Fountain HRT vs Hers: Testosterone, FDA Status and What You'll Pay

That's the starting point. The longer answer matters, because the two price tags aren't measuring the same thing. Fountain Starter bills in four-week blocks, so 52 weeks contain 13 charges, not 12. Hers' lowest published rates come with a 12-month plan. And neither company's public pages settle every detail you'd want before paying. A low advertised rate is not a full quote, and a hormone's name is not proof of the exact product you'll get.

Below, we lay out Fountain's scheduled plan payments over 90 days and 52 weeks, Hers' published rate illustrations, what's known about each box, who should skip each one, and the questions to ask before you hand over a card.

Fountain HRT is best for: women who want testosterone evaluated, like face-to-face video visits, and can pay cash. Skip Fountain if: you need insurance billing or a published patch option; it doesn't list a patch. If you require named FDA-approved products, get the exact kit details before committing.

Hers is best for: women who want standard estradiol (pill or patch) and progesterone from a large, familiar platform, with lower advertised starting rates than Fountain. Skip Hers if: you need a published testosterone option or scheduled video visits. If you want the lowest advertised rate without a 12-month plan, its posted offer doesn't meet that requirement.

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.

What we actually verified · Last verified October 2026

• We read Fountain's HRT page, prices and FAQ, its telehealth consent and its return policy on October 14, 2026.
• We read Hers' menopause page, Hers' own pricing statement (a Hers article updated December 23, 2025), its terms and its refund help article on October 14, 2026.
• We read Gala Health's HRT pages and refund policy on October 14, 2026.
• We checked the retained medical and regulatory points against FDA materials, the federal telemedicine rule, product labeling and medical-society guidance. Where product or commercial details remain unresolved, we say so.
• We did the billing math ourselves from published prices. Every calculation is shown.
• We did not enroll, see a clinician, receive medicine or complete a checkout with any provider. This is a documentation review, not a patient test.
• Still not verified from the sources we could read: Fountain's current product-by-product list and approval status; Hers' shorter-plan price, complete regimen price and exact billing schedule; full current state lists for these women's services; and the HRT-specific application of Gala's conflicting payment and refund wording.

How we make money: Hers and Gala Health are affiliate partners, and we may earn a commission if you start care through our labeled links. Partnerships can affect which providers we feature. We have no affiliate relationship with Fountain and earn nothing if you choose it. Read our affiliate disclosure.

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Fountain HRT vs Hers at a glance

Fountain HRT is a concierge-style, cash-pay program that bundles video visits, round-the-clock text support and a custom hormone kit that can include testosterone. Its displayed rates are $150 to $199 per four weeks of care, with different amounts paid up front. Hers publishes lower starting rates: $79 a month for oral HRT or $134 for patch HRT on a 12-month plan. Its menopause menu lists estradiol, progesterone and vaginal estradiol, but not testosterone.

Here's how they line up on the things that usually decide this choice. The third column is Gala Health, our featured cash-pay partner. It isn't part of the "vs," but it's worth comparing when testosterone isn't on your list. We cover it fully further down.

Sources: Fountain HRT; Hers menopause; Hers pricing article, updated Dec. 23, 2025; Gala hormone health; Gala HRT offer; Gala refund policy. Provider-published; checked October 14, 2026. "Not published" means we couldn't find it, not that the feature doesn't exist.

If one column already looks like you, you don't need to read every section. Start with the provider's own process, and keep the questions near the end of this page handy.

If estradiol and progesterone are what you're seeking and a 12-month plan works for you, Hers is a straightforward route with lower advertised starting rates. Review the prescription, billing schedule and amount due before paying.

Affiliate link. A Hers clinician decides whether treatment is right for you. Check the billing schedule before you pay.

If testosterone is the reason you're here, Fountain is the one of these two that offers it. Go in with your questions ready.

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Which one fits you? A 30-second self-check

The right choice depends on whether you want testosterone considered, which medicine form you prefer, how you want to pay and whether you have insurance you'd like to use. Testosterone assessment and video-first care are the clearest reasons to consider Fountain's premium. If you mainly want estradiol and progesterone, compare the lower advertised rates at Hers and Gala against your full prescription quote.

Answer these four questions. Each answer moves you toward a different starting point.

1. Is low sex drive that bothers you your main unsolved problem, and do you want testosterone considered? Yes → Fountain is the one of these two that lists it. Also check Midi's testosterone availability in your state and your specific insurance coverage; visits and the medication can be billed separately.

2. Do you want an estradiol patch? Yes → Hers or Gala. Fountain doesn't list a patch.

3. Do you want to avoid a long prepaid commitment? Yes → Gala advertises no contract; confirm the amount and period you would pay for before choosing it. Fountain's $199 Starter plan has a published four-week billing interval. Hers' lowest advertised rates are tied to a 12-month plan.

4. Do you have insurance you'd like to use? Yes → Neither of these bills insurance. Your own clinician, an OB-GYN or an in-network service may cost you less.

If your answers point in different directions — or you're not sure what you need yet — that's normal. It's also the moment a quick, structured check helps.

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.

It asks five things: what's bothering you most, what you've tried, your age, your state and any health history a clinician should know. Then it shows one featured online option with its listed price, or tells you plainly when an in-person clinician should come first. It's free, takes about 60 seconds and needs no email. It isn't a medical test or a prescription decision, and it features a small set of partner providers rather than ranking every service.

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How much do Fountain HRT and Hers cost?

