Menopause & Perimenopause
Hot flashes, poor sleep, mood swings? Menopause hormone therapy, prescribed online.
VevaMD offers menopause and perimenopause hormone therapy online in all 50 states, for women 35 to 80. A board-certified, US-licensed physician reviews your private intake and decides whether estradiol (a patch, pill or cream), progesterone, vaginal estrogen or a non-hormonal option is right for you. If prescribed, it ships from a licensed US pharmacy. Hormone therapy is as low as $40/mo, billed $119 every 3 months, one price whatever form your physician chooses. Full refund if not prescribed.
As low as $40/mo, billed $119 every 3 months
Most women (with progesterone): about $67/mo, billed $199 every 3 months
One price. No add-ons. Full refund if not prescribed.
Most women 40 and over need no labs to start. Under 40, or adding testosterone cream: a quick lab test or an upload of your own recent labs, included in your price.
- Price
- As low as $40/mo, billed $119 every 3 months. Most women (with progesterone): about $67/mo, billed $199 every 3 months.
- What's included
- Physician review, medication and any labs you need. No membership fee.
- Visit
- An online intake reviewed by a physician. Live video only for testosterone cream.
- Labs
- Most women 40 and over need no labs to start. Under 40, or adding testosterone cream: a quick lab test or an upload of your own recent labs, included in your price.
- States
- All 50 states. Testosterone cream: 30 states plus DC.
- Prescriber
- Board-certified, US-licensed physicians. VevaMD does not prescribe.
- Pharmacy
- A licensed US pharmacy, if a physician prescribes.
- Shipping
- Ships discreetly to your door if prescribed.
What menopause care costs at VevaMD
If you have a uterus, estrogen is paired with progesterone to protect its lining. That is the most common plan. Your physician decides. You do not pick a product. You answer the questions; your physician chooses the form and the dose. Your price is set by what you need, estrogen alone or with progesterone, and does not change with the form.
| Plan | Who it is for | Price |
|---|---|---|
| Estrogen + progesterone, every 3 months | Most women: you have a uterus | $67/mo, billed $199 every 3 months |
| Estrogen + progesterone, monthly | Most women: you have a uterus | $139/mo |
| Estrogen only, every 3 months | No uterus (after a hysterectomy) | $40/mo, billed $119 every 3 months |
| Estrogen only, monthly | No uterus (after a hysterectomy) | $99/mo |
| Testosterone cream for women (add-on) | Low sexual desire; added to your estrogen plan | Adds from $60/mo, or save with 3-month billing. |
| Escitalopram (non-hormonal) | If you cannot or do not want to take hormones | As low as $79/mo |
No membership fee. No contract; cancel anytime on My VevaMD. Full refund if not prescribed. HSA & FSA eligible. Labs, when you need them, are included in your price.
Most women 40 and over need no labs to start. Under 40, or adding testosterone cream: a quick lab test or an upload of your own recent labs, included in your price.
Want testosterone too? You can choose it in your intake.
For low sexual desire after menopause, testosterone cream can be added to your estrogen plan. Your physician decides.
- Added to your hormone plan, not instead of it. Billed monthly (plus a one-time $99 setup for your first lab and video visit), or every 3 months with no setup fee.
- Your first visit is a live video visit with your physician.
- One lab test before you start (total testosterone), then every 3 months, included in your price. At-home kit, or upload your own recent labs (New York: upload only).
- Available in 30 states plus DC.
An international consensus statement supports a trial of testosterone for postmenopausal women whose low sexual desire bothers them (hypoactive sexual desire disorder), and says the evidence does not support it for other reasons. There is no FDA-approved testosterone product for women in the US. VevaMD's cream is compounded and not FDA-approved, and the same statement prefers approved products over compounded ones, so your physician will talk through the options with you.
Global Consensus Position Statement on the Use of Testosterone Therapy for Women, J Clin Endocrinol Metab 2019Looking for testosterone for men? See TRT →
Testosterone cream for women
Adds from $60/mo, or save with 3-month billing.
A live video visit and labs are required, both included. Available in 30 states plus DC.
Choose it in your intake when you answer the question about sexual desire.
Still having periods? Perimenopause counts.
Perimenopause often starts in your 40s, sometimes earlier, while your periods are still coming, often less predictably. Hot flashes, poor sleep, mood changes and heavier or skipped periods are common.
You do not have to wait until your periods stop to ask a physician about treatment. If you are under 40, the intake includes a quick lab test or an upload of your own labs, included in your price.
Start my private intake →What your physician may prescribe
You do not pick a product. You answer the questions; your physician chooses the form and the dose. Your price is set by what you need, estrogen alone or with progesterone, and does not change with the form.
