Best Online Hormone Replacement Therapy for Women in Perimenopause and Menopause

The best online hormone replacement therapy provider for you depends on a few practical questions, not on a ranking. If you want a live video visit, the same clinicians every time, and follow-ups included in one published price, that is what Golden Leaf Health is built for.

Book your $99 visitWhy Golden LeafCompare side by side

Medically reviewed by Dr. Ashley Alexis, ND,
Updated

Start with what matters to you.

A quick fit check

Video visit, follow-ups included: Golden Leaf Health ($99 first visit, $49 a month with 2–3 doctor follow-ups and messaging, 33 states), or Evernow's membership with messaging.

Hormones and weight care together: Golden Leaf Health, with GLP-1 care through GLPlus Care from the same care team.

Insurance pays: Midi (in-network with most major insurers, all 50 states), or Evernow for video visits with several listed insurers.

No video, fast prescription: Alloy (plan in as little as 12 hours, 24/7 messaging) or Winona (portal messaging, no phone or video visits at all).

We're Golden Leaf Health, and this is our comparison of the five providers women ask us about most, including us. Every fact about another company was read on that company's own website on October 12, 2026, and where a company doesn't say, the table says so.

Why women choose Golden Leaf Health.

Every visit is a live video visit

You talk with a clinician from the first visit, not a questionnaire.

Follow-ups are included

Two to three visits with a doctor, plus messaging with the care team, are part of the $49 a month.

Both prices are published

$99 for the first visit, then $49 a month. Prescriptions and labs are priced separately, and you see the price before anything is ordered.

Weight care from the same team

Perimenopause and menopause are what we treat. If you want help with weight, the same care team offers GLP-1 care through GLPlus Care.

Your first three months

$197

First visit
$99
Month two
$49
Month three
$49

Includes the follow-up visits and messaging. Prescriptions and labs are separate.

Book your $99 visit

Online HRT options, side by side

Compare with
Online hormone replacement therapy provider comparison
 Golden Leaf HealthMidi HealthAlloyEvernowWinona
Live video visitsYes, every visitYesNot stated; messaging-basedYesNo phone or video; portal messaging, 24–48 hour replies
Follow-ups in the priceYes: 2–3 doctor visits plus text check-ins, included in $49/monthFollow-up visits, billed to insurance or self-pay24/7 messaging with your doctorSecure messaging; optional visitsPhysician check-in at 10 weeks; refills automatic
Prices publishedYes: $99 first visit; $49/month; prescriptions and labs separateNot published; depends on planNot published on the pages we readMembership from $35/monthNot published; medication billed every 28 days
Who you seeThe same small care team: Dr. Ashley Alexis, ND; Dr. Steve Groke, MD; Mai Tran, PharmDPhysicians and nurse practitioners trained in women's healthBoard-certified menopause-specialized physiciansA multidisciplinary clinician team30+ board-certified physicians; matched to one licensed in your state
Also sellsGLP-1 weight care through GLPlus Care, our division; optional supplements at member pricingGLP-1s, supplements, skincare, labsSkincare, GLP-1 weight care, hair, gut productsNot statedNot stated
First contactLive video visit, $99Live virtual visitOnline intake, plan in as little as 12 hoursVideo visit (pay-per-visit) or membershipOnline intake through the patient portal
InsuranceNo. FSA/HSA acceptedIn-network with most major insurers; self-pay availableNo. FSA/HSA acceptedYes for video visits (BCBS, Anthem, UnitedHealthcare, Aetna listed); membership self-payNo. FSA/HSA accepted
States33All 50Not statedNot stated37 plus Puerto Rico

Golden Leaf Health

Live video visits
Yes, every visit
Follow-ups in the price
Yes: 2–3 doctor visits plus text check-ins, included in $49/month
Prices published
Yes: $99 first visit; $49/month; prescriptions and labs separate
Who you see
The same small care team: Dr. Ashley Alexis, ND; Dr. Steve Groke, MD; Mai Tran, PharmD
Also sells
GLP-1 weight care through GLPlus Care, our division; optional supplements at member pricing
First contact
Live video visit, $99
Insurance
No. FSA/HSA accepted
States
33
Choose a provider to see its column on a phone.

