Best Online HRT Clinics 2025

If you’ve been feeling overwhelmed by menopause symptoms or are curious about hormone replacement therapy (HRT) and how it might help, you’re in the right place. 

I’m excited to share everything I’ve learned about HRT—from its benefits for menopause symptoms to a detailed look at some of the best online clinics offering this service.

This guide is designed to feel like a heart-to-heart chat between girlfriends, so grab a cup of tea and settle in!

Reviews of Online Hormone Replacement Clinics for 2025

Fountain HRT

Fountain HRT offers a concierge-style telemedicine platform designed to help women navigate perimenopause and menopause with personalized hormone therapy. The service is led by Dr. Doron Stember, a board-certified urologist with extensive experience in hormonal health.​

The Fountain process begins with a brief online assessment, followed by lab testing and a video consultation with a licensed provider.

Treatments are customized based on your lab results and symptoms, and medications are delivered directly to your door.

Pros & Cons

• Pros:
  
  • All-inclusive pricing covers labs, consultations, medications, and shipping
    
  • 24/7 concierge support via text
    
  • “Hyper-personalized” custom treatment plans with precise dosages
    
  • Quick start—most patients begin treatment within a week
    
  • Includes testosterone therapy options for women
    
• Cons:
  
  • Does not accept insurance; all costs are out-of-pocket
    
  • Availability limited to select states
    
  • Some users report limited communication options, such as text-only responses

Fountain HRT provides a range of hormone therapies tailored to individual needs, including estrogen-only therapy, estrogen and progesterone combination therapy, and testosterone therapy for women.

Who is Fountain HRT Best For?

Fountain HRT is ideal for women seeking a comprehensive, tech-forward approach to managing perimenopause and menopause. It’s particularly suited for those who value personalized care and the convenience of home delivery and virtual consultations.​

Fountain HRT may not be for women who need to rely on insurance to pay for care.

Cost With and Without Insurance

• With Insurance: Fountain HRT does not accept insurance; all services are self-pay.
  
• Without Insurance: The all-inclusive membership is priced at $199 per month, covering medications, consultations, lab work, and shipping
  
• Stage of Menopause: Suitable for perimenopausal and menopausal stages.
  
• Age of Women Treated: Typically women aged 40–60.
  
• Insurance Coverage: Not accepted; however, HSA and FSA cards can be used for payment.

Stella

Stella offers a comprehensive online consultation process where you fill out a detailed health questionnaire and then schedule a video consultation with one of their experienced healthcare providers. 

Their platform is designed to be user-friendly, ensuring you feel comfortable from the moment you log on.

Pros & Cons

• Pros:
  
  • Easy-to-use website and mobile app interface
    
  • Quick turnaround for appointments
    
  • Emphasis on personalized care
    
  • Transparent pricing and detailed cost breakdowns
    
• Cons:
  
  • May not be available in all states
    
  • Insurance coverage can vary depending on your provider

Stella offers tailored HRT plans that include estrogen-only therapy, estrogen and progesterone combination therapy, and bioidentical hormone replacement therapy (BHRT). Their treatment plans are customizable to meet your unique hormonal needs.

Who is Stella Best For?

Stella is ideal for women who are tech-savvy, appreciate a modern approach to healthcare, and want a personalized treatment plan. 

It works well for those in perimenopause and early menopause who are looking for a straightforward, digital-first experience.

Cost With and Without Insurance

• With Insurance: Costs can be significantly reduced if your healthcare plan is accepted. Stella partners with several major providers, so it’s best to check if your insurance is on their list.
  
• Without Insurance: Prices for consultations and HRT prescriptions are competitive, with monthly fees typically ranging from $25 to $35 for the service (excluding prescription costs).
  
• Stage of Menopause: Suitable for perimenopausal and early menopausal stages.
  
• Age of Women Treated: Generally, women aged 40–55 benefit most from their services.
  
• Insurance Coverage: Yes, coverage is available with selected healthcare companies such as Aetna, UnitedHealthcare, and Blue Cross Blue Shield (please verify based on your company and region).

Evernow

Evernow emphasizes a comprehensive wellness approach that goes beyond just prescribing hormones. Their consultations cover lifestyle factors, nutritional advice, and stress management, alongside personalized HRT options. 

Every consultation is conducted by professionals who specialize in women’s health.