Fountain HRT publishes charges of $199 every four weeks, $499 every 12 weeks or $1,799 every 48 weeks. The rate-equivalent for 52 weeks of care is about $1,949 to $2,587—not necessarily the cash paid in that window. Hers advertises oral HRT from $79 a month or patch HRT from $134 on a 12-month plan: $948 or $1,608 for twelve advertised monthly rates. Its actual payment schedule and complete regimen total still need confirmation.

Two numbers matter, and people mix them up all the time:

• What leaves your bank account in a set window (90 days, 52 weeks).
• The rate — what each week of care costs on average.

A long prepaid plan can have the lowest rate and still take the most money out of your account in a 52-week window. Here's both, side by side.

What each plan charges in the first 90 days

We counted day 0 as the first plan charge and stopped the count just before day 90. We assumed Fountain's plan renews unchanged, with no cancellations, refunds, promotions or extra fees. These are modeled plan charges, not observed checkout payments. Hers' and Gala's actual schedules were not established.

Our calculations from published Fountain prices, checked October 14, 2026. Fountain charges use its stated billing periods (Fountain HRT). Hers' and Gala's cash totals stay unknown because their actual schedules were not established from the pages reviewed. Hers' starting rates come from its pricing article; Gala's headline comes from its HRT offer. These are plan payments, not complete treatment costs. Purchased care time is not a claim that all medication ships at once.

A worked example. Say you pick Fountain Standard to "keep it to one payment for three months." The plan renews after 84 days. So a second $499 charge lands before your 90-day budget window closes — $998 in total. That second payment isn't for the last six days; it buys the next 12 weeks. Nothing is wrong with that. It just surprises people who expected one charge.

What each plan costs over 52 weeks

We used a 52-week (364-day) window for Fountain, because "a year" hides the four-week problem. Hers' and Gala's twelve-month rate illustrations are labeled separately; twelve calendar months are not exactly 52 weeks.

How we calculated Fountain's rate-equivalent: plan price ÷ weeks in the plan × 52. For example, $1,799 ÷ 48 × 52 = $1,948.92, and $499 ÷ 12 × 52 = $2,162.33. Cash totals count only the modeled charges before day 364; a payment on day 364 is excluded. A full 365-day window starting with a charge would include that next Starter payment: 14 × $199 = $2,786. Unknown required extras are excluded from these partial totals, not assumed to be free.

What those numbers mean for your budget

• Hers pills vs. Fountain Starter: $948 for twelve advertised monthly rates versus $2,587 for 52 weeks at Fountain. That is a $1,639 difference between these published-rate illustrations—not a verified saving on the same prescription.
• Hers patch vs. Fountain Pro's rate: $1,608 for twelve advertised monthly rates versus $1,948.92 for 52 weeks. The $340.92 arithmetic gap doesn't settle product fit or extras, and Fountain Pro's initial plan charge is $1,799.
• Gala vs. Hers pills: $828 versus $948 for twelve advertised monthly rates—a $120 headline-rate difference. Confirm the full prescription price, charge schedule and cancellation terms before treating that as a saving.

Those comparisons only matter if the products fit you. If your clinician recommends testosterone, Hers' published menopause menu doesn't provide that option. Fountain's additional cost may buy a relevant assessment and care model—not proof that everyone needs another hormone.

Why "four weeks" and "a month" aren't the same

A month averages a little over 30 days. Four weeks is 28. That's why Fountain Starter has 13 payments within the 52-week window above instead of 12. If you budget for only twelve $199 payments over those 52 weeks, you'll be short by one full $199 payment. Use actual dates for a calendar-year budget.

What Hers' posted prices do — and don't — tell you

Hers' own article says its oral medications start at $79 a month and patches at $134 a month, both on a 12-month plan. Those are real, provider-published starting rates, below Fountain's displayed rates. But they leave out three things you'll want to see before paying:

• When you're charged. The article doesn't say whether the 12-month plan is billed monthly, prepaid or on another schedule. Hers' terms put the actual interval at checkout and allow some renewals to process early. Look at both the "due today" line and the next processing date.
• What a shorter plan costs. A month-to-month price wasn't established in the pages we reviewed.
• What's included. "From $134" may not cover every medicine you're prescribed, such as progesterone or a vaginal cream. Ask for an itemized total.

Our Hers menopause cost breakdown has more on its plans and renewal terms.

What each price includes — and what might cost extra

Provider-published; checked October 14, 2026.

Before you call anything "cheaper," complete the quote

A partial total can still help you compare, but it has to stay labeled partial. If a cost hasn't been confirmed, it's unknown — not zero, and not included. Use this list when you ask either provider for a written quote.

This is a buying checklist, not a claim that either provider charges each of these fees.

If you have insurance, this may beat both

Neither Fountain nor Hers bills insurance. Your own clinician, an OB-GYN or an in-network telehealth service can sometimes cost less, because your visits go through your plan and your medicine goes through your pharmacy benefit. Check the price of your specific medicine with your pharmacy before you decide. Our HRT cost guide and our list of online HRT providers that accept insurance walk through those routes.

Paying cash, don't need testosterone and don't want a long contract? Gala advertises HRT at $69 a month with no membership fee and no contract. That's the lowest headline rate among these offers. Confirm your prescribed items, actual charge interval, amount due and cancellation agreement before paying.

Affiliate link. Gala's HRT menu doesn't list testosterone, and its offer is cash-pay. A clinician decides whether treatment is right for you.

