Quick answers · Last verified July 2026
20 questions, answer first, number first. Every price, count and grade below renders from the same verified provider file the rankings use, so nothing here can drift out of step with the rest of the site. We earn a commission from some of the platforms named, which never moves a score. How we score and who pays us.
All-in HRT runs $40 to $79 a month at the 3 of 13 women's platforms that bundle the medication into one monthly price. Alloy sets the floor at $40. Visit-fee platforms work on a different clock: Elektra Health $149, Midi Health $150, Gennev $199 per consult, with the prescription billed separately on top of that.
Full verified table: what HRT costs.
$40 a month at Alloy, the cheapest all-in price on our roster, then Winona at $54 and Gala Health at $79. Those figures buy the hormones. A per-visit platform has no monthly rate at all, so a monthly number quoted for Elektra Health or Gennev was invented by whoever published it.
Sorted by verified price: cheapest HRT online.
$74.99 a month at Alloy is the cheapest published estradiol patch on our roster, rising to $149 at Winona. The patch costs roughly twice the pill at the same provider: Alloy prices its estradiol pill at $39.99 and the identical hormone through the skin at $74.99.
Each line above is the provider's own published product string, kept verbatim. More on the form: the estrogen patch guide.
$39.99 a month at Alloy is the cheapest cash price we have verified for systemic estradiol, with no insurer involved at any point. 10 of the 13 women's platforms we track are cash-pay only, so their published price is the whole price. Vaginal estradiol is cheaper again where it fits, from $20.
Every form priced side by side: estradiol, explained and priced.
Testosterone itself starts at $28 a month, Hone Health's injections, and that figure is the trap in this question. Hone Health bills $25 a month for membership and a separate biomarker assessment before any testosterone ships. Price the whole program, and treat the vial price as one line inside it.
Program pricing across the men's wing: what TRT costs.
$99 a month all-in at PeterMD and MangoRx, the cheapest complete programs on our 5-platform men's wing, consults included. The $25 you see quoted for Hone Health is a membership rather than a TRT price, with medication billed on top. Read the coverage line before the number, because the two look identical in a table.
Sorted: cheapest online TRT.
The medication usually is. The visit usually is not. 3 of the 13 women's platforms we track bill insurance (Midi Health, Gennev and Elektra Health); the other 10 are cash-pay and never submit a claim. Generic estradiol and micronized progesterone sit on most commercial formularies, which makes the drug the cheap half of this.
Per-provider reality: HRT and insurance.
Two separate claims decide it, one for the clinician visit and one for the pharmacy fill. Only 3 platforms here bill the first, and none of them publishes which carriers it is in-network with, so you cannot confirm the visit is covered before you start intake. The pharmacy claim is the dependable half.
The cash-pay math if the answer comes back no: cost of HRT.
Part D plans typically list generic estradiol and micronized progesterone, so the drug side usually works. The visit side is where it breaks. 10 cash-pay platforms bill no insurer at all, and Midi Health, which does bill commercial insurance, states on its own pricing page that it accepts no Medicare, Medicare Advantage or Medicaid.
Verify current visit rules on Medicare's telehealth page before booking.
Zero of the 5 men's-wing platforms we track bill insurance. Every one is cash-pay, so TRT bought through telehealth is an out-of-pocket cost whatever your plan says. A plan may still cover testosterone prescribed in person for diagnosed hypogonadism, which is a different route at a different price.
The men's rankings and what each one includes: TRT providers scored.
Safe enough that the FDA removed the boxed warning from menopausal hormone therapy, with the labeling changes approved in February 2026. The agency's stated basis was that randomized studies show women who start within 10 years of menopause, generally before age 60, have a reduction in all-cause mortality and fractures. Real risks remain, including endometrial cancer from unopposed estrogen.
The removal, the February 12 2026 approval date and the mortality and fracture finding all come from the FDA announcement of the approved labeling changes. What was removed and what stayed: the black box warning.