- Prescription
Estradiol pill
Estradiol, the main estrogen your ovaries made before menopause, as one small pill a day.
- Prescription
Estradiol patch
Estradiol through the skin from a patch you change on a schedule.
- Prescription
Estradiol cream
Estradiol in a cream you rub on the skin once a day.
- Prescription
Progesterone
Paired with estrogen if you have a uterus, to protect its lining.
- Prescription
Vaginal estradiol cream
A low-dose vaginal cream, if you have vaginal dryness, pain with sex or urinary symptoms.
- Compounded, not FDA-approved
Testosterone cream
For low sexual desire after menopause, added to your estrogen plan.
- Prescription, off-label for hot flashes
Escitalopram (non-hormonal)
A daily pill for hot flashes if you cannot or do not want to take hormones. It is FDA-approved for depression and anxiety; using it for hot flashes is off-label.
Status shows "Prescription" because the pharmacy that fills these medications also compounds; your physician chooses the product, and you can ask whether yours is an FDA-approved product or compounded.
Is hormone therapy safe? What the FDA changed.
November 10, 2025: the FDA moved to remove most of the boxed warning. The FDA began removing boxed-warning references to heart disease, breast cancer and probable dementia from menopausal hormone therapy labels, and asked labels to drop "use the lowest dose for the shortest time."
FDA: HHS removes misleading warnings on hormone replacement therapy (Nov 10, 2025)February 12, 2026: the first six labels changed. Six products were relabeled first. Many labels, including most estradiol patches, still carry the older wording while their makers finish updates, so you may still see the old warning on your box.
FDA: Menopausal hormone therapies, updated prescribing informationWhat did not change. Estrogen taken alone still carries a boxed warning about endometrial cancer for women with a uterus. That is why estrogen is paired with progesterone if you have one.
FDA: Labeling changes to clarify benefit-risk considerationsWhat the Menopause Society says. For women under 60, or within 10 years of menopause, with no reason to avoid it, the benefits of hormone therapy generally outweigh the risks. It does not need to stop routinely at 60 or 65.
The Menopause Society, 2022 hormone therapy position statementThe full dated tracker: what changed, what stays, which labels →
Estradiol patches have been in short supply in 2026. If your patch is short at the pharmacy, your physician can move you to a pill or cream. FDA: Estradiol transdermal patch availability (Sep 3, 2026)
Bioidentical, compounded, FDA-approved: what the words mean
- HRT and MHT
- The same thing: estrogen, often with progesterone, for menopause symptoms. MHT is the term the FDA and medical societies use now.
- Bioidentical
- A hormone with the same structure as the one your body makes. Estradiol and micronized progesterone are bioidentical, and FDA-approved versions of both exist.
- Compounded
- Made by a pharmacy for one patient's prescription. Compounded hormones, including "BHRT" creams and blends such as Bi-Est, are not FDA-approved.
- FDA-approved
- Reviewed by the FDA for safety, effectiveness and quality before sale. The FDA says it has no evidence that compounded "bioidentical" hormones are safer or more effective than approved ones.
VevaMD vs other online menopause care
| Feature | VevaMD | Midi | Alloy | Evernow | Winona | Elektra |
|---|---|---|---|---|---|---|
| Starting cost | Hormone therapy from $40/mo (billed $119 every 3 months), physician review and any labs included | $250 first visit, then medication billed separately | $49 one-time fee, then estradiol pill from $39.99 | Membership from $35/mo, then medication | Free visit; estrogen tablets $54/mo | $249 first visit, then medication |
| Visit or membership fee on top | No | Yes, per visit | One-time $49 | Yes, monthly | No | Yes, per visit |
| Who prescribes | Board-certified, US-licensed physicians | NPs, nurse midwives, MDs and NDs, overseen by physicians | Board-certified physicians | Not stated on their page | Board-certified physicians | MDs, NPs and midwives |
| Refund if not prescribed | Full refund | Not stated on their page | Not stated on their page | Not stated on their page | Only within 24 hours of ordering | Not stated on their page |
| Testosterone for women | Yes, 30 states + DC | Listed as a treatment | Not stated on their page | Not stated on their page | No | New York only |
| Ages | 35 to 80 | Not stated on their page | Not stated on their page | Not stated on their page | 35 to 59 | Not stated on their page |
| States | All 50 | All 50 | All 50 + DC | All 50 + DC | 37 + Puerto Rico | 16 |
Why VevaMD: one price covers the physician review and the medication, every intake is reviewed by a board-certified physician, there is no membership or visit fee on top, women 35 to 80 are eligible, and you get a full refund if you are not prescribed.
