Coastal HRT Reviews for Women: Pellets, Prices & Fit

By The HRT Index Editorial Team · Editorial research, not medically reviewed · Last updated: October 24, 2026 · Last verified: October 2026

Coastal HRT reviews for women praise a kind, patient team at this Murrells Inlet, South Carolina clinic, so it can suit local women who want in-person, cash-pay care — if you first confirm the exact medicine and full cost. None of the reviews we could read describe a woman's menopause treatment, and its Biote pellets are compounded.

The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.

This review covers Coastal HRT, LLC at coastalhrt.com. Looking for a different "Coastal" clinic? See the list.

Coastal HRT at a glance (checked October 24, 2026)

• Where: 4447 US 17 Business, Suite 105, Murrells Inlet, SC 29576 · (843) 357-1995.
• Hours: Monday to Thursday, 9 a.m. to 5 p.m., per its website. One directory lists different hours, so call to confirm or ask about other appointment times.
• Who treats you: three nurse practitioners (APRNs).
• How care works: an in-office first visit with an exam. Cash-pay. No insurance billing for visits. An itemized receipt is available on request.
• Women's prices:
• $415 first evaluation with labs ($125 for the evaluation when using private insurance for labs, plus your lab bill)
• $399 per Biote pellet insertion
• $99 pre-pellet labs for established patients
• $85 non-pellet follow-up
• Forms listed across its hormone services: injections, topicals, oral medicines and pellets, plus thyroid care. Exact women's products aren't named.
• Ratings we saw: 5.0 from 19 Google reviews (shown on Wanderlog); 4.7 from 14 (Birdeye); BBB A+, not accredited.

Coastal HRT may fit you if you:

• Live near Murrells Inlet, Myrtle Beach or the Grand Strand and want a face-to-face visit and exam
• Are fine paying cash for visits
• Want to talk through pellet and non-pellet options with a clinician
• Will ask for product names and a written quote before you pay

Start somewhere else if you:

• Need the provider to bill insurance for your visits
• Need a specific FDA-approved medicine and can't get confirmation that Coastal prescribes it
• Can't get to Murrells Inlet
• Have unexplained vaginal bleeding, or a history of blood clots, stroke, heart attack, liver disease, or breast or uterine cancer. Start with your own doctor.

One thing to know up front. The public reviews tell you about the office. They don't tell you which hormone you'd get or what a year of care would cost. If you're considering pellets, the form matters. Biote, the pellet company, calls them "custom-compounded," and once a pellet is in, the dose can't easily be changed. That doesn't make Coastal a bad choice. It means pellets deserve their own conversation, and we give you the questions below. Prefer a pill or patch? Jump to the alternatives.

Many women weigh a local clinic against online care, so we hold Coastal to the same standard we use for online services.

Coastal HRT is not a partner, and we earn nothing if you book there. Midi links on this page are also plain links. We may earn a commission if you start care with Gala through a labeled link. How we make money.

What we actually verified · Last verified October 2026

We read (October 24, 2026): - Coastal HRT's homepage, Hormone Optimization page (women's prices and FAQ), team page, policies and weight-loss page - Its Better Business Bureau profile - Google-sourced reviews shown on Wanderlog, and its Birdeye profile - Biote's pellet therapy page - Gala's hormone-health page and $69 HRT page - Midi's pricing page - Sources from the FDA, the Federal Register, ACOG, The Menopause Society and the Office on Women's Health

We confirmed: - The address and listed hours - Three named nurse practitioners - The women's fee list - No insurance billing for visits - A one-hour in-office first consult with an exam - Biote's own description of its pellets as custom-compounded - A BBB A+ rating (not accredited); BBB lists incorporation on July 25, 2022

We did not: call, book, pay, visit, talk with a Coastal clinician, or independently verify current licenses. This is a documentation review, not a patient test.

We could not confirm: - Which exact products women are prescribed - What the $399 pellet fee includes - How often women get new pellets - What progesterone costs - Which physician is named in the practice agreement - Whether hormone visits can be done by video

On this page: Reviews · Who runs it · Cost · Medicines · Pellets · Testosterone · First visit · Questions · Leaving · Alternatives · Verdict · FAQ

Coastal HRT reviews for women: what do patients actually say?

Coastal HRT's public reviews are warm about the staff. Google reviews shown on Wanderlog display 5.0 stars from 19 reviews, and Birdeye showed 4.7 from 14 when we checked on October 24, 2026. But none of the reviews we could read describes a woman's menopause hormone care. They tell you about the people, not the treatment.

First, make sure this is the Coastal you mean

Several unrelated clinics use "Coastal" in their names. This page covers Coastal HRT, LLC at 4447 US 17 Business, Suite 105, in Murrells Inlet, South Carolina. Its website is coastalhrt.com.

If you found another "Coastal" in search, it's a different business with different staff, prices and rules. Coastal Healthcare (Sanibel Island, Florida), Coastal Telehealth (Florida) and Coastal Women's Medical (Little Silver, New Jersey) are examples. Our list is near the end.

What the review numbers actually count

Each site shows a different snapshot. Don't average them. Don't pick the highest one as the "real" score, either.

Where you see it	What we saw (Oct 24, 2026)	What it counts	Useful for	Not useful for
Google reviews, shown on Wanderlog	5.0 from 19 reviews	Clinic-level rating; no service-by-service breakdown	How the team treats people	Judging menopause care
Birdeye	4.7 from 14 (13 from Google, 1 from Birdeye)	A directory's own snapshot	A second dated look	A women's-HRT-only score
Yelp	Page inaccessible during this check; no rating verified	Not established	—	Drawing a conclusion about review count or care
Better Business Bureau	A+ rating; not accredited	Business conduct and complaints	Spotting billing trouble	Care quality. An A+ is not a medical license.
Gold Best Weight Loss Center, 2024 & 2025	Confirmed in the official Best of the Beach directory	A local award for weight-loss services	Local recognition	Menopause-treatment quality or medical credentials

Different numbers can reflect different dates and sources. We have no evidence of anything worse. We couldn't verify the original current Google review feed, so these remain dated snapshots from the named sites.

What the reviews praise, and what they leave out

The readable reviews praise three things: listening, patience and knowledge. For example:

"They take the time to listen to you and your goals." — Jocelyn W., Google review shown on Wanderlog, November 21, 2024. She doesn't say which service she used.

Another reviewer said of nurse practitioner Kerri Jo, "She is so knowledgeable, professional and kind." That was Sarah, in a June 21, 2023 review attributed to Google and reproduced by Wanderlog. Her review describes losing weight with peptides, without identifying a menopause treatment or the exact medicine. The one review Birdeye shows in full is also about weight. Christopher M.'s review praised prices as close to online clinics.

Here's what we did not find in any readable review:

• A woman describing hot flashes, sleep or mood on hormone treatment at Coastal
• Mention of estrogen, progesterone or menopause pellets
• Anything about follow-up, refills or billing for hormone care

A little history adds context. A Coastal post on Nextdoor dated October 18, 2022 focused on male testosterone replacement. Today's website publishes a separate women's price list and a women's symptom list. Women's care is clearly offered now, but those sources don't establish when it began. The accessible review excerpts still don't describe menopause care.