Pros & Cons

• Pros:
  
  • Holistic approach to menopause management
    
  • Detailed lifestyle and wellness consultations
    
  • Can choose between pay-per-visit and membership (all-inclusive) plan
    
  • Excellent customer service with follow-up support
    
• Cons:
  
  • Membership plan might feel too detailed for those who prefer a quick consultation
    
  • Some advanced features require additional fees

Evernow provides several HRT options including estrogen therapy, combination therapy, and BHRT. 

Their plans often include additional resources such as online support groups, educational materials, and access to lifestyle coaching, making it a comprehensive care package.

Who is Evernow Best For?

This clinic is a great match for women who prefer a holistic approach and want to integrate lifestyle changes with their HRT regimen. 

If you’re in perimenopause or mid-menopause and are looking for extra support beyond medication, Evernow might be the best fit.

Cost With and Without Insurance

• With Insurance: Evernow works with many major insurance providers. Check if your plan is on their approved list to benefit from reduced costs.
  
• Without Insurance: Monthly fees typically range from $30 to $40, depending on the package selected.
  
• Stage of Menopause: Particularly beneficial for women in perimenopause and mid-menopause stages.
  
• Age of Women Treated: Primarily serves women aged 40–60.
  
• Insurance Coverage: Yes, coverage is available with companies like Cigna, Aetna, and Humana (confirm with your provider for specifics).

PlushCare

PlushCare is one of the more recognized names in online healthcare and has a solid reputation for accessible, high-quality virtual appointments. Here’s a closer look at what they offer.

PlushCare’s process is simple and straightforward. They offer a free 30-day trial membership that allows you to book same-day virtual appointments, message your care team unlimited times, and even include family memberships—all within their user-friendly app. 

After the trial, membership is only $19.99 per month (excluding prescription costs).

Their three-step plan for HRT is as follows:

1. Book a same-day virtual appointment on the PlushCare website.
   
2. Have a detailed conversation with a PlushCare doctor about your menopause symptoms.
   
3. Pick up your prescription from any local pharmacy.

Pros & Cons

• Pros:
  
  • Free 30-day trial period
    
  • Same-day appointments available even on weekends
    
  • Unlimited messaging with your care team
    
  • Prescription discount card available, offering up to 80% savings
    
• Cons:
  
  • Monthly membership fee may be a downside for some
    
  • Prescription costs are not included in the membership fee
    
  • Availability may vary by location

PlushCare provides HRT options that include both estrogen-only and combination therapies. Their platform is particularly strong in providing support for those who value quick access to healthcare providers and flexible scheduling.

Who Is PlushCare Best For?

PlushCare is best for busy women in mid-menopause who need reliable and fast access to healthcare. 

If you’re juggling work, family, and personal care, the ability to get same-day consultations and manage everything via an app makes PlushCare an excellent choice.

Cost With and Without Insurance

• With Insurance: PlushCare accepts several major insurers which can significantly reduce out-of-pocket costs; however, the discount card for prescriptions is a highlight for uninsured or underinsured patients.
  
• Without Insurance: The membership fee is $19.99 per month (after the 30-day trial), with prescription costs being separate.
  
• Stage of Menopause: Best suited for women in mid-menopause, although many perimenopausal women also find the service valuable.
  
• Age of Women Treated: Typically caters to women aged 40–60.
  
• Insurance Coverage: Yes, available through many providers including Aetna, UnitedHealthcare, and Blue Cross Blue Shield, among others.

HRT Clinic Comparison Table

Below is a table that neatly compares key aspects of the three online clinics:

Clinic Name	Price	Prescriptions Available	Insurance Coverage	App Features
Fountain	$199/month (all-inclusive: medications, lab work, consultations, and shipping	Estrogen, Progesterone, Testosterone	Not accepted; HSA/FSA cards accepted	24/7 concierge support via text; face-to-face video visits; personalized treatment plans
Stella	$25–$35/month (excl. prescriptions)	Estrogen-only, Combination HRT, BHRT	Yes (e.g., Aetna, UnitedHealthcare, BCBS)	User-friendly interface, appointment scheduling, personalized treatment plan
Evernow	$30–$40/month (excl. additional wellness services)	Estrogen, Combination, BHRT	Yes (e.g., Cigna, Aetna, Humana)	Holistic health coaching, wellness resources, support groups
PlushCare	$19.99/month after free trial (excl. prescriptions)	Estrogen-only and Combination HRT	Yes (e.g., Aetna, UnitedHealthcare, BCBS)	Free trial, same-day appointments, messaging, prescription discount tools

Why HRT Is Good for Menopause Symptoms

Navigating menopause and its wide range of symptoms can be challenging, but HRT has helped many women find relief. HRT is designed to replace the hormones that your body stops producing naturally during this stage of life, which can lead to a better quality of life.

