Hers vs Sesame HRT: One Bundle vs Your Own Clinician and Pharmacy

Affiliate disclosure: We may earn a commission if you start with Hers or Sesame through our links. We earn from both. That does not change what we found or what we recommend.

Hers vs Sesame HRT comes down to the care model. Sesame is better if you want a clinician you choose, video visits, ordered labs, and a local pharmacy. Hers is better for asynchronous intake and medication delivery. Sesame shows $54–$59/month ($49 for Costco members) before medication; Hers starts at $79/month on a 12-month oral plan, medication included.

Here’s the thing nobody tells you clearly: the number on the page is not the whole decision. Hers bundles care, medication, and delivery but publishes its starting prices one layer away from the menopause storefront. Sesame publishes a lower care fee, then sends the prescription to your pharmacy, where medication becomes a separate cost.

That difference drives almost everything else — insurance, total cost, appointment format, cancellation risk, and whether you are buying a box or buying continuing access to a clinician.

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.

Best for / not for you

Hers is likely your fit if…	Sesame is likely your fit if…
You want medication delivered instead of picking it up	You want to choose your clinician and meet by video
You would rather complete an online intake than schedule a visit	You want five basic lab panels included when ordered, subject to state exceptions
You want an estradiol pill or patch, progesterone, and vaginal estradiol cream available through one program	You want your prescription sent to a local pharmacy, where drug coverage may apply
You want one bundled starting price	You want a broader published medication list, including Bijuva, Intrarosa, ospemifene, and nonhormonal options
You are comfortable confirming the exact product, formulation, billing cadence, and amount due during checkout	You are comfortable paying for medication separately and confirming your exact subscription offer

Neither is the right answer for every situation. Sesame’s terms exclude Medicare, Medicaid, and TRICARE beneficiaries. Hers operates on a cash-pay basis outside federal, state, and commercial insurance programs. Neither menopause program lists testosterone. Unexplained bleeding after menopause needs prompt medical evaluation, and a history of breast or uterine cancer, blood clots, stroke, cardiovascular disease, or liver disease may change whether systemic hormone therapy is appropriate.

Hers vs Sesame HRT at a glance

Every row below is labeled by what the source actually establishes. “Verified first-party” means the fact appears on a current company page or its legal terms. “Calculated” means The HRT Index performed the arithmetic from published rates. “Confirm before payment” means the company does not publicly resolve the detail for a menopause customer.

What you are deciding	Hers	Sesame	Evidence status
Published care price	Oral medication starts at $79/month; patches start at $134/month, both with a 12-month plan	Current public surfaces show $54–$59/month; eligible Costco members are shown $49/month	Verified first-party public surfaces; exact checkout total must be confirmed
Is medication included?	Yes when filled through a platform pharmacy under the standard bundled model	No; medication is billed separately by the pharmacy	Verified first-party
First clinical step	Online intake reviewed by a licensed provider	Questionnaire, clinician selection, then video visit	Verified first-party
Choose your clinician?	No public clinician-selection directory for the menopause program	Yes, from named provider profiles	Verified first-party
Basic labs included?	The public menopause flow does not list included labs	Yes, if ordered: CBC, A1c, thyroid function, lipid panel, and comprehensive metabolic panel; state exceptions apply	Verified first-party
Can insurance help with medication?	Not in the normal cash bundle; Hers’s terms permit certain prescriptions to be sent to an outside pharmacy, but menopause availability and bundle-price changes are not published	Potentially; the prescription goes to a local pharmacy and drug coverage may apply	Verified first-party plus confirm before payment
Medicare / Medicaid / TRICARE	Cash basis outside federal and state programs; Hers does not submit claims	Terms require the user to certify that she is not a federal health-program beneficiary	Verified first-party
Cancellation deadline	At least 2 days before the applicable renewal processing date	Up to 48 hours before the applicable renewal processing date	Verified first-party
Partial-period refund	Hers says it does not offer refunds for partially used subscription periods except at its discretion	No prorated monthly refund; prepaid multi-month plans use a published repricing formula	Verified first-party
FDA-approved or compounded?	Hers’s patient guide says a plan may contain commercially available medication, custom-compounded medication, or both	Sesame lists commercial products and generics, and separately says compounded BHRT may be prescribed	Verified first-party; exact dispensed product must be checked
Testosterone	Not listed in Hers’s menopause program	Not available through the online program because Sesame says its providers cannot prescribe controlled substances online	Verified first-party
State availability	Hers says treatment is not available in all 50 states; no menopause state list is published	Provider availability depends on licensure and location; no complete menopause state list is published	Confirm during intake

A blank, a range, or “confirm before payment” is intentional. We do not turn missing data into an estimate.