Read Coastal's reviews yourself in two minutes

A review helps you most when it matches your situation. Here's a quick way to find those.

1. Open Google Maps, search "Coastal HRT Murrells Inlet," and tap Reviews.
2. Sort by "Lowest" first, then "Newest." Complaints about billing or follow-up tend to show up there.
3. Look for your service. Search the reviews for words like "estrogen," "hot flashes," "pellet" or "menopause."
4. Notice time in care. "Great first visit" is different from "a year in and they still answer my messages."

A lack of visible complaints doesn't prove there are none. And a glowing weight-loss story can't tell you how menopause care feels there. Reviews describe the service. They can't tell you what's safe or helpful for your body.

Kind reviews also can't tell you whether a local pellet clinic or an online pill-and-patch service fits you better. The right online menopause care isn't the same for every woman — it depends on your symptoms, what you've already tried, your age, your state and your health history. Some situations belong with an in-person clinician first. Use The HRT Index's Find My HRT Path tool to explore a featured care option for your situation — and to flag when online care isn't the right starting point — before your first consult.

Free · About 60 seconds · No email required. It features online services, so it won't book Coastal HRT for you. It's care navigation, not a diagnosis or a decision about whether you should take hormones. How it works.

Who runs Coastal HRT, and is it legit?

Coastal HRT, LLC has a physical clinic in Murrells Inlet with three named nurse practitioners. BBB lists its incorporation date as July 25, 2022 and rates it A+ (not accredited), and Biote lists it as a provider. We haven't independently verified the clinicians' current licenses. Its site doesn't name the physician on its practice agreement, so it's fair to ask; that omission alone doesn't show a rule has been broken.

The clinicians

Coastal's team page lists three nurse practitioners. An APRN (advanced practice registered nurse) is a nurse with graduate training who can diagnose and prescribe. FNP-BC and NP-C are national nurse practitioner board certifications.

Clinician (as listed by Coastal)	Credentials shown	Background Coastal publishes
Beverly Trotter	APRN, FNP-BC	Nursing degrees from the Medical University of South Carolina and the University of South Carolina; 35+ years as a nurse and NP combined
Kerri Jo McCoy	APRN, NP-C	Nursing degree from Marshall University; master's from MUSC (2007)
Lauren Kuperus	APRN, NP-C	Bachelor's (and 2015 master's) in nursing from Francis Marion University

These are the clinic's own statements. We did not check them against licensing records.

What "Biote Certified Provider" means

Coastal appears in Biote's provider directory as certified to offer the Biote method. That is a company-program credential, not independent proof of every clinician's current credentials. It isn't a medical board certification, and it isn't Menopause Society certification.

We found no mention of Menopause Society certification (called MSCP) on Coastal's site. That doesn't mean the clinicians aren't skilled. You can search The Menopause Society's practitioner directory yourself.

South Carolina's physician rule

South Carolina law requires nurse practitioners performing medical acts under a practice agreement to have a physician readily available for consultation (South Carolina Code §40-33-34(C)–(D)). That doesn't mean the physician must be in the room or that the clinic must publish the name on its website. It's still reasonable to ask who that physician is and how they're involved.

Check a license in one minute

The South Carolina Board of Nursing lets you verify a nurse practitioner's license. Coastal's policies page points complaints to the same state agency. A license check can show whether a license is active. It can't tell you how good the care is.

The weight-loss side of the business

Coastal also runs a compounded weight-loss program, with GLP-1 shots starting at $250 for the first six weeks. It offers that program by video visit in South Carolina, Florida and Arizona (weight-loss page). We don't review it here. Some readable reviews concern weight loss without naming the exact treatment, so they don't establish menopause-care results. If weight is your main concern, see our weight care guide.

What does Coastal HRT cost for women?

Coastal HRT publishes its women's prices. The first evaluation with labs costs $415, or the evaluation costs $125 when you use private insurance for labs at Quest, plus your lab bill. A Biote pellet insertion costs $399, pre-pellet labs for established patients cost $99, and non-pellet follow-ups cost $85. Non-pellet medication costs aren't on the list, and Coastal doesn't bill insurance for visits.

The published women's fee list

Charge	Price	What it is, per Coastal	What to ask
Initial evaluation and bloodwork	$415	First assessment, lab work included	"Which tests are included?"
Initial evaluation, using private insurance for labs	$125	First assessment; labs drawn at Quest and billed to your plan	"Is it the same test list as the $415 option?"
Biote pellet insertion	$399	Per insertion, "any dose"	"Does that include the pellet? Estradiol, testosterone or both?"
Biote pre-pellet bloodwork	$99	For established patients	"Is this needed before every new pellet?"
Hormone follow-up visit (non-pellet patients)	$85	Per visit	"How many follow-ups in the first year?"

Source: Coastal HRT, Hormone Optimization, checked October 24, 2026. The $225-a-month testosterone subscription on the same page is for men only.

BHRT, which you'll see on Coastal's site, stands for bioidentical hormone replacement therapy. We explain what "bioidentical" does and doesn't mean below.

What isn't on the price list

These are the gaps a written quote should fill:

• Medication for non-pellet care (pills, creams, gels, shots) and where it's filled
• A progestogen (a medicine such as progesterone that protects the uterine lining), if you still have a uterus and use systemic estrogen — estrogen that acts throughout the body
• Whether pellet patients pay for follow-up visits
• What's inside the $399: the pellet itself, the hormone or hormones, and the insertion
• Your lab bill, if you use insurance for the labs
• How often women typically get a new pellet
• Deposits, no-show fees and what's due the day you book

The women's fee menu doesn't label these prices as introductory offers or promotions.

Does Coastal HRT take insurance?

Not for visits. Coastal says it "does not bill insurance for office visits or services." It also says some FDA-approved prescriptions may be covered at your pharmacy, while compounded medicines and pellets "are generally not covered." If you ask, it will give you an itemized receipt (a superbill) to send your insurer for possible out-of-network repayment (Coastal's FAQ). A superbill doesn't guarantee your insurer will pay anything.

One local example shows why pellets are usually out of pocket. BlueCross BlueShield of South Carolina's medical policy treats hormone pellet implants for menopause as investigational, noting they aren't FDA-approved (BlueCross SC policy). That's one insurer's policy. Check your own.

Coastal's site doesn't mention HSA or FSA cards. Ask before you plan to use one.

The $290 question: should you use insurance for the labs?

Coastal's two starting options differ by exactly $290 ($415 − $125). That number is your break-even.

If both options cover the same tests and collection services, with no extra charge on the cash side, compare your full out-of-pocket lab bill with $290:

Your expected lab bill through insurance	Which first visit costs less
Less than $290	The $125 visit plus insurance labs
Exactly $290	Both come to $415
More than $290	The $415 cash bundle
Unknown, or the tests or collection services differ	No fair comparison yet

This is our arithmetic from Coastal's published prices, not a savings figure from Coastal.