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What's actually in the box? FDA-approved, compounded and bioidentical

Hers publishes estradiol pills, estradiol patches, progesterone pills and estradiol vaginal cream; the exact prescription still matters. Fountain says its kit can include estrogen, progesterone and testosterone, but its current product-by-product approval status wasn't established from the primary pages we could read. Our July review reported a compounded vaginal cream; we could not recheck that underlying disclosure for this comparison.

Three words cause most of the confusion here. Here's what each one actually means.

• FDA-approved means the FDA reviewed the finished medicine — the exact pill, patch or cream — for safety, effectiveness and quality before it was sold.
• Compounded means a pharmacy mixed the medicine for a patient. Compounding can fill a real need, such as an allergy to an ingredient in an approved product. But a compounded medicine is not FDA-approved, and it doesn't go through the FDA's review before it's sold (FDA).
• Bioidentical means the hormone has the same chemical shape as the one your body makes. It says nothing about approval. Many FDA-approved estradiol and progesterone products are bioidentical. So are many compounded ones.

So "bioidentical hormones," which Fountain and Gala both advertise, doesn't answer the question you care about. The product name does.

Product by product: what each provider has published

Sources: Fountain HRT and Hers menopause, checked October 14, 2026. The historical vaginal-cream statement comes from our July 23, 2026 Fountain review, not a newly verified product disclosure. Sign-up search snippets were not used to establish a current formulation.

Hers links a DailyMed record for Bionpharma oral micronized progesterone that identifies generic application ANDA200900. That is product-level evidence, not proof that every Hers prescription uses that manufacturer or that every listed pill, patch and cream has been checked individually. Ask for the actual product on your prescription.

What the medical groups say. The American College of Obstetricians and Gynecologists says compounded bioidentical hormone therapy shouldn't be prescribed routinely when FDA-approved versions exist (ACOG). The Menopause Society notes that custom-compounded hormones haven't been shown to be safer or more effective than approved bioidentical products (The Menopause Society). Neither statement says compounding is never appropriate. They say there should be a clear reason for it.

A product-check sheet you can use with any provider

Ask for these before committing to a medication plan. The clinician may need to complete an evaluation before naming your prescription; ask about any evaluation fee and non-prescribing policy first.

Until a specific product is named, a provider's general FDA-approved wording does not verify the medicine in your box. Approval of an ingredient—or a different product using it—is not approval of that preparation.

Whole-body symptoms and vaginal symptoms are different questions

Systemic hormone therapy — a pill, patch, gel or spray — travels through your whole body. It's the kind used for hot flashes, night sweats and the sleep problems that come with them. Local vaginal estrogen — a low-dose cream, tablet or ring used in the vagina — mainly treats dryness, painful sex and some urinary symptoms. It isn't a replacement for systemic treatment of hot flashes (The Menopause Society).

That changes the comparison. If vaginal dryness is your only problem, you may not need a full systemic plan at all. A focused conversation about local treatment could be the cheaper, simpler fit. Our vaginal estrogen guide explains the options.

When progesterone changes the comparison

If you still have a uterus and use systemic estrogen, you generally need something to protect the uterine lining (the endometrium). Estrogen alone can thicken it, which raises the risk of endometrial cancer. Usually that protection is a progestogen, such as oral micronized progesterone. The exact medicine, form and schedule are your clinician's call. (The Menopause Society)

Two practical questions follow:

• Is the protection included in the price? Hers' "from" price and Fountain's kit price may or may not cover everything your regimen needs. Ask.
• Is the form a proven one? Compounded progesterone applied to the skin as a cream or gel can have variable absorption and may not provide enough uterine-lining protection. If your plan uses one, ask why that form was chosen and whether an approved oral option would suit you (British Menopause Society, May 2026).

If you've had a hysterectomy, this part may not apply to you. Your clinician will tell you.

Want to start with a clearly published pill-and-patch menu? Hers lists estradiol and progesterone options. Check the exact products and the complete payment terms during its provider process.

Affiliate link. Confirm the product names on your prescription and the billing schedule at checkout.

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Does Hers offer testosterone? Does Fountain?

Fountain offers testosterone for women if its clinician prescribes it; Hers' menopause program does not list it. Testosterone treatment for menopausal symptoms is off-label in the U.S.; there is no FDA-approved testosterone product specifically for women. Clinicians may consider a men's product at an appropriately adjusted dose, while compounded products are not FDA-approved. The strongest evidence supports treatment of distressing low sexual desire after menopause, following a full assessment.

This is the biggest real difference between Fountain and Hers, so it's worth getting right.

What the evidence supports

A global consensus statement endorsed by international medical societies, including the Endocrine Society and the International Menopause Society, reviewed the research on testosterone for women. Its main findings (Global Consensus Position Statement, 2019):

• The one evidence-based use is hypoactive sexual desire disorder (HSDD) in postmenopausal women. HSDD means low sexual desire that bothers you, diagnosed after a full assessment.
• There isn't enough evidence to use testosterone for energy, mood, brain fog, muscle, weight or bone.
• Safety beyond about two years of use hasn't been established.
• A blood testosterone level shouldn't be used to diagnose HSDD.
• Compounded testosterone generally isn't recommended when an approved option is available.

The FDA held a public meeting on testosterone use in menopausal women on September 17, 2026. It described growing off-label use, open questions about testosterone's role in mood, thinking and muscle and bone health, and a lack of long-term safety data on heart and breast cancer risk (FDA). A public meeting is not a new approval. It's a sign the evidence is still being sorted out.

That doesn't mean women who feel better on testosterone are imagining it. The research still leaves important questions unanswered. It means testosterone is a specific tool with a specific best-supported use—not an automatic upgrade every menopause plan is missing.

