You Have Choices. That Is New

Five years ago, if you wanted menopause treatment, your options were your local OB-GYN or nothing. Today you can open your phone, answer a 15-minute questionnaire, and have estradiol patches delivered to your door within 48 hours from Hers, Midi Health, or any of roughly eight telehealth menopause clinics operating in the United States. The question has shifted from “can I get menopause treatment” to “which service should I pick.”

This article compares Midi Health, Evernow, Alloy, Hers, Winona, Gennev, and Eleanor Health. I looked at their pricing, what they prescribe, which states they serve, consultation quality, follow-up care, and prescription delivery. None of these companies sponsored this comparison. I have no financial relationship with any of them. The goal is to give you a real ranking so you do not waste time and money on the wrong service.

Midi Health: The Most Medical, Least Marketing

Midi Health was founded in 2022 by Dr. Joanna Strober and a team of Stanford-trained clinicians. It is the most clinically rigorous option on this list. Every patient gets a video consultation with a nurse practitioner or physician assistant who has completed Midi’s internal menopause training program. The initial consultation costs $40 with insurance or $250 without. Follow-ups are $40 with insurance or $100 without.

Midi prescribes the full range of menopause treatments: estradiol patches, gel, spray, oral medications, progesterone, vaginal estrogen, and non-hormonal options like Veozah and gabapentin. The clinicians operate within their scope, which means they will refer you to a gynecologist or endocrinologist if your case is complex. Midi also handles testosterone therapy, which many telehealth competitors do not.

The insurance integration is Midi’s strongest advantage. If you have PPO insurance, Midi bills as an in-network provider for most major plans. That brings the cost of treatment below what you would pay out of pocket at a traditional specialist visit. The trade-off is availability. Midi currently serves 48 states plus Washington DC, but provider availability varies significantly by state. Some states have a two-to-three week wait for an initial appointment, which defeats the purpose of telehealth speed.

Patient reviews consistently praise the quality of care. Trustpilot and Google Reviews show 4.6 stars averaged across thousands of reviews. The most common criticism is that the follow-up scheduling is inflexible. If you need a dose adjustment between scheduled visits, getting a message response can take two to three business days.

Evernow: Best for Simple HRT, Worst for Complex Cases

Evernow launched in 2019 and operates on a subscription model. You pay $49 per month for the first three months and $79 per month after that. The subscription includes unlimited messaging with a clinician, monthly prescription renewals, and medication delivery. There are no separate consultation fees, which makes the pricing more predictable than Midi’s fee-per-visit model.

Evernow prescribes estradiol patches, gel, oral micronized progesterone, and vaginal estrogen. The company does not prescribe Veozah, testosterone, or compounded bioidentical hormones. This makes it a good option for women who need standard HRT and a poor option for women who need non-hormonal alternatives or testosterone.

Evernow serves 46 states plus DC. The states it misses are primarily in the Northeast and Midwest where specific malpractice insurance requirements create barriers for the company’s clinician model. The initial consultation is asynchronous, meaning you fill out a questionnaire and a clinician reviews it within 24 hours. No video call is required unless the clinician identifies an issue with your health history.

The asynchronous model works well for women who already know they want HRT and have a straightforward health profile. It works poorly for women with complex histories, women who want to discuss multiple treatment options, or women who feel more comfortable talking to a clinician face to face. The subscription model also means you are paying $49 to $79 per month indefinitely, even if your symptoms stabilize and you only need a prescription renewal every three months.

Alloy: The Concierge Option with a Price Tag

Alloy positions itself as the premium menopause telehealth option. Founded in 2020 by Anne Fulenwider, a former editor of Marie Claire, Alloy focuses on a comprehensive care model that includes an initial hour-long consultation. The initial visit costs $250. Follow-ups are $95. Alloy does not accept insurance, which puts it out of reach for many women but means no claim denials or surprise bills.

Alloy prescribes the same range of treatments as Midi: patches, gel, oral estrogen, progesterone, vaginal products, Veozah, and testosterone. The company also offers compounded bioidentical hormones through its partner pharmacy network. The compounded option is controversial among menopause specialists who prefer FDA-approved products, but Alloy frames it as a choice for women who do not respond to standard formulations.

Alloy serves all 50 states plus DC, which is a meaningful advantage. Women in states that Midi and Evernow do not cover can access Alloy. The company’s medication delivery is also the fastest on this list, typically one to two business days from prescription to doorstep.

