PeterMD, MangoRx), 2 D (Hers Menopause, Maximus). The grade moves independently of the score, which is the point of having it: a platform can deliver good care and still refuse to tell you what it charges until you are inside the funnel.

Why is the estrogen patch in shortage?

In November 2025 the FDA began removing black-box warnings (for cardiovascular disease, breast cancer, and dementia) from menopausal hormone therapy products, with labeling changes approved in February 2026, and demand surged. Estrogen-patch prescriptions are up 184% since 2018 (Truveta). Multiple estradiol patch products from Amneal, Zydus, Sandoz, Noven and Viatris are now on the ASHP shortage list (including Amneal's Dotti), though the FDA has not added estradiol patches to its own shortage database. Gel, spray, and pill alternatives are not in shortage; our live tracker shows which providers can switch you.

Does HRT Picks cover TRT for men?

Yes. A clearly-labeled second wing at /trt covers 4 TRT clinics under the same methodology and transparency grading. The short version: men's Plus at Hone is $135/mo before medication; its $25 Basic plan excludes hormone therapy. Highest-scored is Hone Health (7.5/10), the labs-first platform with the largest verified review base in the category; the cheapest flat monthly is MangoRx at $99/mo covering visits, consultations and medication, with labs billed on top at $75 or $100, which makes month one $174 to $199 (a broad men's-health platform, not a TRT specialist).

How do you score and rank these providers?

A 0-10 score on fixed weights (cost 25%, formulary 20%, clinical depth 20%, patient experience 20%, transparency 15%) plus a separate A-F Transparency Grade. Two hard rules: affiliate status is excluded from score computation, and any provider with an unanswered BBB F rating is capped at 7.0 no matter how good the rest looks. Every price carries a Verified or Reported status label with the verification date.

Are HRT comparison sites independent?

We earn commissions when readers sign up with some of the platforms listed, disclosed on every page. Our score is methodology-driven, never adjusted for affiliate status: if a higher-scored platform pays less than a lower-scored one, the higher-scored one ranks higher anyway. Where we have no independent review data we say 'Not surfaced' instead of inventing ratings. Full firewall details in our editorial policy.

Find your path

Featured Partners

Providers we may earn a commission from. Scores never move for affiliate status.

Winona logoWinona

8.4/10

$54 per 28 daysGrade B

Sesame Care logoSesame Care

7.6/10

$99 per visit + medicationGrade B

Hone Health logoHone Health

7.5/10

$155/mo + medicationGrade C

Wisp logoWisp

7.3/10

$99 per visit + medicationGrade B

Some links above are affiliate links. We may earn a commission at no extra cost to you. Scores are methodology-only and never move for affiliate status. How we score.