Fountain's HRT page promotes outcomes such as energy, body fat, muscle and mental clarity alongside its hormone program. Those claims don't establish that testosterone itself improves those outcomes; the consensus statement does not support prescribing it for those purposes.

The rules that affect online testosterone

• Testosterone is a Schedule III controlled substance in the U.S. It needs a valid prescription from a clinician registered to prescribe controlled substances (DEA).
• The current temporary federal rule permits eligible telemedicine prescribing without a prior in-person visit through December 31, 2026. For testosterone, that generally means an audio-video visit with an appropriately DEA-registered prescriber and compliance with applicable federal and state law—not permission for every online service to prescribe it everywhere (Federal Register).
• Why that matters for your plan: if you prepay Fountain's 48-week plan in late 2026, part of it runs past that date. Ask Fountain what happens to a testosterone prescription and to your prepaid balance if the rules change.

Possible side effects worth asking about

At levels kept within the usual female range, trials found mild increases in acne and body or facial hair in some women. Levels above that range can cause effects such as voice deepening and scalp hair loss. That's why the exact product, the clinician's dosing decision and the follow-up plan matter more than the word "testosterone" on a sales page (global consensus; ISSWSH clinical guideline).

Self-check: is testosterone really your deciding factor?

1. Is low sexual desire that bothers you your main unsolved problem?
2. Have you discussed other possible causes and treatment options with a clinician, including whether estrogen therapy is relevant to your symptoms?
3. Are you comfortable discussing off-label treatment and asking separately whether the exact product is FDA-approved or compounded?
4. Are you willing to do follow-up checks?

If you said yes to 1 and 4: that is a reason to discuss a testosterone assessment, not proof you need a prescription. Fountain is one cash-pay route. Midi currently lists testosterone prescribing in specific states and Washington, DC; check your state and coverage. Its visits may go through insurance, while compounded testosterone is paid for separately at the pharmacy.

If you said no to 1: testosterone is not an evidence-backed reason to pay more for energy, weight or brain fog alone. Compare the services around your actual concern, and bring any sexual-health concerns to your clinician rather than waiting for another treatment to fail.

Fountain's exclusivity claim refers to a combination of testosterone treatment, face-to-face video visits and 24/7 support—not to testosterone access alone. Midi's current policy confirms that Fountain is not the only service with a testosterone pathway. Compare the actual care and monitoring each can offer in your state, rather than choosing on an exclusivity slogan.

Testosterone is the piece you want, and you're paying cash? Fountain is the one of these two that offers it. Take the questions at the end of this page with you.

Not an affiliate link—we earn nothing from Fountain. Want to use insurance? Check Midi's coverage and its testosterone availability in your state first.

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What care looks like after you sign up

Fountain uses a face-to-face video visit before prescribing, follow-up video visits and a 24/7 concierge team you can text or call. Hers describes an online intake reviewed by a licensed provider, followed by unlimited messaging and check-ins; it does not publish a scheduled-video model. Fountain says routine hormone monitoring is not standard care. Hers' public menopause page does not establish a blanket lab requirement or exemption.

How each one works, step by step

Sources: Fountain HRT and Hers menopause, checked October 14, 2026.

If seeing a clinician's face on screen matters to you, that's Fountain's clearest published care-model advantage. If you're comfortable writing to your provider, Hers is worth comparing at its lower advertised starting rates.

Who answers when you need help?

Support and clinical care aren't the same thing. A support team can fix a shipping problem. Only a clinician can change your prescription.

Fountain advertises a "high-touch concierge support team available 24/7" that "typically respond[s] within 10 minutes or less." Its telehealth consent form, last updated July 24, 2024, says something narrower about medical care: its telehealth services are "available 8 hours a day, 5 days a week," and its medical group has no in-person clinics (Fountain telehealth consent). Both can be true. Just ask who is answering, and when a clinician can act.

Hers describes "unlimited online access to provider messaging, regular check-ins, and treatment adjustments as needed." It doesn't publish an expected reply time.

Three questions settle this for either one:

1. Do I get a scheduled conversation with a clinician, or messaging only?
2. Who handles a side effect or a medicine question?
3. How quickly does a clinician — not support staff — usually reply?

We did not measure either company's clinician reply times, so we don't publish a tested response-time claim.

Do you need lab tests?

Hormone tests are often unnecessary to identify menopause in otherwise healthy women aged 45 or older with typical symptoms and period changes. That is not a no-testing rule for every age or situation: earlier menopause and other possible causes can need investigation (NICE guidance, section 1.3). Monitoring a specific treatment—especially testosterone—is a separate question; its clinical guideline calls for baseline and follow-up testosterone measurements (global consensus).

Fountain's HRT page now answers the question directly: "Routine hormone-level monitoring is not part of standard Fountain HRT care." Hers doesn't publish a lab requirement.

A distinction worth knowing. Routine menopause hormone panels and monitoring a testosterone prescription are not the same thing. Fountain's FAQ says routine hormone monitoring isn't standard; testosterone guidance calls for specific baseline and follow-up checks. If labs matter to you, ask Fountain exactly which tests, when, where and who pays. Its general FAQ does not settle those treatment-specific details (Fountain; global consensus).

Plan your refills before you switch

If you're already on hormone therapy and thinking of moving to Fountain or Hers, settle continuity first. A lower price doesn't help if there's a gap between prescriptions.