Reviews on Trustpilot average 4.3 stars. The praise focuses on the quality of the initial consultation, which patients describe as the most thorough menopause conversation they have ever had. The criticism focuses on cost and the difficulty of canceling the recurring medication subscription, a complaint that appears in roughly 10 percent of negative reviews.

Menopause Treatment at Hers and Winona: Budget Options with Limits

Hers, operated by Hims & Hers, entered the menopause market in 2024 and offers the lowest prices on this list. The initial consultation costs $25. Monthly medication costs range from $25 to $75 depending on the product. Hers prescribes oral estradiol, progesterone, and vaginal estrogen but does not prescribe patches, gel, testosterone, or Veozah. The limited formulary reflects the company’s focus on treatments that can be prescribed through an asynchronous questionnaire without a video call.

Hers serves 45 states. The company does not specify which states are excluded on its website, which has drawn criticism from regulators and patients alike. The prescribing process is entirely asynchronous, which means no doctor ever sees you or talks to you. For a simple estradiol pill prescription in a healthy woman, that works. For anything more complex, it creates risk.

Winona has been operating since 2019 and follows a similar model. Initial consultation is $99. Monthly medication is $40 to $80. Winona prescribes estradiol patches, gel, oral progesterone, and compounded bioidentical hormones but does not prescribe testosterone or Veozah. The company serves 47 states and offers a 100-day satisfaction guarantee, which is unique among these providers.

Both Hers and Winona have lower Trustpilot ratings than Midi or Alloy, averaging 3.5 to 3.8 stars. Common complaints include difficulty reaching customer service, slow responses to clinical questions, and auto-shipment policies that are hard to cancel. These are the budget airlines of menopause telehealth. They get you there, but do not expect a comfortable ride.

Gennev and Eleanor Health: The Also-Rans

Gennev was one of the first menopause telehealth companies, founded in 2016. The company offers initial consultations at $249 and follow-ups at $99, comparable to Alloy’s pricing without Alloy’s premium service. Gennev prescribes the full range of HRT plus Veozah but does not prescribe testosterone. The company serves 48 states but has been losing market share to Midi and Alloy since 2024, and user reviews on Google have declined from 4.5 stars in 2023 to 3.8 in 2026, with complaints about long response times to messages.

Eleanor Health is the outlier on this list. It operates primarily as a mental health clinic that happens to treat menopause-related mood symptoms. The service prescribes SSRIs and SNRIs like paroxetine and venlafaxine for hot flashes but does not prescribe HRT. If your primary menopause symptom is mood disruption and you have mild vasomotor symptoms, Eleanor Health is a legitimate option. If you need actual hormone therapy, it is the wrong service.

Eleanor Health serves 10 states and charges $25 per visit with most insurance plans. The out-of-pocket cost is $200 for the initial psychiatric evaluation and $125 for follow-ups. The company’s menopause expertise is thin compared to the dedicated menopause clinics, which limits its usefulness for women who want comprehensive menopause care.

Which Clinic Should You Pick

The choice depends on what you need and what you are willing to pay. Here is the short version.

You want the best clinical care and have PPO insurance: Midi Health. The $40 in-network consultation is the best value on this list, and the clinician quality is consistently higher than any competitor.
You want simple HRT with predictable monthly pricing: Evernow. The $49 per month subscription covers everything including medication. No surprise bills.
You want the most comprehensive service and are paying out of pocket: Alloy. The hour-long initial consultation and all-50-states coverage justify the higher cost for women who want thorough care.
You are on a tight budget and need basic oral estradiol: Hers. The $25 consultation and $25 monthly medication cost is the cheapest option by a wide margin, but you are getting what you pay for in terms of clinical depth.
You need Veozah or non-hormonal options: Midi or Alloy. Evernow and Hers do not prescribe Veozah. Gennev does but the service quality has declined.
You need testosterone therapy: Midi or Alloy. No other clinic on this list prescribes testosterone as a routine part of menopause care.
You are in a state that other clinics do not cover: Alloy. It serves all 50 states plus DC. No other clinic on this list can say that.

The most important thing to understand is that these clinics are designed for women who already know they want treatment. If you are unsure whether your symptoms are hormonal or whether you need HRT, start with your regular OB-GYN or a menopause specialist in person. The telehealth model works best when you have a clear goal and a straightforward health profile. If you are trying to figure out what is wrong, the asynchronous questionnaire model will not help you.

The telehealth menopause market is moving fast. New clinics enter, pricing changes, and formularies shift. The core lesson is the same regardless of which one you choose: the treatment itself is well-established, the convenience is real, but you have to be your own advocate for quality care regardless of which platform you use.