Two examples:

• You've met your deductible. Your plan says your share of the lab panel is $40. The insurance route costs $125 + $40 = $165, or $250 less than the cash bundle.
• You have a high deductible you haven't met. Your plan says you'd owe $360 for the same panel. The insurance route costs $125 + $360 = $485, or $70 more than the cash bundle.

Both lab bills are examples to show the math, not real insurer quotes. You can get your real number by calling your plan with the test list.

Copy this question for the clinic:

"Before I choose, can you send me the test list for each option and any collection fees so I can compare the same services?"

Your first bill: three examples

These add up Coastal's listed charges for three possible starts. They are subtotals, not quotes, and they assume the charges are separate. Coastal hasn't confirmed what is due when you book or when each charge falls.

Example	Math	Known subtotal	Still unknown
Cash labs, then a first pellet	$415 + $399	$814	What's in the $399; progesterone; later visits and labs
Insurance labs, then a first pellet	$125 + $399	$524, plus your lab bill	Your lab bill; the same items as above
Cash labs, then pills or cream with one follow-up	$415 + $85	$500	Medication cost; how many follow-ups

Two cautions:

• Don't automatically add the $99 pre-pellet labs to your first visit. Coastal lists that charge for established patients, and initial labs are included in the $415 option or billed separately through insurance. Ask whether any additional tests are required.
• Don't split a pellet fee into a "monthly price." Coastal hasn't published a women's repeat-insertion schedule.

Your first year with pellets: if the clinic quotes 2, 3 or 4 insertions

How often you'd need a new pellet is the biggest unknown in the yearly cost. Biote says patients may need "as few as two" insertions a year (Biote). Your clinic will set your own schedule.

So here's the math for 2, 3 or 4 insertions in year one. These are hypotheticals. Use the number your clinic actually quotes. We assume the $99 labs come before each repeat insertion; ask whether that's true.

Insertions quoted for year one	Cash labs ($415 start)	Insurance labs ($125 start)
2	$415 + (2 × $399) + (1 × $99) = $1,312	$125 + (2 × $399) + (1 × $99) = $1,022 + lab bill
3	$415 + (3 × $399) + (2 × $99) = $1,810	$125 + (3 × $399) + (2 × $99) = $1,520 + lab bill
4	$415 + (4 × $399) + (3 × $99) = $2,308	$125 + (4 × $399) + (3 × $99) = $2,018 + lab bill

Every subtotal above is incomplete. Each still leaves out a progestogen such as progesterone if you have a uterus and are prescribed systemic estrogen, any follow-up fees for pellet patients, and anything else your quote adds. Unknown is never $0. These examples also assume each $399 insertion charge is separate from the evaluation; the clinic must confirm what that fee includes.

Time counts too. In the three-insertion example, suppose the initial lab draw, consult and first insertion each require a separate trip. Two repeat insertions with labs would bring that to five trips if each repeat lab draw and insertion can share a visit, or seven if they can't. The clinic would need to confirm that scheduling is possible. At 25 minutes each way, that's about 4.2 to 5.8 hours of driving (trips × 2 × 25 minutes ÷ 60). Your distance and schedule will differ.

How the cost compares with online or insurance routes

These options buy different things, so don't rank them from cheapest to most expensive. Use the table to see which kind of bill each one sends.

Route	Published starting charge; amount due at booking unconfirmed	First 90 days: conditional arithmetic	Year one: conditional arithmetic	Not included or unknown
Coastal HRT, pellets, cash labs	$415 evaluation with initial labs	$814 if the evaluation and a separate $399 insertion are both charged in the window	$1,312 / $1,810 / $2,308 for the 2 / 3 / 4-insertion examples above	Contents of the $399; progestogen if needed with systemic estrogen; pellet follow-ups; actual dates
Coastal HRT, non-pellet, cash labs	$415 evaluation with initial labs	$415 for the evaluation alone; $500 if one $85 follow-up is also charged in the window	$585 if the evaluation and two $85 follow-ups are charged in the year	Medication; required follow-up count; actual dates
Gala, online plan	$69/month advertised; confirm the first charge and its timing	$207 if three $69 charges fall in the window; the number of charges is unconfirmed	$828 if twelve $69 charges fall in the year; the billing interval is unconfirmed	Labs if ordered; whether every prescribed medicine is included; exact billing dates and terms
Midi, self-pay video visits	$250 initial visit	$400 if the initial visit and one $150 follow-up are charged in the window	Depends on visits	Medication and labs are separate; insured patients instead need their plan's cost share
Your own doctor	Your plan's cost share, or a self-pay fee	Depends on your plan and care	Depends on your plan and care	Visit, medication and lab costs; ask the office and insurer

Coastal, Gala and Midi prices were checked October 24, 2026 (Coastal, Gala HRT offer, Midi). These are worked examples, not complete cost quotes or verified payment schedules. A $69 "month" does not establish calendar-month or 28-day billing; confirm the dates before counting charges.

Your 90-day quote worksheet

Ask Coastal (or any clinic) to fill in a written quote, then copy it here. It works for any provider.

What to record	Your entry
Date of the quote, and the 90 days it covers	___ to ___
First-visit option (cash $415 / insurance $125 / other)	______
Exact tests included	______
Your out-of-pocket lab bill, including collection fees, if using insurance	$______ or unknown
Exact medicine(s): name, form, pharmacy, how long a supply lasts	______
Pellet insertions or medicine charges inside the 90 days	$______ or unknown
Required follow-ups (number × price)	___ × $___
Repeat labs, shipping or other required fees	$______ or unknown
Amount due today	$______ or unconfirmed
Next charge date and what it's for	______
Ongoing price and how often	$___ every ___
Cancellation, refund and refill rules (in writing?)	______

How to add it up:

1. Add every confirmed charge once.
2. If anything required says unknown, write "Known subtotal — full cost incomplete" and list what's missing.
3. A blank is never $0.

This sheet is for your budget only. It doesn't ask about symptoms or health history. Medicine names can still reveal private health information, so keep the completed sheet private.

Before you book, one medicine check. If you'd only take an FDA-approved product, ask Coastal to name one before you commit. Biote describes its pellets as custom-compounded, and compounded medicines are not FDA-approved. More on that below.

If you live nearby, like the idea of face-to-face care, and are fine paying cash, keep this worksheet open while you look at Coastal's women's options.

Regular link. We earn nothing if you book with Coastal HRT. Looking at the page doesn't commit you to anything.

Which hormones and medicines does Coastal HRT offer women?

Coastal HRT lists injections, topicals, oral medicines and Biote pellets across its hormone program, plus thyroid care. Its women's price list confirms pellet care and non-pellet follow-ups, but it doesn't name the exact women's products. Its own FAQ mentions both FDA-approved prescriptions and compounded medicines, so ask which one you'd get before you pay.