Estradiol patches have been harder to find in some places. The FDA said on September 3, 2026, that patches "remain available" and that supply had nearly doubled over the previous year, but certain products could still be hard to find. Its advice: talk to your pharmacist about availability and possible substitution, and to your clinician about alternatives. Don't change your medicine on your own (FDA). On April 22, 2026, Reuters reported Hers' statement that it had steady patch inventory; that was a company statement at that time, not a current stock guarantee (Reuters).

Before switching, write down:

• Your current product name, strength and form
• How many days of medicine you have left
• When your new clinician will review you
• Which pharmacy will fill the new prescription
• Who to contact if a shipment is late
• How to get your records from your current provider

Fountain's terms say you can ask for a prescription to be sent to a pharmacy of your choice. They don't say whether that changes your membership price. (Fountain terms, checked October 14, 2026.)

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Does either take insurance? What about HSA or FSA, states and age?

Neither Fountain nor Hers bills health insurance through the cash-pay offers compared here. Hers says some medicines may be HSA- or FSA-eligible; Fountain's HRT pages did not settle that payment question. We did not verify complete current state lists for these women's services, so check availability before committing.

Insurance

Fountain's HRT page says "No insurance involved." Hers says insurance "isn't required," and it doesn't bill it. Gala is also cash-pay.

If you want to use insurance, these routes are worth checking first:

These are ordinary links, not affiliate links.

HSA and FSA

Paying with HSA or FSA money is different from using insurance. Hers says some of its medicines are HSA- or FSA-eligible (Hers). Gala says it accepts FSA and HSA. Fountain doesn't state either way. Eligibility depends on your account rules, so keep itemized receipts.

States

• Fountain: don't use a men's-program state list to establish women's HRT or testosterone availability. Confirm the service and prescription you need.
• Hers: its menopause page says care is not available in all 50 states. We did not verify a complete current exclusion list; older state references should not decide your choice today.
• Gala: its HRT page says it serves most U.S. states and confirms availability during assessment. Confirm your state and when a charge can occur; its landing page and linked general policy use different payment-timing language.

Age

Each provider sets its own age rules, and they can differ by medicine. Fountain's terms require platform users to be 18 or older; that is not a promise that every adult qualifies for women's HRT. Confirm treatment-specific limits during sign-up.

Not sure where to start? Find My HRT Path asks about your state along with your symptoms and history, then offers featured care navigation or guidance on a different starting point. It is not a directory of every service or a provider's acceptance decision.

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Can you cancel? What happens to your money?

Both Fountain and Hers use automatic renewal until cancelled under their terms. Fountain's return policy describes a pro-rated refund of unused prepaid treatment, but not care already delivered or medication shipped. Hers' help article requires changes at least 48 hours before the next payment processes and says prescriptions already processed by the pharmacy are non-refundable. Ask for your plan's exact cutoff and refund calculation before prepaying.

Stopping a renewal, ending care and getting money back are three different things. Here's what each provider has published.

Sources: Fountain return policy (last updated Apr. 3, 2024) and terms; Hims & Hers refund help article and Hers terms; Gala refund policy (Feb. 2026). Checked October 14, 2026. Hers' processing date can precede shipment. Gala's linked policy includes weight-loss wording, so obtain the applicable HRT agreement rather than assuming every row governs your purchase.

One open question on Fountain. Its return policy describes pro-rated refunds of unused prepaid treatment, while its current terms describe auto-renewal and account closure at the end of a billing period. On a 48-week plan, those two need to fit together. Get the actual refund calculation in writing before prepaying.

One open question on Gala. Its HRT landing page says you are charged if approved; the linked general refund policy says the first charge occurs when intake is completed. That policy also includes weight-loss wording and different refund language for initial versus later medical disqualification. Ask which HRT agreement applies, when your card is charged and exactly what would be refunded (HRT page; policy).

Our take (budget judgment, not medical advice): start with the smallest commitment that gets you appropriate care—Fountain Starter, or a Hers or Gala plan whose amount due and terms you've seen—until you've met your clinician, confirmed your exact medicine and received a first shipment. Don't let a renewal deadline decide a medication change; plan stopping or switching with your clinician.

Ask this before buying, and save the answer:

"For this exact plan, if I cancel after my first follow-up, when does my care end, which payment stops, how much is refunded and how do I get my records and keep my prescription going?"

A good answer has a date, an amount and a plan. "Cancel anytime" alone doesn't answer it.

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What customer reviews can — and can't — tell you

Reviews show what individual people experienced with appointments, support and billing. They can't tell you which medicine will work for you, and a company-wide review score isn't a menopause-specific clinical rating.

Fountain HRT: the current Fountain Trustpilot profile is merged and includes more than one service, so an older HRT-only review count is not a current HRT score. A September 2, 2026 reviewer whose post names Fountain HRT wrote, "My appointments have always gone smoothly." That is one person's reported service experience, not a tested response time or proof of symptom improvement. We read the account on the profile; we did not verify the patient interaction.

Hers launched its menopause specialty in October 2025 (company launch announcement). The comparison did not establish a reliable set of menopause-specific patient reviews, so we haven't borrowed quotations about weight loss, hair or another Hers service.

About "comparison" articles you'll see. Check whether a page carries a paid-partnership label. Sponsorship doesn't make every statement wrong, but it is a reason to inspect the evidence behind the recommendation. This page isn't paid for by Fountain. Hers and Gala are our affiliates, and we've told you that at the top.

Use reviews to decide what to ask — how easy appointments are to get, who answers messages, how refunds went — not to predict your symptoms.

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Which is right for you?

Your symptoms, payment preference and medicine preference decide this — not the brand. Find the row that sounds most like you.

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Is there a cheaper or better-fit option than Fountain or Hers?