HRT has been known to:

• Reduce hot flashes and night sweats: Many women report significant decreases in these symptoms.
• Improve sleep quality: By stabilizing hormone levels, HRT can help with better sleep.
  Enhance mood and overall emotional balance: Hormone fluctuations can impact our mood, and HRT can offer much-needed stability.
• Preserve bone density: Lower estrogen levels during menopause can lead to bone loss. HRT helps keep bones strong.

By addressing these issues, HRT can give you back a sense of balance and help you feel more like yourself during and after menopause.

Common Symptoms by Menopause Stage

Understanding the different stages of menopause can help you know what to expect—and what to discuss with your healthcare provider:

• Perimenopause:
  
  • Symptoms: Irregular periods, mood swings, hot flashes, sleep disturbances, and subtle changes in libido.
    
  • What’s happening: Hormone levels begin to fluctuate. You might experience milder forms of the symptoms that come later.
    
• Menopause:
  
  • Symptoms: More pronounced hot flashes, night sweats, vaginal dryness, and mood changes become more common.
    
  • What’s happening: Your body officially transitions into menopause when you’ve gone 12 months without a menstrual period.
    
• Postmenopause:
  
  • Symptoms: Fewer hot flashes over time, but potential long-term effects such as bone density loss and heart health concerns may arise.
    
  • What’s happening: The body has adjusted to the lower levels of estrogen, and some symptoms may recede while others, like joint pain or decreased energy, can persist.

Knowing where you are in your menopause journey is crucial to tailoring the treatment that best suits your needs.

The Science Behind HRT

Hormone Replacement Therapy (HRT) is a treatment that helps replace hormones—like estrogen and progesterone—that your body produces less of during menopause. Here’s a breakdown of how it works, the science behind it, and how it’s administered:

What HRT Is

• Purpose: HRT is used to ease menopausal symptoms by supplementing the hormones that your body isn’t making enough of during menopause.
  
• Why It’s Needed: As women age, especially during the transition into menopause, the ovaries gradually stop producing hormones. This decline can lead to uncomfortable symptoms like hot flashes, mood swings, and changes in sleep patterns.

How HRT Works

• Replacing Hormones: HRT supplies the body with extra estrogen and, if needed, progesterone. These hormones act on many parts of the body and help balance out the drop in natural hormone levels.
  
• Mechanism: When you take HRT, the added hormones travel through your bloodstream and attach to receptors (little “locks” on your cells that hormones “unlock” to make things happen). This helps restore a balance, making your body work more like it did before menopause.
  
• Benefits:
  
  • Reduces Hot Flashes and Night Sweats: By keeping your hormone levels steady, HRT helps calm the overactive systems that cause sudden heat and sweating.
    
  • Improves Mood and Sleep: Stable hormone levels can help keep mood swings in check and lead to better sleep quality.
    
  • Supports Bone Health: Estrogen helps maintain bone density, reducing the risk of osteoporosis (brittle bones).

The Research Behind HRT

Over many years, scientists found that during menopause, when hormone levels drop, women often experience uncomfortable symptoms. Clinical studies and research trials showed that replacing these hormones can relieve symptoms and improve quality of life.

Imagine your body has a thermostat that controls temperature and mood. Before menopause, this thermostat works well because it gets regular hormone “signals.” When these signals drop, your thermostat gets confused, leading to hot flashes or mood changes. HRT is like adding extra batteries to your thermostat so it can keep things steady and comfortable.

Thousands of studies have been conducted to test HRT. These studies have shown that, for many women, HRT significantly reduces symptoms like hot flashes, improves sleep, and helps maintain bone strength. Researchers also keep studying HRT to understand the best ways to use it safely.

How HRT Is Administered

There are several ways to take HRT, and your doctor will help decide which method is best for you:

• Pills: You can take HRT in the form of daily tablets that work just like other medications.
• Patches: These are adhesive patches you stick on your skin. They slowly release hormones over time, keeping your levels steady throughout the day.
• Gels and Creams: You can apply these directly to your skin. They allow hormones to be absorbed into your bloodstream gradually.
• Injections: In some cases, HRT may be given as an injection. This method is usually done by a healthcare provider and is less common.
• Custom-Compounded Medications: Some women choose bioidentical hormone replacement therapy (BHRT), where the hormones are specially prepared to closely match the hormones naturally produced by your body.

Each method has its own benefits, and the best choice depends on your lifestyle, your symptoms, and your overall health.