What's confirmed, and what still needs a product name

Question	What Coastal's pages show	Question that settles it
Does Coastal offer Biote pellets?	Yes. The women's price list names them.	"Which hormones are in my pellet, and which pharmacy makes it?"
Is every treatment a pellet?	No. Coastal lists women's non-pellet follow-ups; its general hormone program also lists injections, topicals and oral medicines.	"Which exact non-pellet medicines do you prescribe for women?"
Can I get a specific FDA-approved patch, gel or pill?	Not stated	"Can you prescribe this exact product, and where is it filled?"
Do you offer vaginal estrogen for dryness?	Coastal lists vaginal dryness as a symptom. It doesn't list a treatment.	"Do you prescribe low-dose vaginal estrogen?"
Do you offer non-hormonal options for hot flashes?	Not stated	"If I can't take hormones, what would you suggest?"

Source: Coastal HRT homepage and Hormone Optimization page, checked October 24, 2026.

Does "bioidentical" mean FDA-approved?

No. Bioidentical describes the molecule: the hormone has the same structure as the one your body makes. It says nothing about whether the finished medicine was tested and approved.

The Menopause Society explains that "bioidentical" began as a marketing term for custom-mixed hormones. It also notes that many well-tested, FDA-approved bioidentical estradiol and progesterone products are sold in regular pharmacies (The Menopause Society).

So the useful question is never "Is it bioidentical?" It's: "Is this exact product FDA-approved, or compounded?" For the full explanation, see compounded vs FDA-approved HRT.

Different medicines do different jobs

Here's what each type is generally for. This doesn't mean Coastal offers each one.

Type	What it's generally for	Worth asking
Systemic estrogen (pill, patch, gel or pellet). "Systemic" means it goes through your whole body.	Hot flashes, night sweats, and some sleep and mood symptoms	"Which form fits my history, and can I adjust or stop it?"
Progestogen (such as micronized progesterone) with systemic estrogen	Protecting the lining of the uterus when you still have one	"How will you protect my uterus?"
Low-dose vaginal estrogen	Vaginal dryness, pain with sex, some urinary symptoms. It doesn't treat hot flashes.	"Would local treatment handle my main problem?"
Testosterone	No FDA-approved use for menopausal women. The best evidence is for low desire that causes distress after menopause.	"What exactly are we treating, and how will we check side effects?"
Non-hormonal prescriptions (such as fezolinetant)	Hot flashes without estrogen	"What monitoring does it need, and who pays for it?"

Source: The Menopause Society; Federal Register, August 18, 2026. Testosterone gets its own section.

For more on local treatment, see our vaginal estrogen guide. For options without hormones, see non-hormonal options.

Are Biote pellets safe for women? What to weigh before you say yes

Biote pellets are custom-compounded hormone implants, and no hormone pellet is FDA-approved to treat menopause symptoms. ACOG says compounded menopause hormones shouldn't be prescribed routinely when FDA-approved options exist, and notes that pellets are made to dissolve rather than be removed. Some women like the convenience. The tradeoff is less control over your dose.

What a pellet is

A hormone pellet is a tiny cylinder of hormone placed under the skin, usually near the hip, through a small cut in a short office visit. It slowly releases hormone over months. Biote says some patients need as few as two insertions a year (Biote). That's Biote's own statement, not a confirmed schedule for a woman at Coastal.

What the sources say

• Biote itself calls its pellets "custom-compounded" and says its trained providers get them from outsourcing facilities. Its site carries a note that its statements "have not been evaluated by the Food and Drug Administration" (Biote).
• The FDA says compounded drugs are not FDA-approved. The agency does not check their safety, effectiveness or quality before they're sold (FDA).
• ACOG, the American College of Obstetricians and Gynecologists, says compounded bioidentical menopause hormones "should not be prescribed routinely when FDA-approved formulations exist." It notes a pellet "is not designed to be removed, but instead to dissolve over time." Because of limited safety data and that removal problem, it recommends forms other than pellets for testosterone (ACOG Clinical Consensus No. 6, 2023; PubMed summary).
• The Menopause Society says custom-compounded hormones "are not safer or more effective" than approved bioidentical ones. It warns they may not contain the amount prescribed. Too little progesterone can leave the uterus unprotected; too much estrogen can overstimulate it (The Menopause Society).
• BlueCross BlueShield of South Carolina calls pellet implants for menopause investigational, notes there are no FDA-approved pellets for menopause symptoms, and lists problems with removal (BlueCross SC policy).

What pellets do well, to be fair

Pellets mean fewer doses to remember. Biote reports about six million insertions over its history. Convenience is a real reason women consider pellets, but a procedure count doesn't prove that pellets are safer or work better than an FDA-approved patch, gel or pill.

The control problem, in plain words

A clinician can adjust or stop a pill or patch more readily. A pellet keeps releasing hormone as it dissolves and isn't designed for routine removal. If a side effect shows up, contact the treating clinician; don't assume you must simply wait it out. That's the part to understand before choosing a pellet: its dose isn't readily changed after insertion.

ACOG notes that clinicians may test for too-high testosterone in women using pellets, and that one pellet study reported abnormal uterine bleeding (ACOG). This doesn't mean every woman will have a problem. It means you should hear the plan for a problem before the pellet goes in.

If you still have a uterus

Systemic estrogen on its own can thicken the lining of the uterus (the endometrium), which raises the risk of uterine cancer. That's why women who still have a uterus and use systemic estrogen generally need a progestogen too (The Menopause Society). Coastal's price list doesn't mention progesterone, so ask how your uterus would be protected and what it costs. Report any unexpected bleeding to your clinician.

Ask these before any pellet

Question	Why it matters
"Is this pellet estradiol, testosterone or both? What dose?"	The price list only says "any dose."
"Why a pellet instead of an FDA-approved patch, gel or pill for me?"	ACOG prefers approved products when they exist.
"What happens if my dose turns out too high? Can the pellet be removed?"	Pellets are made to dissolve, not come out.
"How will you check my levels and side effects, and how often?"	Shows the follow-up plan.
"If I have a uterus, how will you protect it?"	Estrogen alone can thicken the lining.
"Can I try a non-pellet option first?"	A pill or patch can be adjusted or stopped more readily with your clinician.

For more context, see is compounded HRT safe? and our review of another clinic that discusses pellets, HerKare.

If you'd rather start with something your clinician can adjust more readily, an online plan with an estradiol pill or patch may suit you better. Gala lists estradiol pills or patches, micronized progesterone to protect the uterus when needed with systemic estrogen, vaginal estradiol and non-hormonal options. It advertises $69 a month for the online visit, prescription and shipping; it doesn't list pellets. Any required lab draw or exam may still mean a local trip. Before paying, confirm the exact medicine, whether every prescribed medicine is included, any lab charges and the billing dates.

Gala may pay us if you enroll. A licensed clinician decides whether to prescribe. Cash-pay; availability depends on your state.

Does Coastal HRT prescribe testosterone for women?

Coastal HRT advertises hormone optimization for women and lists Biote pellets at "any dose," but its site doesn't say whether women's pellets contain testosterone. In the U.S., no testosterone product has an FDA-approved use for menopausal women. Testosterone is also a prescription Schedule III controlled substance. Ask exactly what's in your pellet, and why.

Where the FDA stands. In August 2026, the FDA said that "there are no FDA approved indications for testosterone therapy for menopausal women." It noted that off-label use has grown and that long-term safety data beyond 24 months are limited. The agency announced a public workshop for September 17, 2026 to look at the evidence. A workshop is not an approval (Federal Register).