Competitor details are from each company's own public pages, checked October 19, 2026. Sources: Midi [1][2][3][4]; Alloy [1][2][3][4]; Evernow [1][2]; Winona [1][2]; Elektra [1][2].
How it works
- 1
Online intake
Answer private questions about your symptoms, your cycle, your health history and current medications.
- 2
Physician review
A board-certified, US-licensed physician reviews your intake. They may message you with follow-up questions.
- 3
Labs or video if needed
Labs are needed if you are under 40 or for testosterone cream; otherwise only if your physician asks. When labs are needed, the at-home kit is the usual path, or you can upload your own recent panel. Testosterone cream includes a live video visit.
- 4
Pharmacy ships
If your physician decides treatment is right for you, it ships from a licensed US pharmacy to your door.
Your care team
Who treats you
Every intake is reviewed by a board-certified, US-licensed physician licensed in your state. They make every prescribing decision. VevaMD never does. Care is provided by Beluga Health, P.A., a physician group licensed in all 50 states and DC.
Board-Certified Physicians
A board-certified physician reviews your intake and decides whether any prescription is appropriate. VevaMD is a technology company, not a medical provider.
Licensed in Your State
The physician who reviews your intake is licensed to practice in the state where you live.
Women 35 to 80
Perimenopause, menopause, or years after it. Your physician looks at your age, your history and how long it has been since your last period.
VevaMD is a wellness technology platform. All medical services are delivered by independent board-certified physicians in our provider network.
Who it may be for
- Women 35 to 80 with perimenopause or menopause symptoms: hot flashes, night sweats, poor sleep, mood changes or vaginal dryness.
- Women in any of the 50 states. Testosterone cream is available in 30 states plus DC.
- Women who would rather handle this privately online than in an office.
Who it is not for
- Anyone with unexplained vaginal bleeding.
- Anyone with breast cancer or a history of it, or another estrogen-dependent cancer.
- Anyone with a current or past blood clot, stroke or heart attack.
- Anyone with liver disease or a known clotting disorder.
- Anyone looking for a guaranteed result. Results vary, and a prescription is never guaranteed.
What the research shows
A Cochrane review found oral estrogen reduced weekly hot-flush frequency by about 75% compared with placebo.
MacLennan et al., Cochrane Database of Systematic Reviews 2004.The Menopause Society’s 2022 hormone therapy position statement describes hormone therapy as the most effective treatment for hot flashes, for the right person.
The Menopause Society, 2022 hormone therapy position statement. Menopause 2022.In November 2025, FDA started removing boxed-warning language on cardiovascular disease, breast cancer, and probable dementia from menopausal hormone therapy labels. On February 12, 2026, it approved the first six revised labels. Systemic estrogen-alone products keep a boxed warning about endometrial cancer.
FDA announcements, November 10, 2025 and February 12, 2026.
The hot-flush finding is about oral estrogen in that review, not a compounded product and not a promise for you. Compounded hormones such as Bi-Est are not FDA-approved. Prescriptions are only issued if a licensed physician determines treatment is appropriate.
Safety and side effects
- Common side effects include breast tenderness, bloating, headache and spotting, most often in the first months.
- Serious risks include blood clots, stroke and gallbladder disease. Estrogen taken alone raises the risk of endometrial cancer in women with a uterus, which is why progesterone is paired.
- Tell your physician about any unexpected bleeding.
- Testosterone cream can cause acne or unwanted hair growth; your physician checks your levels.
Report a side effect to FDA MedWatch. For a medical emergency, call 911.
Available in all 50 states
One price wherever you live. Testosterone cream is available in 30 states plus DC. States we serve.
Menopause care by city
Common questions
What is the difference between HRT, MHT and bioidentical hormones?
HRT (hormone replacement therapy) and MHT (menopausal hormone therapy) mean the same thing: estrogen, often with progesterone, for menopause symptoms. Bioidentical means the hormone has the same structure as the one your body makes. Estradiol and micronized progesterone are bioidentical, and FDA-approved versions of both exist. Compounded "BHRT" creams and blends such as Bi-Est are not FDA-approved, and the FDA says it has no evidence they are safer or more effective than approved hormones.
Is menopause hormone therapy safe? What did the FDA change?
In November 2025 the FDA began removing boxed-warning language on heart disease, breast cancer and probable dementia from menopausal hormone therapy labels, and the first six revised labels came on February 12, 2026. Many labels, including most patches, still show the older wording while makers update them. Estrogen taken alone still carries a boxed warning about endometrial cancer for women with a uterus. The Menopause Society says that for women under 60, or within 10 years of menopause, with no reason to avoid it, the benefits generally outweigh the risks. Your physician weighs your own history.
How much does menopause HRT cost?