If you're paying cash and don't need a testosterone pathway, Gala Health is worth comparing first. It advertises HRT at $69 a month with no membership fee and no contract, and lists estradiol pills or patches, progesterone and vaginal estradiol. Its pages use both FDA-approved and compounded-drug wording, so confirm the exact products, full quote and payment terms. Its HRT menu does not list testosterone, and the offer does not bill insurance.

For a reader comparing Fountain and Hers, the real question may be simpler: "I want standard menopause hormone therapy, prescribed online, at a fair price, without a long contract." Gala’s published offer is strongest for that comparison—provided its actual prescription and payment terms fit.

Why Gala stands out for that reader

Provider-published; checked October 14, 2026. Sources: Gala HRT offer, Gala hormone health, Gala refund policy.

Gala also says a provider usually reviews your assessment within a day, a short video visit is required in some states, your care team is reachable seven days a week and shipping is free. It says your exact plan and price are shown before you pay.

The published-rate math is simple: $69 × 12 = $828, compared with Hers' $79 × 12 = $948 for oral HRT. The $120 difference is between advertised twelve-month rate illustrations, not verified complete prescriptions or charges. Gala's exact billing cycle, items included and applicable cancellation terms still determine what you actually pay.

Gala's limits — read these before you click

• No published testosterone pathway. If that's your reason for looking, the HRT offer reviewed here doesn't establish that fit.
• No insurance billing. If your plan would cover a clinician and generic medicines, that could cost less.
• Charge timing and refunds need a clear answer. One HRT page says charging follows approval, while the linked general policy says charging starts when intake is completed. That policy calls for 72 hours' cancellation notice and restricts refunds, but includes weight-loss wording. Get the applicable HRT terms before authorizing payment (HRT page; policy).
• Mixed signals on product status. Gala's main HRT pages say it prescribes "FDA-approved bioidentical forms." Another Gala HRT page carries a notice that "compounded drugs are not FDA-approved." Ask which exact product would be dispensed to you.
• Confirm the price for your prescription. Ask whether the $69 offer covers your chosen route and every prescribed item, including any progesterone or vaginal treatment, and how much is charged at each renewal.
• Ratings aren't HRT-specific. Don't use Gala's company-wide reviews or weight-loss stories to predict your menopause-care experience.

What one Gala patient said, as published by Gala: "Gala's provider walked me through the options." — Allison, 51. Gala chose and published this testimonial; we haven't verified the patient interaction, and it isn't evidence of typical results. (Gala hormone health)

Paying cash, no testosterone pathway needed, and you'd rather avoid a long contract? Gala describes a roughly five-minute HRT assessment and says it shows your plan and price before you pay. Check the amount due, billing cycle and governing terms before authorizing a charge.

Affiliate link. A clinician decides whether treatment is right for you. Confirm your plan, billing interval and total before paying. For the full details, read what we verified about Gala's HRT offer.

Other alternatives worth knowing

• Midi Health — insurance-billed virtual menopause visits and a current state-specific testosterone pathway. Confirm prescription costs separately. Not an affiliate.
• Your own clinician plus generic medicines — may cost less when your visits and prescription are covered; compare your actual copays and deductible.
• Alloy — a cash-pay alternative that publishes named hormone products and prices before you start. Its HRT menu was checked October 14, 2026; ask about the full regimen, not unrelated skincare or weight-loss products. Not an affiliate.

Want the wider field? See our comparison of the best online HRT providers.

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When online care isn't the right starting point

Start with an in-person assessment for new or unexplained vaginal bleeding or a possible pregnancy. A history of blood clots, stroke, heart attack, active liver disease or hormone-sensitive cancer calls for an individual clinician or specialist assessment before choosing hormone treatment. These histories do not all imply the same rule for every systemic or local medicine; coordinated online care may be part of the plan later.

A comparison page can't decide whether hormone therapy is safe for you. A clinician who knows your history can. If an online intake redirects you to in-person care, that's not a failure. It can be exactly the right result. (The Menopause Society)

Fountain's own consent form says its providers don't handle medical emergencies, that it has no in-person clinics, and that some needs aren't right for telehealth. If you have a medical emergency, call 911.

About the warnings on hormone products. On February 12, 2026, the FDA announced an initial group of six menopausal hormone-therapy products with approved labeling changes, including removal of several boxed-warning statements. That did not remove every warning or update every product at once. Unopposed systemic estrogen still raises endometrial-cancer risk in someone with a uterus. Read the current label for your exact product, and ask your clinician how it applies to you (FDA; The Menopause Society).

To find a clinician with a menopause focus or certification near you, use The Menopause Society's practitioner directory. Our guides to HRT benefits and risks and non-hormonal options can help you prepare.

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Questions to ask before you pay

Ask for the commercial terms before committing, and for your proposed medicines after the clinician has assessed you. An evaluation may have its own charge, so establish that fee and the non-prescribing policy first. Copy the list for the provider you're choosing into its chat or text thread.

For Fountain HRT

1. Please tell me the exact name, strength, form and maker of every estrogen, progesterone, testosterone and vaginal product you'd prescribe me — and whether each is FDA-approved or compounded.
2. If I have a uterus, what's protecting my uterine lining, in what form?
3. What exact amount is charged today, and on what date and for how much is the first renewal?
4. If I choose the 48-week plan and cancel in month two, how much do I get back? Please show the calculation.
5. Can I get testosterone on its own if I already take estrogen and progesterone from another prescriber?
6. What happens to my testosterone prescription and my prepaid balance if federal telehealth rules change after December 31, 2026?