What the evidence supports. An international consensus statement found the clearest evidence for one use: hypoactive sexual desire disorder (HSDD) in postmenopausal women. HSDD means low sexual desire that causes distress. The International Society for the Study of Women's Sexual Health (ISSWSH) clinical guideline reviews that consensus and also advises against compounded testosterone because safety and effectiveness evidence is lacking (full guideline). Testosterone isn't a proven fix for general tiredness, brain fog or aging.

Off-label isn't the same as compounded. "Off-label" means an FDA-approved medicine prescribed for a use outside its approved label. A compounded testosterone pellet is different again: the product itself isn't FDA-approved.

If testosterone comes up, ask:

• What symptom is it meant to treat?
• Is it in my pellet, and at what dose?
• How will you check for side effects such as acne, unwanted hair growth, hair thinning or voice changes?
• What happens if I want to stop?

For a fuller look, see our guide to libido and menopause.

What happens at your first Coastal HRT visit?

Coastal HRT starts with online forms, then a lab order, then a one-hour in-office consultation with a physical exam once your results are back. If treatment fits, prescriptions may be written that day. A pellet insertion is booked as a separate visit. The clinic's published hormone care starts in person in Murrells Inlet.

The steps, as Coastal describes them

1. Fill out forms through Coastal's patient portal: intake, consents and a health questionnaire.
2. Get a lab order. If you pay cash, blood can be drawn in the office. If you use insurance, you go to a Quest Diagnostics location.
3. Have a one-hour consultation in the office after your results arrive. It covers your history, medicines, symptoms and lab results, plus a physical exam.
4. Get a plan. Prescriptions may be ordered that day if treatment is appropriate.
5. Book a pellet visit if a pellet is chosen.

Source: Coastal HRT FAQ.

Can you do it by video?

We couldn't confirm that. Coastal's weight-loss page offers video visits in South Carolina, Florida and Arizona, and its policies page mentions telehealth in general. But the hormone visit it describes is in person, with an exam (policies). If driving is hard for you, ask which follow-ups can be done remotely.

Hours: Coastal's website lists Monday through Thursday, 9 a.m. to 5 p.m. Birdeye lists different hours, so call before you go or ask about other appointment times.

What the lab tests can and can't tell you

Coastal says it uses LC-MS/MS, a method that separates and measures compounds in blood, and that it looks past "normal" lab ranges toward "optimal" levels.

An accurate test is a good thing. But there are limits to what blood hormone levels can tell you:

• For perimenopause: your health care provider can usually tell from your age and symptoms. Blood hormone tests are usually not needed to diagnose it (Office on Women's Health).
• For dosing compounded hormones: ACOG says hormone tests are not recommended for prescribing and dosing, because there's too little data to read them that way (ACOG).

None of this means labs are useless. Thyroid tests or a check for another cause of your symptoms can matter. Testing can also help monitor treatment safety, including checking for excessive testosterone in a woman already using pellets. It means a bigger panel isn't automatically better care. A helpful question:

"Which result would change your recommendation, and which tests will need repeating?"

What to bring

• A short timeline of your symptoms and when they started
• Every medicine and supplement you take
• Past hormone or thyroid treatments and how they went
• Recent mammogram or Pap results if you have them (ask what the clinic needs)
• Your top three questions, from the list below

Keep these notes for your clinician. The HRT Index doesn't collect them.

What should you ask Coastal HRT before you book?

Ask for names, numbers and a plan, in writing. You want the exact products, what the $399 pellet fee includes, how often pellets are repeated, how your uterus is protected, what happens if a dose is too high, and who your clinician and the physician on the practice agreement are. Good answers name a product, a price and a person.

The 10 questions

#	Copy this question	Why it matters
1	"Which hormone products would you prescribe for a woman like me, by name? Is each one FDA-approved or compounded?"	"Bioidentical" doesn't tell you.
2	"Does the $399 pellet fee include the pellet itself? Is it estradiol, testosterone or both?"	The list only says "any dose."
3	"How often do your female patients get a new pellet, and is the $99 bloodwork needed each time?"	This sets your yearly cost.
4	"If I still have a uterus, how will you protect it? Is progesterone included, and what does it cost?"	Estrogen alone can thicken the lining.
5	"What happens if my dose is too high after a pellet? Can it be removed?"	Pellets are made to dissolve, not come out.
6	"Can I start with a pill, patch, gel or cream instead?"	These can be adjusted or stopped more readily with your clinician.
7	"Who will be my clinician, and which physician is named in your practice agreement?"	The state requires a physician to be available for consultation under the agreement.
8	"Which visits must be in person, and which can be done by video?"	Video is listed only for weight loss.
9	"If I use insurance for labs, can you send me the test list so I can compare it with the $415 bundle?"	This lets you use the $290 rule.
10	"If I cancel, stop or move my care, what do I owe, and how do I get my records?"	Refunds are "case-by-case."

Copy-ready version

MY COASTAL HRT QUESTIONS (keep private)

1. Products, by name — FDA-approved or compounded? ______________________
2. What the $399 includes (pellet? estradiol / testosterone / both?) ____
3. How often a new pellet? $99 labs each time? _________________________
4. How my uterus is protected; progesterone cost: _______________________
5. Plan if my dose is too high; can it be removed? ______________________
6. Non-pellet option I could start with: ________________________________
7. My clinician: __________  Physician on practice agreement: _____________________
8. In person vs video: _________________________________________________
9. Test list for $415 vs $125 + insurance labs: _________________________
10. Cancel / stop / records — what I owe: ______________________________

The one thing still open for me (circle):  medicine · price · insurance · location · support

You can ask all of these before agreeing to any treatment. Booking a consultation doesn't mean you have to choose a pellet, or any treatment at all.

Circle the one thing still open for you. If it's price, the worksheet above shows which numbers still need a written quote. If it's medicine, ask question 1 first. If it's insurance or location, the alternatives below may fit better. If it's support, read the next section.

If you live nearby and want in-person care, call with these questions open. You don't have to decide on pellets at your first visit.

Regular link. We earn nothing if you book with Coastal HRT.

What should you know about cancellation, support and refills?

Coastal HRT asks for at least 24 hours' notice to cancel or reschedule. It says refunds for services or medicines are handled case by case. Its public policies don't spell out deposits, no-show fees, how refills work, or what happens to your prescription if you leave.

Before you pay for a visit

Get these in writing:

• What's due when you book, and what's due at the visit
• The fee for a late cancellation or missed visit, if any
• When refunds apply, especially after labs are drawn, medicine is ordered, or a pellet is placed

"Case by case" is not a money-back promise. If a fee isn't published, treat it as unknown until you've asked (Coastal's policies).

Before you commit to ongoing care

Ask:

• How do I request a refill, and how much notice do you need?
• Which visits or labs are required before a refill?
• Who answers if I have a side effect, including on a Friday or a weekend?
• Will I usually see the same clinician?
• If I move my care, how do I get my records and medication list?

A new clinician may want their own assessment before continuing a prescription. Plan the move with both offices. Don't stop, stretch or switch a medicine on your own.