Hormone therapy is as low as $40/mo, billed $119 every 3 months. Most women (with progesterone): about $67/mo, billed $199 every 3 months. The price is set by what you need (estrogen alone, or with progesterone), not by the form your physician chooses. Non-hormonal escitalopram is as low as $79/mo. There is no minimum term and no surprise charges.
Can I start hormone therapy in perimenopause?
Yes. You can start the intake while your periods are still coming but changing, or after they have stopped. The program is for women 35 to 80. If you are under 40, the intake includes a quick lab test or an upload of your own labs, included in your price. Your physician decides whether hormone therapy, a non-hormonal option, or nothing is right for you.
Patch, pill or cream: what is the difference?
All three deliver estradiol. The pill is swallowed; the patch and cream go through the skin. The Menopause Society notes limited observational data suggesting a lower clot risk through the skin than by mouth. Your physician chooses the form based on your history and preference, and your price is the same whichever form you get.
Do I need a video visit or labs?
Estrogen and progesterone start with an online intake, usually with no video visit. Most women 40 and over need no labs to start. Under 40, or adding testosterone cream: a quick lab test or an upload of your own recent labs, included in your price. Testosterone cream includes a live video visit and is available in 30 states plus DC.
Can women take testosterone?
An international consensus statement supports a trial of testosterone for postmenopausal women whose low sexual desire bothers them, and not for other reasons. There is no FDA-approved testosterone product for women in the US; VevaMD's testosterone cream is compounded and not FDA-approved. You can add it to your estrogen plan in your intake. It requires a lab test and a live video visit, both included in your price, and is available in 30 states plus DC.
Are there non-hormonal options for hot flashes?
Yes. A physician may prescribe escitalopram, a daily pill that is FDA-approved for depression and anxiety and used off-label for hot flashes, if you cannot or do not want to take hormones.
Why would I need progesterone?
If you have a uterus, estrogen taken alone can thicken its lining and raise the risk of endometrial cancer. Progesterone protects the lining, so it is paired with estrogen. If you have had a hysterectomy, you usually do not need it. Your physician decides.
What can menopause hormone therapy (HRT) include?
Depending on your history, a physician may prescribe estradiol (as a pill, patch, cream or vaginal form), Bi-Est, progesterone, or testosterone cream. Your physician decides what, if anything, is appropriate.
Who reviews my intake?
VevaMD is a technology company, not a medical provider. Board-certified, US-licensed physicians review every intake and decide whether a prescription is right for you.
Are Bi-Est and testosterone cream FDA-approved?
No. Bi-Est and testosterone cream are compounded, not FDA-approved. Some estradiol and progesterone products are FDA-approved and others are compounded. Your physician chooses, and you can ask which one you are prescribed.
What if the physician says no?
If a physician decides treatment is not right for you and nothing is prescribed, your first payment is refunded in full.
Will I be charged today?
Not for starting. The intake is free to start. You see your plan and exact price before you pay, and if a physician decides not to prescribe, your first payment is refunded in full.
Can I use my HSA or FSA?
In most cases, yes. VevaMD provides itemized receipts you can submit to your plan. VevaMD does not bill insurance.
Sources
- FDA: HHS removes misleading warnings on hormone replacement therapy (Nov 10, 2025)
- FDA: Menopausal hormone therapies, updated prescribing information
- FDA: Labeling changes to clarify benefit-risk considerations
- The Menopause Society, 2022 hormone therapy position statement
- FDA: Estradiol transdermal patch availability (Sep 3, 2026)
- Global Consensus Position Statement on the Use of Testosterone Therapy for Women, J Clin Endocrinol Metab 2019
- FDA: Menopause (women's health topics)
- ACOG Clinical Consensus: Compounded bioidentical menopausal hormone therapy
- Cochrane review of oral estrogen, MacLennan et al. 2004. Accessed 2026-10-05.
- The Menopause Society, 2022 hormone therapy position statement. Accessed 2026-10-05.
- FDA labeling changes for menopausal hormone therapy, February 12, 2026. Accessed 2026-10-05.
Ready to see if you qualify?
See If I QualifyA licensed physician reviews your intake and decides whether treatment is right for you. You'll see your price before you pay.
Last updated 2026-10-23. Content standards
Clinical care is provided by board-certified, US-licensed physicians. VevaMD Inc is a technology and marketing storefront only — not a medical provider or a pharmacy. Medications are dispensed by licensed U.S. partner pharmacies after a valid prescription. Compounded medications are prepared by state-licensed pharmacies for individual patients. They are not FDA-approved and have not been reviewed by FDA for safety, effectiveness or quality. Prescriptions are only issued if a licensed physician determines treatment is appropriate. Individual results vary.