Headache leads the estradiol patch label at 14.9% to 50% depending on dose, against 23.6% on placebo. Breast tenderness runs 6.5% to 17%. Weight increase peaks at 8.5% on the 0.025 mg/day arm and shows no dose-response at all. The placebo column is the part almost every side-effect list omits.
All ten reactions across all five doses, with placebo beside each: estradiol patch side effects. Rates transcribed from the Vivelle-Dot (estradiol transdermal system) label on DailyMed.
The 60 in that question is a threshold for starting. Beginning HRT before 60 or within 10 years of your last period keeps the risk-benefit balance favorable; beginning it later shifts cardiovascular and stroke risk upward, so the conversation gets more individual. Continuing therapy you started in your fifties is a separate decision from initiating it at 65.
The age-at-initiation balance is set out in The Menopause Society 2022 position statement. The timing rule in full: is HRT safe in 2026.
No fixed cutoff exists. The age you keep reading, 60, describes when the evidence supports starting, and it comes from the timing rule the FDA cited when it approved the 2026 labeling changes. How long you stay on it is settled with a clinician against your own history and symptoms rather than by a number on a chart.
The Menopause Society 2022 position statement is the consensus most prescribers work from.
HRT replaces the estradiol, and usually the progesterone, that your ovaries stop producing at menopause. Clinicians also call it menopausal hormone therapy. It comes as a pill, patch, gel, spray, cream or vaginal insert, and 11 of the 13 platforms we track dispense a patch. Anyone with a uterus taking estrogen needs progesterone alongside it to protect the endometrium.
The endometrial-protection rule is the approved indication on the Prometrium (progesterone, USP) capsules label, indicated to prevent endometrial hyperplasia in nonhysterectomized postmenopausal women receiving estrogen. The hormone itself, defined and then priced: estradiol.
When symptoms are bothering you, and ideally within 10 years of your last period or before age 60. That window is the timing rule, and the FDA cited it directly when it approved the February 2026 labeling changes. Waiting for periods to stop completely is not a requirement, because perimenopause symptoms are treatable while cycles are still happening.
The FDA states the timing rule and the February 2026 approval date in its announcement of the approved labeling changes. If you are still cycling: HRT in peri.
Two clocks run, and only one of them is ours to verify. Getting the prescription takes a day or two on most platforms here, because intake is asynchronous and no in-person visit is required. Symptom response is the clock nobody should promise you a number on, and dose changes are made at follow-up rather than in week one.
The intake sequence, step by step: how to get HRT online. Ask any prescriber for their review interval before you pay.
An adhesive worn on the skin that releases estradiol into the bloodstream without passing through the liver first, changed weekly or twice weekly by product. 11 of the 13 women's platforms we track dispense one, published from $74.99 a month. The route matters: transdermal estrogen carried lower venous thromboembolism risk than oral in the BMJ 2019 data.
Supply is the other variable right now. The patch tracker carries live per-provider availability against the ASHP shortage listing. The route comparison is Vinogradova et al, HRT and risk of venous thromboembolism, BMJ 2019.
Wisp publishes the cheapest at $20, and 5 of the 13 women's platforms we track dispense a vaginal form. Each bills it on a different unit, so the verbatim strings are below rather than a single invented per-month figure. It is dosed far below systemic therapy and treats local symptoms.
Vaginal estrogen is generally considered separately from systemic HRT in the risk discussion, and ACOG's menopause guidance calls the vaginal ring, tablet and cream "local" estrogen therapy, prescribed for vaginal symptoms. Every estradiol form compared.
Hormone implants placed under the skin, offered by 1 of the 16 platforms on our roster: Defy Medical, which publishes no pellet price at all, only a stated average for the practice as a whole. Once a pellet is in, the dose cannot be adjusted, and stopping means waiting it out. Compounded pellets are not FDA-approved.
What the word bioidentical does and does not mean: bioidentical HRT. FDA on human drug compounding.
This is general information, not medical advice. HRT and TRT are prescription therapies and the right one for you is a decision for you and a licensed clinician. Prices were last verified July 2026 and providers change them without notice; each figure is dated on the relevant provider review. Reviewed by Iacob Pastina.
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