Coastal HRT vs Gala, Midi or your own doctor: which fits you?

Coastal HRT fits local women who want in-person, cash-pay care and are weighing pellet or non-pellet options. Gala may fit women who want a clinician to consider an estradiol pill or patch from home, with progesterone if needed, once the full prescription price is confirmed. Midi may fit women whose insurance plan covers its video visits, and your own OB-GYN fits women who need an exam or have a complicated history. These routes buy different kinds of care, so compare the care first and the price second.

Side by side

	Coastal HRT	Gala Health HRT	Midi Health	Your OB-GYN or a menopause specialist
Best for	Local, in-person care; confirm the exact pellet or non-pellet product	Online pill-or-patch care when cash pay and the confirmed prescription price fit	Video visits covered by your exact plan	Exams, complicated history
How care works	One-hour in-office first visit with exam; pellets placed in office	5-minute online assessment; clinician review "usually within 1 day"; short video visit in some states	Scheduled video visits	Office visits
Where	Murrells Inlet, SC	"Most US states" (no published list; SC not confirmed)	Check your state and plan	Local
Medicines listed	General program lists injections, topicals, oral medicines, Biote pellets and thyroid care; exact women's products unconfirmed	Estradiol pill or patch; micronized progesterone; vaginal estradiol cream or tablets; non-hormonal options including fezolinetant	Ask for the exact product	Ask whether the clinician prescribes the product you need
FDA-approved or compounded	Products not named; pellets are compounded	Says it prescribes "FDA-approved bioidentical forms"; another Gala page carries a compounding notice, so confirm your product	Confirm your product	Depends on the product
Testosterone	Not stated for women; ask	Not listed	Separate program; confirm	Depends on the clinician
Published price	$415 first visit with labs ($125 with insurance labs); $399 per pellet; $85 follow-up	$69/month advertised: visit, prescription and shipping	$250 first visit, $150 follow-up (self-pay); medication and labs extra	Your plan's cost
Insurance	Doesn't bill for visits; superbill on request	Cash-pay; says FSA/HSA accepted	Says it is in-network with most PPO plans; confirm your exact plan and state. Medicare patients self-pay only; no Medicaid	Confirm the clinician is in your network
Our link	Plain link	Affiliate	Plain link	Directory link

Checked October 24, 2026: Coastal; Gala hormone health, current HRT offer and other HRT landing page with a compounding notice; Midi pricing and appointment-cost help. This table doesn't mean any option is clinically better.

A 20-second self-check

Pick the line that matters most to you:

• "I want face-to-face care near Murrells Inlet." → Coastal HRT, with the 10 questions.
• "I want a pill or patch from home and can pay cash." → Gala (below), after confirming the complete price.
• "Insurance has to pay for my visits." → Midi, or your own in-network doctor.
• "I have unexplained bleeding, or a history of clots, stroke, heart attack or a hormone-sensitive cancer." → An in-person clinician first (next section).
• "I honestly don't know." → Find My HRT Path (below).

When Gala is the stronger fit

Gala is worth a close look if you prefer online care, have decided against pellets, or want to compare its advertised $69 monthly plan with Coastal's $415 evaluation-and-lab bundle. Coastal also lists non-pellet care, so a preference against pellets alone doesn't rule it out. Here's what Gala's current HRT pages offer (Gala's HRT program only; not its weight-loss program).

Four kinds of treatment, chosen by a clinician:

What Gala lists	What it's generally for	Keep in mind
Estradiol pills or patches	Hot flashes, night sweats and other menopause symptoms	Ask for the exact product and strength.
Micronized progesterone	Protecting the uterine lining during systemic estrogen treatment; Gala says it may also help sleep, and a randomized trial reported better perceived sleep quality	If you have a uterus and use systemic estrogen, ask which progestogen will protect the lining and whether it's included.
Vaginal estradiol cream or tablets	Vaginal dryness and pain with sex; low-dose vaginal estrogen can also help prevent recurring urinary tract infections (UTIs)	Local treatment; it doesn't replace systemic estrogen for hot flashes or treat an active UTI.
Non-hormonal medicines, including fezolinetant	Hot flashes and night sweats without estrogen, for women who can't or don't want to use hormones	Fezolinetant (Veozah) carries a boxed warning for rare liver injury and needs liver blood tests before starting, monthly for three months, and at months six and nine (DailyMed label). Ask who arranges and pays for them.

Offer sources: Gala hormone health and Gala HRT offer, checked October 24, 2026. Clinical context: The Menopause Society, the progesterone randomized trial and the Veozah label linked above. The trial's perceived-sleep improvement doesn't establish an FDA-approved sleep indication or a typical result; its main hot-flash/night-sweat outcome was not statistically significant.

What stands out for a woman comparing it with Coastal:

• Online care without pellet-insertion visits. A clinician can adjust or stop a pill or patch more readily. Care starts online, with a short video visit in states that require one. Blood draws or other in-person testing may still be needed.
• A lower advertised plan price. Gala advertises "$69/month — flat," with no membership fee, no price rise when your dose changes, and "your exact plan and price" shown before you pay. Confirm the full regimen, first charge and billing dates.
• Speed and support. Gala says a U.S.-licensed provider usually reviews your assessment within a day, advertises free one-to-two-day delivery after pharmacy preparation, and says your care team is reachable seven days a week. Those are its service claims, not response times we tested.
• Fewer routine labs. Gala says hormone testing usually isn't needed and labs are ordered only when they'd change your plan. Fezolinetant requires the liver tests noted above; other testing depends on the medicine and your history.

Gala shares one patient story on its hormone page. Marisa, 49, said, "Within three weeks of starting estradiol I was sleeping through the night again." Gala chose that story, and it's one person's experience, not a typical result.

Gala's limits, stated plainly:

• No insurance billing. If you need a provider to bill your plan, Gala isn't your match.
• No testosterone or pellets on its HRT pages.
• No in-person exam. If you need one, see someone locally.
• Its pages don't fully agree on medicine type. Gala's main pages say it prescribes FDA-approved bioidentical forms, but another Gala HRT page carries a compounding notice. Ask for the exact product before paying.
• Cancellation and charge timing matter. The HRT offer says "cancel anytime," while Gala's general refund policy requires at least 72 hours' notice before billing and says the first charge occurs when intake is completed. Another HRT page says you're charged if approved. The general policy still uses weight-loss wording, so confirm which terms apply to HRT rather than assume either promise settles it.
• No published state list or HRT age range. Gala says it won't charge you if it can't serve your state.
• Mixed review pool. Its Trustpilot score covers all Gala programs, including weight loss, so it isn't an HRT-only rating.

The Gala questions to settle before you pay

What's unclear	Ask Gala
FDA-approved forms on one page; a compounding notice on another	"What exact product and maker would I receive? Is it an FDA-approved finished medicine or compounded?"
When you're charged	"Is my card charged before or after the clinician decides?"
"Cancel anytime" vs a 72-hour cutoff	"Which deadline and method apply to my HRT plan?"
What the $69 covers	"Does it cover every medicine I'm prescribed, including progesterone if needed or fezolinetant? Are any labs extra?"
Billing interval and commitment	"What is due now, how often am I billed, what is my next charge date, and is there any minimum commitment?"
Refund if no medicine is prescribed	"If the clinician declines treatment, which charges are refunded, and does the full-refund or remaining-charge wording apply to my HRT order?"

