How Find My HRT Path Works

Find My HRT Path is a free, private, 60-second quiz that routes your answers through the HRT Index Path Framework and returns one primary provider match plus two backup routes. No email. No account. Your answers stay in your browser and are never sent to us. The framework and its logic are public and citable below.

The HRT Index Path Framework: gates in order

The framework applies an ordered sequence of decision gates. Each gate filters the option set before the next is applied. The result is not a score — it is a routing decision expressed as a plain-language Decision Verdict.

Gate 1 — Symptom profile and primary goal

The first gate identifies the reader's primary symptom cluster and goal. Options cover vasomotor symptoms (hot flashes, night sweats), mood and sleep, brain fog, genitourinary and local vaginal symptoms, energy and fatigue, joint pain, weight concerns, and low libido. This gate sets the initial route direction: systemic HRT, local vaginal therapy, or a specialist-first path.

If symptoms are exclusively genitourinary — vaginal dryness, pain during sex, or urinary symptoms — the framework routes toward low-dose local vaginal estrogen as the targeted standard of care, rather than full-body systemic HRT.

Gate 2 — Safety flags (when in-person or specialist care is the right first step)

Before any provider routing, the framework checks for conditions that indicate online subscription HRT is not the right starting point. These flags include:

• A personal history of estrogen-receptor-positive breast cancer or a strong first-degree family history.
• A personal history of deep-vein thrombosis, pulmonary embolism, or a known clotting disorder.
• A recent cardiovascular event (heart attack or stroke).
• Active or undiagnosed abnormal vaginal bleeding.
• Pregnancy, breastfeeding, or actively trying to conceive.
• Age under 18.

When a safety flag is detected, the framework does not continue to provider matching. It routes to a specialist-first recommendation (Midi Health for in-network specialist care, or Sesame for pay-per-visit) and explains clearly why the safety flag matters. It does not say HRT is impossible — it says a form-based subscription intake is not the right first step for that situation.

Gate 3 — Uterus and progesterone status

Women with a uterus who take systemic estrogen must also take a progestogen to protect the uterine lining. The framework captures uterus status (intact, post-hysterectomy, or unknown) and uses it to filter providers. Providers that do not handle progesterone for women with a uterus are excluded from the recommendation. The framework does not route anyone with a uterus to an estrogen-only systemic product without a progestogen.

Gate 4 — Systemic versus local route

If Gate 1 indicated a local-only symptom profile (vaginal dryness, comfort, genitourinary symptoms without systemic hot flashes or mood symptoms), the framework confirms the local route and routes to low-dose vaginal estrogen providers. If symptoms are systemic, the framework continues to Gate 5.

Gate 5 — FDA-approved versus compounded preference

The framework asks explicitly whether the reader wants FDA-approved-only medication. If yes, providers whose primary offering is compounded hormones are excluded. The framework labels FDA-approved and compounded options separately and does not imply compounded products are safer, more natural, or equivalent to FDA-approved products.

Compounded hormone products are not FDA-approved finished drugs and are not reviewed by the FDA for safety, efficacy, or manufacturing quality in the way FDA-approved products are. ACOG's 2023 guidance states that compounded bioidentical hormone therapy should not be prescribed routinely when FDA-approved formulations exist.

Gate 6 — Provider model

The framework filters by how the reader wants to access care:

• Insurance-billed specialist care — routes to Midi Health (in-network with most major PPO plans, menopause-trained clinicians).
• Subscription / asynchronous care — routes to Alloy, Winona, Evernow, or others depending on formulary and state.
• Pay-per-visit — routes to Sesame (self-pay video visit, provider of your choice, prescription sent to your pharmacy).

Gate 7 — Insurance, cost, and state availability

The final gate applies state availability filters (some providers do not serve all 50 states), insurance billing (only Midi bills insurance directly among the providers in the framework), and cost sensitivity. The framework uses verified pricing data from the provider research set — the same data published on the comparison pages — and routes accordingly.

The output: a Decision Verdict, not a score

The framework outputs one primary provider match, a plain-language explanation of why that match fits the answers given, and two backup routes. There is no numeric score on the result page. The 100-point provider scoring methodology used internally by The HRT Index is not published numerically in this phase; the public output is a Decision Verdict — a plain-English statement of fit and reason.

Providers in the framework

The HRT Index Path Framework routes among the 8 providers in the current research set: Midi Health, Alloy, Winona, Evernow, Hers, Gennev, Pandia Health, and Wisp. Providers are included based on the evaluation criteria in the HRT Index methodology. The framework is updated when provider coverage changes or new research warrants.

Privacy

Quiz answers are processed entirely in your browser using client-side logic. No health information — symptoms, medication preferences, uterus status, or any other answer — is transmitted to The HRT Index or to any analytics service. If you allow session storage in your browser, your answers are stored locally so you can resume if you navigate away; this data does not leave your device.

Affiliate links in results use an opaque route identifier only. No health information appears in outbound URLs.