For Hers

1. Is my plan billed monthly or all at once, and how much is due today?
2. What does the month-to-month plan cost?
3. Which exact estradiol and progesterone products will you ship, and does my price include both?
4. Is the vaginal cream a generic of an FDA-approved product?
5. Do you serve my state, and can I switch between the pill and the patch without starting a new plan?

For Gala Health

1. Is $69 my price for my exact plan — pill or patch — and how often am I billed?
2. Do I need a video visit in my state?
3. Which exact products will ship, and are they FDA-approved or compounded?
4. Which refund policy covers my HRT plan, and what date must I cancel by to avoid the next charge?

A clear, written answer settles each commercial question. For a prescription-specific question, a clear answer may be that the clinician first needs to assess you; ask when the proposed treatment will be explained and whether any further payment follows.

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How we compared Fountain HRT and Hers

We read each provider's public pages, prices, frequently asked questions and policies; checked product status where a finished product could be identified; checked the retained medical and regulatory claims against primary sources; did the billing math ourselves; and recorded the source-check dates. We did not enroll, receive care or complete a checkout, and we didn't score either provider.

Every comparison on The HRT Index follows The HRT Index Verification Standard, built on five pillars, in this order:

A missing answer stays visible as a question rather than being turned into a score. Read more about how we verify provider claims and our medical review policy.

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Fountain HRT vs Hers: frequently asked questions

Is Fountain HRT or Hers cheaper? Hers publishes lower starting-rate illustrations: $948 for twelve $79 oral-HRT monthly rates or $1,608 for twelve $134 patch rates on a 12-month plan. Fountain's rate-equivalent is $1,948.92 to $2,587 for 52 weeks, but its cash payments can differ. Compare the complete prescribed items and actual charge dates before calling either cheaper for you.

Does Hers offer testosterone for women? Not in its published menopause program as of October 14, 2026. Hers has said it plans to add more treatment options, so check its current menu.

Is Fountain HRT FDA-approved? Fountain is a care service, not a medicine. We did not establish the current approval status of each kit product. Our older review reported a compounded vaginal cream, but its underlying disclosure was not reverified here. Ask for each finished product name and whether it is FDA-approved or compounded.

Are Hers' hormones FDA-approved? Hers lists estradiol pills and patches, progesterone pills and vaginal estradiol cream. Its linked progesterone record identifies an approved generic application, but that does not verify every dispensed product or manufacturer. Confirm the exact prescription instead of treating a medication category as an approval guarantee.

Does Fountain or Hers take insurance? No. Both are cash-pay. Hers says some medicines may be HSA- or FSA-eligible.

Do I need blood tests to start? Not routinely to identify menopause in otherwise healthy women aged 45 or older with typical symptoms. Earlier menopause, other possible causes and treatment-specific monitoring can change that answer. Fountain says routine hormone monitoring is not standard care; Hers' page does not establish a blanket testing rule.

Does Hers do video visits? Hers' menopause page describes an online intake, provider review and messaging, not scheduled video visits. Fountain includes video visits.

Which is better for perimenopause? Either may be a route after a clinician reviews your symptoms, age and history; Hers describes its menopause-product use for perimenopause as off-label. Choose on the proposed treatment, availability and complete price, not a presumed need for testosterone. Menopausal hormone therapy is not contraception, so discuss pregnancy prevention separately when relevant (NICE).

Can I get an estradiol patch from Fountain? Fountain's current HRT page doesn't list a patch, so do not assume it will supply one. Hers and Gala both list patches; confirm the actual product and availability.

Its displayed rate is about $150 per four weeks, but the actual plan charge is $1,799 every 48 weeks. If it renews unchanged, another $1,799 lands at week 48—$3,598 in modeled plan payments before 52 weeks elapse. Part of that second purchase covers time after the window. It has the lowest rate, $150 per four weeks, but it charges $1,799 at the start, and if it renews, another $1,799 lands at week 48 — $3,598 inside 52 weeks.

Is Fountain HRT the same as Fountain TRT? Same company, Fountain Vitality, but different programs. FountainTRT is for men. Don't use its prices or state list for the women's program.

Hers is part of Hims & Hers Health, Inc., a publicly traded company. Its menopause page displays a LegitScript seal and describes licensed-provider review. Those facts do not independently verify every clinician's credentials or whether a particular prescription is suitable for you. Hers is run by Hims & Hers Health, Inc., a publicly traded company. It displays a LegitScript seal, and prescriptions come from licensed providers who review your intake.

Will Find My HRT Path choose between Fountain and Hers for me? No. The tool asks about your situation and shows one featured online option or tells you when in-person care should come first. It features a small set of partner providers, so it isn't a ranking of every service.

Can I switch from Fountain to Hers, or the other way? A new provider may accept you after its clinician reviews your history and current prescription, but a transfer is not guaranteed. Bring the product names, doses, forms and pharmacy details, and arrange the next refill before changing services.

Which one will make me feel better fastest? We can't determine that from this documentation review. We did not identify a head-to-head clinical study of Fountain, Hers and Gala; advertised timelines and individual testimonials are not a comparative clinical trial.

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Your next step

If a testosterone assessment is your reason, compare Fountain with Midi's state-specific pathway and your insurance coverage. If you're seeking estradiol and progesterone, compare Hers and Gala on the exact prescription, amount due and renewal terms. If you're still unsure, answer the one question below that's still open for you.

You don't have to choose a subscription today. Pick the question that could still change your decision, and take the step that answers it. Print this or screenshot it for your first consult.