If a pill or patch from home sounds right for you, check Gala's current plan and keep this page open for those questions.

Featured affiliate option. Gala may pay us if you start care through this link. A prescription is never guaranteed. Read our full Gala HRT review.

When insurance or a named medicine matters more

If you need a provider to bill your insurance for visits, Coastal and Gala won't meet that need. Midi Health says it's in-network with most PPO plans. Its self-pay prices are $250 for a first video visit and $150 for a follow-up, and medication and labs are separate.

Two exceptions matter. Midi says it can't treat Medicaid or Medi-Cal patients, even as self-pay. Medicare patients can see Midi only as self-pay and can't submit claims for Midi visits or medicines (Midi pricing). If you have Medicaid, your plan's own in-network clinicians are the place to start.

Want to use insurance for visits? Check your exact plan before comparing a cash monthly price.

Plain link. We don't earn from Midi. Compare the two online options in Gala vs Midi.

If one specific FDA-approved medicine is a must for you, confirm that exact product with any provider before you pay for a visit. The Menopause Society's practitioner directory can help you find an in-person menopause specialist near the Grand Strand. You can also start with the doctor you already have. For the wider field of online options, see our comparison of online HRT providers.

When should you see a clinician before choosing any service?

Some symptoms and health histories need a clinician's full review before any clinic or online service can help. That includes unexplained vaginal bleeding, bleeding after menopause, and a history of blood clots, stroke, heart attack, liver disease, or breast or uterine cancer. Start with your own doctor or a menopause specialist in those cases.

Bleeding after menopause is not normal. The Office on Women's Health says to see your health care provider right away if it happens (Office on Women's Health).

Some histories usually rule out systemic hormones. The Menopause Society says women with breast cancer, uterine cancer, unexplained uterine bleeding, liver disease, a history of blood clots or cardiovascular disease generally should not use systemic hormone therapy (The Menopause Society). That doesn't mean you're out of options. A clinician may discuss local or non-hormonal treatment.

Timing matters. The Menopause Society says hormone therapy can help control moderate to severe symptoms, with a generally more favorable benefit–risk balance for suitable women starting before age 60 or within 10 years of menopause. Your health history still matters; starting later can carry greater risks and needs individual review.

About the 2026 label change. On February 12, 2026, the FDA approved labeling changes for six menopausal hormone products, removing boxed-warning statements about heart disease, breast cancer and probable dementia (FDA). That was the first group of products, not every warning on every product. It doesn't make hormones risk-free. It also doesn't apply to compounded products like pellets, which have no FDA-approved label at all. Our 2026 label change explainer has the details.

None of this is advice to start, stop or change a medicine. It's what to raise so your clinician has the full picture. A quiz or a five-star review can't clear a medical red flag.

Is Coastal HRT worth it? Our verdict

Coastal HRT can be worth it for women near the Grand Strand who want a one-hour initial visit and in-person care, as long as they confirm the exact products and a written yearly cost first. If you don't want pellets, ask Coastal about its non-pellet options; if you also prefer online care, compare Gala. If you need insurance to pay for visits, check Midi's coverage or your own in-network doctor.

Here's how Coastal looks on The HRT Index Verification Standard. These are plain-language judgments, not scores.

Pillar	What we checked	What we found
1. Clinical legitimacy	Business identity, named clinicians, physician relationship, licenses	A physical clinic with three named nurse practitioners; BBB lists incorporation in 2022. The physician on its practice agreement isn't named on its site. Current individual licenses weren't independently verified.
2. Care quality	Visit length, exam, follow-up, what patients report	A published one-hour first visit with an exam. Readable reviews praise the team, but none describes a woman's menopause care or long-term follow-up. Clinician continuity needs to be confirmed.
3. Medication fit	Named products, FDA-approved vs compounded, uterus protection, alternatives	A broad list of forms, but no product names. Biote pellets are compounded. How progesterone is handled isn't published.
4. Price transparency	Today's charge, yearly cost, extras, refund terms	Women's service prices are public. Medication, progesterone, booking charges and how often pellets are repeated are missing. Refunds are case by case.
5. Access	Location, hours, video visits, insurance	Convenient for the Grand Strand, with Monday–Thursday hours. Video visits for hormones are unclear. Coastal doesn't bill insurance for visits.

What would raise our view:

• Named women's products, with each one labeled FDA-approved or compounded
• A published pellet schedule and a yearly cost estimate
• Reviews from women describing menopause care and follow-up
• The name of the physician on the practice agreement
• Remote follow-ups for hormone care

Our approach is explained in our methodology.

Choose your next step

Pick the step that answers your biggest remaining question. You don't have to decide on treatment today.

If this is you	What's still open	Your next step
You live nearby and are fine with in-person, cash-pay care	The exact products and a written quote	Call Coastal with the 10 questions
You'd rather have a pill or patch from home	Product, state and billing terms	Gala's HRT plan, after the Gala questions
Your insurance has to pay for visits	Your network and your share of the cost	Midi or your own in-network doctor
You have a red-flag history or unexplained bleeding	A clinical review comes first	Your own doctor or a menopause specialist
You have no symptoms and are just curious	Nothing to buy yet	Our HRT benefits and risks guide
You're still not sure which kind of care fits	Matching your situation to a route	Find My HRT Path, below

Still not sure where to start? The free Find My HRT Path quiz asks about what's bothering you, what you've tried, your age, your state and your health history. Then it shows a featured online care option, or tells you when online care isn't the right place to start. It takes about 60 seconds and doesn't ask for your email. It doesn't diagnose you or decide whether you should take hormones; a clinician does that.

We may earn a commission from providers the quiz features, and that affects which ones appear. See how it works.

How we reviewed Coastal HRT

This is a dated documentation review, not a patient test.

• What we read: we read Coastal HRT's public pages, its BBB profile and two review directories on October 24, 2026. We checked medical claims against the FDA, ACOG, The Menopause Society and the Office on Women's Health. We compared Coastal with Gala's and Midi's published offers.
• What we didn't do: call, book, pay, visit, talk with a clinician, or independently verify current licenses.
• How we used reviews: we quoted only short, named excerpts and noted which service each one describes. We didn't sample every review or calculate complaint rates.
• How we kept facts apart: we separate what Coastal says, what reviewers say, what medical sources say, and our own judgment, and we label each.
• Money: Coastal HRT and Midi links here don't earn us a commission. Gala may pay us a commission if you enroll through our link. Gala's featured spot in Find My HRT Path is a disclosed affiliate placement, not a ranking of every provider. Read our affiliate disclosure.
• Corrections: if something here is out of date, email partners@thehrtindex.com. We log material corrections.

Coastal HRT questions

Where is Coastal HRT, and when is it open? It's at 4447 US 17 Business, Suite 105, in Murrells Inlet, South Carolina. Its website lists Monday through Thursday, 9 a.m. to 5 p.m. Directory hours differ, so call (843) 357-1995 to confirm or ask about other appointment times.

