Menopause hormone therapy: the shortlist

The qualifying hormone picks here list menopause hormone therapy: estradiol, progesterone or both. Some also sell testosterone or other care, but the cards on this page are about HRT.

The forms vary by program. You'll see pills and capsules, skin creams and patches, and a mix of FDA-approved products and pharmacy-compounded ones. Several programs show the HRT price only after you finish the intake.

HRT is prescription estrogen. If you still have a uterus, it's paired with a progestogen, because estrogen alone raises the risk of endometrial cancer. After a hysterectomy, estrogen alone is the usual route.

The labels cover moderate to severe hot flashes and night sweats, and vaginal and vulvar symptoms of menopause. Some products are also approved to help prevent osteoporosis. Vaginal estrogen on its own treats local symptoms like dryness and painful sex.

The updated labels add a line on timing. For moderate to severe hot flashes, starting systemic HRT can be considered in women under 60 or within 10 years of menopause.

On November 10, 2025, FDA asked every maker of menopause hormone therapy to take heart disease, breast cancer and probable dementia out of the boxed warning. The endometrial-cancer warning stays on systemic estrogen-alone products.

The change arrives one product at a time. The first six updated labels were approved on February 12, 2026: Prometrium, Divigel, Cenestin, Enjuvia, Estring and Bijuva. Many other patches, gels, vaginal products and generic tablets may still print the old box.

The risks didn't disappear. Stroke, blood clots and breast cancer stay in the Warnings and Precautions section, even on updated labels. Ask your pharmacist which version your product carries.

FDA-approved estradiol and micronized progesterone are chemically identical to the hormones your body makes. So bioidentical doesn't mean compounded, and an approved patch or capsule already fits that word.

Compounded hormones are mixed by a pharmacy to a prescription, often as a cream. FDA doesn't review them before they're dispensed, and it says it has no evidence they're safer or more effective than approved hormone therapy. A 2020 National Academies report suggested keeping them for people allergic to an ingredient in an approved product, or who need a form no approved product offers.

Estriol is the clearest case: no FDA-approved product contains it. Winona sells its own compounded body creams next to FDA-approved patches, tablets and capsules, so ask which one a plan uses.

Bijuva's label is a fair example of the no-go list. It isn't for women with unexplained genital bleeding, breast cancer now or in the past, a known or suspected estrogen-dependent cancer, a blood clot in a leg or lung now or before, or active arterial disease such as a recent stroke or heart attack.

Prometrium capsules contain peanut oil, so they're out if you're allergic to peanuts. Answer the intake's questions on bleeding, clots and cancer history fully. They decide what's safe for you.

Where a program prints a price, estradiol runs $58.66–$218 a month and progesterone $42.37–$234. That range covers programs that publish a figure. Gala, Strut Health and Prime Doctor RX show theirs only inside the intake.

Billing is the next thing to check. Winona and Goldspan Health bill every four weeks, which is a fixed 28-day charge interval. AgelessRx adds a monthly membership to the medication. KIN Meds advertises age-specific menopause plans; its medication and membership descriptions need to be reconciled in the selected agreement before assuming a complete recurring total.

Insurance may cover FDA-approved generic estradiol at your own pharmacy. Compare the actual copay and any clinical fee with the complete self-pay offer. Some self-pay programs bundle visits and medication; others separate them. Obtain the complete recurring total before comparing.

How you're seen depends on the program. Winona's doctors prescribe by portal message, with no labs needed, for women 35 to 59 in 37 states plus Puerto Rico. KIN Meds describes different assessment routes by age, with eligibility and testing determined during review. Confirm which visits and laboratory charges apply to your plan.

Gala says its clinicians diagnose menopause by symptoms, age and cycle pattern, and order labs when they'd change the plan. WePeptideRx asks for labs before its first order ships. If you'd rather talk it through live, ask for a video visit before you pay.

Is it FDA-approved or compounded? If it's compounded, ask why an approved version won't work for you.

I have a uterus. What protects it? The plan should name the progestogen.

Which label does my product carry? The updated one, or the older boxed warning.

What will month two cost? Include any membership, visit fee and shipping. For the full picture on estrogen and progesterone, read menopause HRT explained, or go back to the full hormones list.