The right online HRT provider isn't the same for every woman — it depends on your symptoms, your age and whether you have a uterus, your medication route preference (patch, pill, gel, or vaginal estrogen), your risk history, your insurance or cash-pay situation, and your state. Some situations belong with an in-person clinician first. Because a general answer can't resolve those for you, use The HRT Index's Find My HRT Path tool to match your situation to the right provider — and to flag when online care isn't the right starting point — before your first consult.

Does one model already sound like your situation? If you want an asynchronous intake and delivered medication, check Hers eligibility and availability (sponsored link). If you want to choose a clinician and send the prescription to your pharmacy, see Sesame’s current menopause subscription (sponsored link).

A licensed clinician decides whether treatment and any prescription are appropriate. Completing an intake or booking a visit does not guarantee a prescription.

Hers vs Sesame HRT: which one is better?

Sesame is the stronger default for women who value clinician choice, a live visit, ordered basic labs, and pharmacy flexibility. Hers is the stronger convenience choice for women who value an asynchronous process, delivery, and one bundled starting price. Neither wins every category, and the cheapest choice changes with medication route and pharmacy cost.

That sounds less dramatic than declaring one universal winner. It is also the answer the evidence supports.

Hers is built around the bundle. You complete an online intake. A licensed provider trained in women’s health reviews it. If prescribed, medication is delivered. Hers publicly presents a kit with three potential parts: an estradiol pill or patch, a progesterone pill, and estradiol vaginal cream. Ongoing provider messaging and treatment adjustments are included.

Sesame is built around continuing clinician access. You complete a questionnaire, choose from named provider profiles, attend a video visit, and receive prescriptions at your preferred pharmacy. Basic lab work is included when the clinician orders it, with payment and laboratory exceptions in specific states. Medication is not included in the subscription fee.

If this matters most	Better fit	Why
Medication delivered	Hers	Platform-pharmacy fulfillment is part of the bundle
Talking to a clinician live before treatment	Sesame	The published flow includes a video visit
Choosing who treats you	Sesame	Named clinician profiles are visible before booking
Vaginal estradiol cream in the same program as systemic treatment	Hers	Hers lists it as one of the kit’s three possible parts
Five basic lab panels when ordered	Sesame	Included subject to state-specific exceptions
Using a local pharmacy or possible drug coverage	Sesame	Prescriptions are sent to the pharmacy you choose
One bundled starting price	Hers	Care, platform-pharmacy medication, and delivery are combined
Bijuva, Intrarosa, ospemifene, or listed nonhormonal options	Sesame	Sesame publishes the broader medication menu
Avoiding a scheduled video appointment	Hers	The standard public flow is asynchronous intake and provider review

Now let’s do the part both models make easy to misunderstand: the money.

What does Hers actually charge for menopause treatment?

Hers publishes two menopause starting rates in its own insurance guide: oral medication starts at $79/month and patches start at $134/month, both with a 12-month plan. Those figures include medication under the standard platform-pharmacy model, but they are “starting at” prices—not a guaranteed quote for every treatment combination.

The current Hers menopause page does not print a dollar amount in its main sales copy. The figures appear in Hers’s official insurance guide, updated December 23, 2025.

Read the language carefully:

• Oral medications start at $79/month with a 12-month plan.
• Patches start at $134/month with a 12-month plan.
• Hers says it offers other subscription models and price points, but it does not publish the menopause-specific month-to-month rate, exact billing cadence, or exact amount due today on the public storefront.

Write down three numbers, not one

This is the habit that prevents most subscription-price surprises:

1. The advertised monthly equivalent
2. The plan length
3. The amount charged to your card today

Those are not interchangeable. A $79 monthly equivalent attached to a 12-month plan does not establish that you can buy one month for $79 or that your card will be charged only $79 at checkout.