Is Coastal HRT legit? Coastal has a physical clinic, three named nurse practitioners and a BBB A+ rating (not accredited); BBB lists incorporation in 2022. We haven't independently verified the clinicians' current licenses. You can start a license check with the South Carolina Board of Nursing.

Does Coastal HRT treat women, or mostly men? It offers women's care and publishes a women's price list. A 2022 clinic post focused on male testosterone, but that doesn't establish today's patient mix or when women's care began. The accessible review excerpts don't identify menopause care.

How much is a Biote pellet at Coastal HRT? The published insertion fee is $399 ("any dose"). The first evaluation is $415 with initial labs, or $125 when using private insurance for labs, plus your lab bill. Established patients are listed at $99 for pre-pellet labs. Ask what the $399 includes, whether it's additional to the evaluation, and how often you'd need a new pellet. See the cost math.

Does Coastal HRT take insurance? It doesn't bill insurance for visits. Some FDA-approved prescriptions may be covered at your pharmacy, and Coastal will give you a superbill. Pellets usually aren't covered.

Can I see Coastal HRT by video for hormones? We couldn't confirm that. Coastal offers video visits for weight loss, but its hormone process starts with an in-office visit and exam. Ask which follow-ups can be remote.

Are Biote pellets FDA-approved? No. Biote describes its pellets as custom-compounded, and compounded medicines aren't FDA-approved. FDA-approved estradiol patches, gels and pills exist if that matters to you.

Can a hormone pellet be taken out? ACOG notes pellets are made to dissolve over time, not to be removed. Ask the clinic what it does if your dose turns out too high, before the pellet goes in.

Do I need progesterone with estrogen pellets? If you still have a uterus and use systemic estrogen, guidelines call for a progestogen to protect the lining. Ask how Coastal handles this and what it costs.

Does a five-star rating mean the treatment works? No. Ratings describe the service. Most readable Coastal reviews are general or about weight loss, and none we could read describes menopause treatment.

Will Find My HRT Path tell me whether I should take hormones? No. It's a care-navigation quiz that points you to a featured online option or to guidance. A clinician decides whether any treatment is right for you.

Is Coastal HRT the same as Coastal Healthcare or Coastal Women's Medical? No. Those are separate businesses. See the list below.

Looking for a different "Coastal" clinic?

Several unrelated practices use "Coastal" in their names. This page reviews only Coastal HRT, LLC in Murrells Inlet, South Carolina. We haven't reviewed the clinics below.

Name	Location	Note
Coastal Healthcare	Sanibel Island, Florida	Cash-pay clinic; offers hormone consultations by video, with in-person exams or labs when needed
Coastal Telehealth	Florida	Florida-based video-visit practice
Coastal Women's Medical	Little Silver, New Jersey	Women's concierge practice
Coastal Age Management MD	Savannah and Pooler, Georgia	Age-management practice
Coastal Health & Vitality	Richmond Hill, Georgia	Hormone, peptide and weight practice
Coastal MD	Long Island, New York	Separate integrative-health practice

If you're comparing online options instead of a local clinic, The HRT Index's Find My HRT Path tool can show you a featured option for your state, or tell you when online care isn't the right place to start.

Sources

Coastal HRT, LLC (provider statements, checked October 24, 2026)

• Homepage: location, hours, services
• Hormone Optimization: women's prices, first-visit process, insurance FAQ
• About Us: clinicians and published credentials
• Policies: cancellation, refunds, telehealth policy, licensing contact
• Weight Loss: compounded weight program and video-visit states

Reviews and business profiles (checked October 24, 2026)

• Wanderlog: Coastal HRT, LLC: Google-sourced rating and review excerpts
• Birdeye: Coastal HRT, LLC: rating snapshot and listed hours
• Better Business Bureau: Coastal HRT, LLC: rating, accreditation, incorporation date
• Yelp: Coastal HRT: page inaccessible during this check; no rating or review count verified
• Nextdoor: Coastal HRT, LLC: October 18, 2022 clinic post and separate undated business description
• Best of the Beach official directory: Gold Best Weight Loss Center, 2024 and 2025

Biote

• Bioidentical Hormone Replacement Therapy With Pellets: "custom-compounded" description and company insertion claims; checked October 24, 2026

Alternatives (primary pages checked October 24, 2026)

• Gala: Hormone Health
• Gala: Micronized progesterone
• Gala: Non-hormonal care
• Gala: HRT offer, $69/month
• Gala: Other HRT landing page: compounding notice and charge-after-approval wording
• Gala: General refund policy: intake charge, cancellation and refund terms; applicability to the HRT order must be confirmed
• The HRT Index: Gala Health HRT review: related editorial review
• Midi Health: Pricing and insurance
• Midi: Appointment costs: medication and lab exclusions
• Midi: Medicare and Medicaid self-pay policy
• Midi: Testosterone program

Medical and regulatory

• FDA: Compounding and the FDA: Questions and Answers
• FDA: FDA Approves Labeling Changes to Menopausal Hormone Therapy Products (February 12, 2026)
• Federal Register: Testosterone Use in Menopausal Women; Public Workshop (August 18, 2026)
• ACOG: Compounded Bioidentical Menopausal Hormone Therapy, Clinical Consensus No. 6 (published online October 19, 2023); PubMed abstract
• The Menopause Society: Hormone Therapy (checked October 24, 2026); practitioner directory
• Office on Women's Health: Menopause basics (updated October 19, 2026)
• ISSWSH: Clinical practice guideline for systemic testosterone in women with HSDD (2021)
• DEA: Drug scheduling: testosterone Schedule III
• Randomized trial of oral micronized progesterone in perimenopause (2023): perceived sleep and primary-outcome distinction
• DailyMed: Veozah (fezolinetant) prescribing information (updated February 26, 2026; checked October 24, 2026)
• BlueCross BlueShield of South Carolina: Implantable Hormone Pellets for Females, CAM 019 (annual review April 1, 2026)
• South Carolina: Code §40-33-34; SC Board of Nursing

The HRT Index is an independent editorial publication. We are not a healthcare provider, pharmacy or telehealth service. Nothing here is medical advice, a diagnosis or a treatment plan. For decisions about starting, stopping or changing hormone therapy, talk with a licensed clinician who knows your history. In an emergency, call 911.

MY COASTAL HRT QUESTIONS (keep private)

1. Products, by name — FDA-approved or compounded? ______________________
2. What the $399 includes (pellet? estradiol / testosterone / both?) ____
3. How often a new pellet? $99 labs each time? _________________________
4. How my uterus is protected; progesterone cost: _______________________
5. Plan if my dose is too high; can it be removed? ______________________
6. Non-pellet option I could start with: ________________________________
7. My clinician: __________  Physician on practice agreement: _____________________
8. In person vs video: _________________________________________________
9. Test list for $415 vs $125 + insurance labs: _________________________
10. Cancel / stop / records — what I owe: ______________________________

The one thing still open for me (circle):  medicine · price · insurance · location · support