Why You Should Talk With a Doctor About Whether HRT Is Good for You

Before starting any treatment, it’s crucial to have a conversation with your doctor. HRT isn’t one-size-fits-all. Your doctor will consider:

• Your personal health history
  
• Specific symptoms and how they affect your quality of life
  
• Risk factors such as family history of heart disease or cancer
  
• Your overall lifestyle and wellness goals
  

A personalized consultation ensures that you receive the treatment that best matches your hormonal needs while minimizing potential risks.

What’s the Difference Between HRT and HT?

It’s easy to get confused by the terminology:

• HRT (Hormone Replacement Therapy):
  Focuses on replacing the hormones that your body no longer produces in sufficient quantities after menopause. This typically includes estrogen and sometimes progesterone.
  
• HT (Hormone Therapy):
  Although the terms are sometimes used interchangeably, HT can refer to a broader category of treatments that manipulate hormone levels. This may include treatments for conditions other than menopause (like testosterone therapy for men).

Understanding this distinction is important when discussing treatment options with your healthcare provider.

Who HRT Is Best For

HRT is often best suited for women who:

• Are experiencing significant menopausal symptoms such as severe hot flashes, night sweats, and mood changes
  
• Have a family history of early menopause or related health conditions
  
• Are in the perimenopausal or early menopausal stage and want to manage symptoms effectively
  
• Are looking for ways to maintain bone density and overall health during the transition

It’s important to note that each woman’s experience with menopause is unique, and HRT can be tailored to your specific needs.

Who HRT Is Not For

HRT may not be the best choice for everyone. For instance, it might not be recommended if you:

• Have a history of hormone-sensitive cancers such as certain types of breast cancer
  
• Have unexplained vaginal bleeding or other contraindications
  
• Are at high risk for blood clots or cardiovascular disease
  
• Prefer alternative, non-hormonal treatment methods

Discussing these factors with your doctor can help determine if HRT is safe and beneficial for you.

Types of Hormone Replacement Therapy Available

There are several types of HRT available to meet different needs. Here’s a closer look at each option.

Estrogen Therapy

Estrogen therapy is often recommended for women who have undergone a hysterectomy (removal of the uterus) since there is no need for progesterone. It primarily helps relieve symptoms such as hot flashes, vaginal dryness, and mood swings. Estrogen therapy can be delivered via pills, patches, gels, or creams, making it adaptable to different lifestyles.

Estrogen and Progesterone Therapy

For women who still have a uterus, a combination of estrogen and progesterone is usually prescribed. The addition of progesterone helps prevent the increased risk of endometrial cancer that can occur when estrogen is used alone. This therapy is particularly effective in managing a broader range of menopausal symptoms and is available in various forms including pills, patches, and creams.

Bioidentical Hormone Replacement Therapy (BHRT)

BHRT uses hormones that are chemically identical to those your body naturally produces. Many women are attracted to BHRT because it is often marketed as a “natural” option that can offer more balanced symptom relief with potentially fewer side effects. These hormones can be delivered in various forms including creams, gels, and custom-compounded prescriptions designed to meet your individual hormonal needs.

Off-Label Testosterone Therapy

Though typically associated with men, testosterone also plays an important role in women’s health — especially during and after menopause. In some cases, women experience a significant drop in testosterone levels, leading to symptoms such as low libido, fatigue, decreased muscle mass, and brain fog.

It’s important to note that testosterone therapy for women is considered off-label in the U.S., meaning it’s not officially FDA-approved for this use, though it is still legally prescribed by many hormone specialists.

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How to Take HRT

Taking HRT correctly is key to maximizing its benefits. Here are some general guidelines:

• Consult Your Doctor: Never start HRT without a thorough evaluation from a healthcare provider. They will determine the best type and dosage for you.
• Follow the Prescription: Whether you’re using pills, patches, gels, or creams, follow your prescription instructions carefully.
• Monitor Your Body: Keep track of your symptoms and any side effects. Regular follow-ups with your doctor are essential to ensure the treatment is working as expected.
• Adjustments Over Time: Your hormone needs can change as you move through different stages of menopause. It’s important to revisit your treatment plan periodically.

Cost of Hormone Replacement Therapy

Cost is a major consideration for many women. The overall expense of HRT can vary widely based on several factors:

• Type of HRT: Estrogen-only therapies tend to be less expensive than combination or BHRT options.
• Delivery Method: Pills, patches, gels, and creams can have different costs associated with them.
• Insurance Coverage: Many online clinics offer competitive pricing if you have insurance coverage. Always check with your provider to see which clinics are in-network.
• Out-of-Pocket Costs: For women without insurance, monthly membership fees plus prescription costs should be factored into your budget. As seen in our reviews, clinics like PlushCare offer a free trial period, which might help you evaluate whether the service is worth the expense.