Still unsure which kind of online care fits you? The free Find My HRT Path quiz asks about your symptoms, what you've tried, your age, your state and your health history. It points you to a featured option, with its listed price, or tells you plainly when online care isn't the right place to start. About 60 seconds, no email, and it's care navigation — not a diagnosis.

Already decided? Go straight to the provider that fits you.

Keep reading: Fountain HRT review · Hers menopause cost · Gala Health HRT review · Fountain HRT vs Winona · Fountain HRT vs Midi Health · Best online HRT providers · How Find My HRT Path works · HRT and libido

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Sources

Provider sources — checked October 14, 2026 unless noted

• Fountain HRT — plans, prices, medicines, FAQ: https://fountain.net/hrt
• Fountain telehealth consent (last updated July 24, 2024): https://fountain.net/telehealth-consent
• Fountain return policy (last updated April 3, 2024): https://fountain.net/return-policy
• Fountain terms of use (read October 14, 2026): https://fountain.net/terms
• Hers menopause: https://www.forhers.com/menopause
• Hers, "Does Insurance Cover HRT for Menopause?" (updated December 23, 2025): https://www.forhers.com/blog/does-insurance-cover-hrt
• Hims & Hers refund help article: https://support.hims.com/hc/en-us/articles/360031526911-What-is-your-refund-policy
• Hims & Hers menopause launch announcement, October 15, 2025: https://www.businesswire.com/news/home/20251015848037/en/Hers-Launches-Menopause-and-Perimenopause-Specialty-Taking-the-Next-Step-Toward-$1B-of-Hers-Revenue-in-2026
• Hers terms and conditions: https://www.forhers.com/terms-and-conditions
• Hers telehealth consent: https://www.forhers.com/telehealth-consent
• Hers-linked Bionpharma oral micronized progesterone label, ANDA200900 (product-record example, not a dispensing guarantee or a substitute for a current patient label): https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=3acad9b0-7ec6-4d5e-9852-32ffadbbed6d
• Gala Health hormone health: https://galahealth.co/hormone-health
• Gala Health HRT offer: https://galaglp1.com/lp/hrt1
• Gala Health HRT page with compounded-drug notice: https://galaglp1.com/lp/hrt
• Gala Health refund policy (last updated February 2026): https://galahealth.co/refund-policy
• Midi Health pricing and insurance (read October 14, 2026): https://www.joinmidi.com/pricing-insurance
• Midi Health, requirements for a testosterone prescription (read October 14, 2026): https://joinmidi.zendesk.com/hc/en-us/articles/27718891440667-What-is-required-to-get-a-prescription-for-testosterone
• Gennev insurance and pricing (read October 14, 2026): https://gennev.com/patients/insurance-pricing/
• Alloy hormone-product menu (read October 14, 2026): https://www.myalloy.com/solutions
• Reuters, April 22, 2026: dated reporting of Hers’ patch-inventory statement, not current inventory proof: https://www.reuters.com/legal/litigation/hims-hers-expands-into-menopause-care-estrogen-patch-demand-rises-2026-04-22/
• Fountain Trustpilot company profile: service-only September 2, 2026 account, read on the merged profile; no clinical score inferred: https://www.trustpilot.com/review/fountain.net

Medical and regulatory sources

• FDA, compounding questions and answers: https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers
• FDA, labeling changes for menopausal hormone therapy products (February 12, 2026): https://www.fda.gov/news-events/press-announcements/fda-approves-labeling-changes-menopausal-hormone-therapy-products
• FDA, estradiol transdermal patch availability update (September 3, 2026): https://www.fda.gov/drugs/drug-alerts-and-statements/fda-update-estradiol-transdermal-patch-availability
• FDA, public meeting on testosterone use in menopausal women (September 17, 2026): https://www.fda.gov/consumers/womens-health-events/fda-public-meeting-testosterone-use-menopausal-women-09172026
• DEA, drug scheduling: https://www.dea.gov/drug-information/drug-scheduling
• Federal Register, fourth temporary extension of controlled-medication telemedicine flexibilities, published December 31, 2025; effective January 1–December 31, 2026: https://www.federalregister.gov/documents/2025/12/31/2025-24123/fourth-temporary-extension-of-covid-19-telemedicine-flexibilities-for-prescription-of-controlled
• Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019), readable full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC6821450/
• ISSWSH clinical practice guideline for systemic testosterone for HSDD in women (2021): https://pmc.ncbi.nlm.nih.gov/articles/PMC8064950/
• ACOG, compounded bioidentical menopausal hormone therapy (2023; reaffirmed 2026): https://www.acog.org/clinical/guidance/clinical-consensus/2023/11/compounded-bioidentical-menopausal-hormone-therapy/
• The Menopause Society, hormone therapy: https://menopause.org/patient-education/menopause-topics/hormone-therapy
• The Menopause Society, practitioner directory: https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx
• NICE, menopause identification and management, sections 1.3, 1.5 and 1.8 (updated April 15, 2026): https://www.nice.org.uk/guidance/ng23/chapter/recommendations
• British Menopause Society, Progestogens and endometrial protection (May 2026), page 1: https://thebms.org.uk/wp-content/uploads/2026/05/14-NEW-BMS-TfC-Progestogens-and-endometrial-protection-MAY2026-A.pdf

The HRT Index is an independent editorial publication, not a healthcare provider, pharmacy or telehealth service. This page is educational and isn't medical advice. Talk with a licensed clinician before starting, stopping or changing hormone therapy. Found something out of date? Email partners@thehrtindex.com, and we'll log the correction.