Checked October 12, 2026 on each company's public site. Companies change their offers often; if something here is out of date, email [email protected] and we'll correct it.

What matters more than the brand

  1. 1

    Insurance or cash

    If you have a plan Midi is in-network with, a visit may cost you a copay, and that is hard to beat on price. The trade is that insurance-billed care tends to run on the insurer's visit structure. Cash-pay practices are more predictable and usually simpler, and FSA and HSA cards work with all of them.

  2. 2

    Video visit or questionnaire

    Questionnaire-based services are fast and work well for refills and straightforward cases. For a first prescription in perimenopause, where symptoms overlap with thyroid, sleep, mood and many other things, a live conversation with a clinician may identify issues a form misses. If you've never been on hormone therapy, we'd choose a video visit, with us or anyone else.

  3. 3

    What happens after the prescription

    Hormone therapy often needs adjustment. Most women change dose or form at least once in the first months, and the difference between a good result and giving up is whether a prescriber is reachable when that happens. Ask every provider how many follow-ups are included, who provides them and what a dose change costs. Our answer is two to three visits with a doctor and messaging with the care team, inside the $49 a month.

  4. 4

    What else they're selling

    The large menopause brands have expanded into GLP-1 weight medications, skincare and supplement lines. Golden Leaf Health offers GLP-1 care too, through GLPlus Care, our weight-care program, and optional supplements at member pricing. Whoever you choose, ask why a product is being recommended for you.

Where Golden Leaf Health fits

You see the same three clinicians, by video, every time. Your first visit is $99, usually within days, and ongoing care is $49 a month, including the follow-ups most services charge for. We prescribe FDA-approved bioidentical products and, where there's a reason, compounded prescriptions, and we tell you which and why. You pay one published price directly, and FSA and HSA cards work. If you want a named clinician who knows your history rather than a platform, that is what we offer.

First visit

$99

Video visit with a clinician.

Ongoing care

$49 a month

Follow-ups and messaging. Prescriptions and labs are separate.

When another provider is the better fit

We would rather tell you now than after your first visit.

You want insurance to pay

Midi is in-network with most major insurers, and Evernow takes several insurers for video visits.

You want a prescription without a visit

Alloy and Winona work from an online intake and messaging.

You live outside the states we serve

We see patients in 33 states. Check your state.

Questions, answered plainly.

What is the best online hormone replacement therapy provider?

It depends on whether you want insurance billing (Midi, and Evernow for video visits), a live video visit or a questionnaire and messaging (Alloy and Winona are messaging-based), and how much follow-up is included. Golden Leaf Health is a small practice built around video visits with the same care team and follow-ups included in a $49 monthly membership, for women who want a clinician who knows them rather than a platform.

Which online HRT providers take insurance?

As of October 2026, Midi Health is in-network with most major insurers, and Evernow accepts several insurers for video visits. Alloy, Winona and Golden Leaf Health are cash-pay; all three accept FSA and HSA cards.

What are the best online providers for HRT dose adjustments?

Look for providers that include follow-up visits with a prescriber rather than charging per visit or relying on a questionnaire. Golden Leaf Health includes two to three follow-up visits with a doctor plus messaging in membership; Evernow and Alloy adjust through messaging; Winona reviews at ten weeks through its portal; Midi books follow-up visits, billed to insurance or self-pay.

Is online HRT safe?

Yes, when a licensed clinician takes a proper history, chooses the form and dose for you and follows up. Hormone therapy is prescribed on symptoms and history, which video visits handle well. What to avoid is any service that prescribes from a questionnaire alone with no way to reach a prescriber when something changes.

How much does online HRT cost?

At Golden Leaf Health, $99 for the first visit and $49 a month for ongoing care, with prescriptions and labs priced separately. The large brands range from insurance copays to monthly memberships and per-medication pricing; most don't publish a full price list, so check the current figures on each site before you decide.

Company facts from joinmidi.com, myalloy.com, evernow.com and bywinona.com, read October 12, 2026.

Sources: The Menopause Society; FDA, 2026 label changes for menopausal hormone therapy.

This is general information, not medical advice. Talk with your provider about your health and treatment options.