By comparing costs and understanding what’s covered by your insurance, you can make a more informed decision on which clinic fits your budget.

Pros and Cons of Hormone Replacement Therapy

Like any treatment, HRT has its advantages and potential drawbacks. Here’s a quick rundown:

Pros	Cons
Effective symptom reliefImproved quality of lifeBone health benefitsCustomizable options	Potential side effectsNot suitable for everyoneCost considerationsRegular monitoring required

Alternatives to Hormone Replacement Therapy

If HRT doesn’t feel like the right choice for you, there are several alternatives to consider:

• Lifestyle Modifications: Diet, exercise, and stress management can help alleviate menopausal symptoms.
• Non-Hormonal Medications: Certain medications can help manage symptoms like hot flashes and mood swings without hormones.
• Natural Supplements: Some women find relief with herbal supplements (like black cohosh or red clover), though it’s important to consult with a healthcare provider before starting any supplement.
• Mind-Body Therapies: Techniques such as yoga, meditation, and acupuncture have shown promise in managing menopausal symptoms.
• Counseling and Support Groups: Talking with other women going through menopause can provide emotional support and practical tips.

Each alternative comes with its own set of benefits and limitations, so it’s important to discuss these options with your doctor to see what might work best for you.

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FAQs

How Long Do You Have to Do Hormone Replacement Therapy?

The duration of HRT varies from woman to woman. Some may use it for a few years to get past the worst of their symptoms, while others may continue longer based on their health needs and doctor’s advice. Regular check-ins with your healthcare provider can help determine the optimal length of time for your treatment.

Does Hormone Therapy Actually Work?

Yes, many women find that hormone therapy significantly reduces menopausal symptoms and improves overall quality of life. However, the results can vary, and it might take a few weeks to a couple of months to notice the full benefits.

Why Are Some Doctors Against HRT?

Some doctors are cautious about HRT because of potential risks, such as an increased risk of blood clots, stroke, or some types of cancer in some women. However, when used appropriately and under medical supervision, many of these risks can be managed effectively. Your doctor can help weigh the benefits against the risks in your specific case.

Does HRT Cause Weight Gain?

Weight gain can be a concern, but research suggests that HRT may actually help stabilize weight for some women by improving metabolism and energy levels. Since metabolism shifts in your 40s can make weight management harder, it’s important to combine HRT with a healthy lifestyle to manage weight effectively.

What Are Signs of Low Estrogen?

Low estrogen can cause various symptoms, including:

• Hot flashes and night sweats
• Mood swings or depression
• Vaginal dryness and discomfort
• Sleep disturbances
• Reduced bone density

If you notice these symptoms, it might be worth discussing with your healthcare provider.

What Are Signs That HRT Is Not Working?

If you continue to experience severe symptoms despite being on HRT, it may be an indication that your treatment plan needs to be adjusted. Other signs include persistent mood swings, lack of improvement in sleep quality, or new side effects that weren’t present before. Regular monitoring and open communication with your doctor are key.

Does Insurance Cover HRT?

Many insurance plans do cover HRT, especially when provided through reputable online clinics. Coverage details can vary widely by plan and location. Always check with your insurance provider to confirm which services are included.

How Long Does It Take HRT to Start Helping Symptoms?

Most women begin to notice improvements in their symptoms within a few weeks to a couple of months of starting HRT. However, the exact timeline can vary based on individual factors, including the type of therapy and your overall health.

Wrapping It Up

Navigating menopause can feel overwhelming, but knowledge is power. Whether you decide on hormone replacement therapy or explore other alternatives, the most important step is talking with your doctor and finding a solution that fits your lifestyle and health needs.

Online HRT clinics like Stella, Evernow, and PlushCare offer convenient, flexible, and personalized ways to manage your symptoms. By comparing their services, pricing, and insurance coverage, you can choose the option that best aligns with your stage of menopause and personal preferences.

Remember, you’re not alone on this journey. Many women are exploring these options and finding real relief, and I hope this guide has helped illuminate some of the possibilities for you. If you ever feel uncertain, always seek advice from a trusted healthcare provider who understands your unique health story.

Thank you for taking the time to read this comprehensive guide. I truly hope it brings clarity and comfort as you navigate this important stage of life. Here’s to feeling your best, every day!