Medically reviewed by Patricia Shelton, MD
For those experiencing symptoms related to the menopausal transition, hormone replacement therapy (HRT) may be a good option. Although it’s not right for everyone, HRT does relieve symptoms in many people. In fact, HRT is widely considered to be the most effective treatment for the symptoms of menopause, such as hot flashes and vaginal dryness.
HRT is only available by prescription. If you’re considering trying HRT, then you’ll need to talk to a doctor first. You could choose to see your regular primary care provider to talk about your symptoms and discuss the pros and cons of HRT in your particular case, but this option may not work well for everyone. Some people find it difficult to get an appointment with their primary doctor, while others would prefer to talk about HRT with an expert in this particular field. In fact, studies have shown that many primary care doctors don’t have a lot of knowledge about menopause, so talking with an expert makes sense.
One option that you can consider is telehealth. This involves meeting with an HRT expert over video chat, who will have an in-depth conversation with you and can then prescribe you HRT or other medications if you and they decide together that this is a good option for you.
If you’re looking for a telehealth provider for HRT, it can be confusing to know where to start. Here are the top three telehealth providers specializing in treating the symptoms of the menopausal transition.
Midi Health focuses specifically on women in midlife. The providers are all women in this phase of life as well, so they understand and can empathize with what you’re going through. They’re able to prescribe not only HRT, but other medications that might be helpful, such as SSRIs (antidepressants), bisphosphonates (for strengthening bone), or semaglutide (to help with weight and body composition changes).
One advantage of Midi Health is that it accepts insurance for patients from 12 states (Alabama, Arizona, California, the District of Columbia, Maine, Maryland, Massachusetts, Michigan, New York, Texas, Utah, and Virginia). More states are expected to be added to this list soon. This helps to bring the service in reach of more people. However, self-pay is also an option, so if you don’t live in one of these states, it doesn’t mean that you can’t consider Midi Health. You are also allowed to use funds from your flexible spending account (FSA) or health savings account (HSA) to pay for Midi Health treatment.
Evernow also focuses specifically on treating the symptoms of menopause. One big advantage of Evernow is that their model uses a model called “asynchronous telemedicine.” This means that you don’t need a specific appointment date and time. Instead, you communicate with your medical team through messaging. This is far more convenient for many people, and avoids a potentially lengthy wait for finding an appointment time that will work for you.
Evernow providers only offer prescriptions for HRT as well as venlafaxine and paroxetine, which are two SSRIs (antidepressants) that are commonly used for treating menopause symptoms. If you’re mainly interested in considering HRT, then Evernow may be a good option, but if you think that you may need additional prescriptions beyond this, then it may not meet your needs.
Evernow is not considered to be “in network” with any insurance providers, and you generally can’t use insurance to pay for Evernow treatment. However, funds from your FSA or HSA can be used for this.
Like Evernow, Alloy focuses on menopause treatment and works through an asynchronous model. You start with a detailed questionnaire that helps to determine what your best treatment options may be. A menopause-trained doctor will then review your information and will write a prescription for any treatment they believe will be safe and effective for you. This helps to remove the barrier of trying to find a convenient appointment time before you can get started.
Alloy then serves as your pharmacy, delivering your treatments directly to your home. This helps to make the entire process as convenient as possible.
Besides HRT, Alloy offers a few custom products that may help women during and after menopause. These include a custom-formulated probiotic and prebiotic, designed to enhance and feed your gut bacteria in order to help optimize estrogen levels, as well as a prescription vaginal cream designed to enhance sexual arousal and enjoyment and an estrogen face cream to help with skin issues. Women who are interested in trying these products may want to consider Alloy. However, there is still a limited number of prescriptions that you can receive through Alloy.
Like Evernow, Alloy also doesn’t take insurance. However, you may still be able to use your HSA or FSA to pay for your treatments.
Overall, the top three menopause providers are:
- Midi Health: takes insurance, includes a (virtual) visit with a provider, can provide the widest variety of prescription treatments
- Evernow: convenient asynchronous treatment model, offers only HRT and antidepressants
- Alloy: delivers prescriptions directly to your home, convenient asynchronous treatment model, offers only HRT and a small number of additional options