Hers route	Published starting monthly equivalent	Published plan term	12-month starting total, calculated
Oral medication	$79	12 months	$948
Patch	$134	12 months	$1,608

What Hers does not publicly settle for a menopause customer:

• The exact amount charged at checkout
• The month-to-month rate
• Whether the progesterone pill or vaginal estradiol cream changes the quoted price
• Whether the exact product dispensed will be commercially available, custom compounded, or a combination
• Whether choosing an outside pharmacy changes the bundled platform price

That is not a reason to reject Hers. It is a reason to screenshot the checkout and get those answers before you submit payment.

What does Sesame actually charge for its menopause subscription?

Sesame’s current public menopause pricing is internally inconsistent: the service page’s search-facing metadata shows “from $54/month,” while the same page and first-party menopause content also show $59/month. Its Costco page lists $49/month for eligible members. Medication is separate at every rate.

Sesame currently exposes both $54 and $59 on first-party public surfaces for the same menopause program. Its search-facing service-page title has appeared as “from $54/month,” while the page copy, provider profiles, and menopause articles show $59/month. Its Costco member perks page lists $49/month for eligible members. Because those figures do not resolve to one standard offer, the exact checkout amount must be confirmed.

Sesame price	Who it applies to	What is included	What is separate
$54–$59/month	Current non-Costco public surfaces; exact offer must be confirmed	Provider selection, video visits as needed, unlimited messaging, treatment adjustments, and included basic labs when ordered subject to state exceptions	Medication at the pharmacy
$49/month	Eligible Costco members after membership verification	The women’s-health subscription benefit described by Sesame	Medication at the pharmacy

The draft treated $99/month as the number to plan around. That was based on an older launch-era figure and is not the current public menopause rate. It does not belong in a 2026 cost verdict.

The part we still have to say out loud

Sesame describes its pricing as transparent and upfront. Its own current public surfaces still expose two non-Costco monthly figures, and the complete treatment cost cannot be known from the subscription number alone because the drug is a separate pharmacy charge. The final cost depends on the prescription, pharmacy, insurance, discount-card eligibility, and state-specific lab rules.

That is not the same problem Hers has. Hers makes the bundle hard to price before checkout. Sesame makes the all-in treatment cost impossible to know until the prescription reaches the pharmacy.

If seeing a complete number before sharing medical information is your top priority, neither model fully solves that. Wisp’s current menopause consult page publishes $99 for a consult plus three months of care-team access, with medication paid separately at a local pharmacy. Wisp does not pay us for that mention.

Sesame’s trade is different: you are paying for clinician choice, visits, messaging, ordered basic labs, and medication management. The prescription remains outside the subscription, which creates uncertainty but also preserves pharmacy choice.

If that is the trade you want: see Sesame’s current plan and what it includes (sponsored link). Medication is billed separately at the pharmacy.

Which is cheaper—Hers or Sesame HRT?

Hers is not automatically cheaper, and Sesame is not automatically cheaper. The answer depends on route and pharmacy cost. At current public rates, Sesame’s non-Costco care fee is $240–$300/year below Hers’s oral starting total and $900–$960/year below Hers’s patch starting total—but Sesame still has to add medication.

The cleanest comparison is not a discount-card snapshot that can change tomorrow. It is the medication-cost break-even point: how much can the pharmacy medication cost each month before Sesame becomes more expensive than Hers’s published starting rate?

The HRT Index 12-month break-even model

Calculated—not a provider quote. The table uses Hers’s published 12-month starting rates and Sesame’s current public $54 and $59 figures plus its $49 Costco rate. It assumes no added fees and does not predict what a clinician will prescribe.

Route and Sesame tier	Hers published 12-month starting total	Sesame 12-month care fee	Medication can average up to this amount before Sesame reaches the Hers starting total
Oral route vs Sesame at $54	$948	$648	$25/month
Oral route vs Sesame at $59	$948	$708	$20/month
Oral route vs Sesame Costco at $49	$948	$588	$30/month
Patch route vs Sesame at $54	$1,608	$648	$80/month
Patch route vs Sesame at $59	$1,608	$708	$75/month
Patch route vs Sesame Costco at $49	$1,608	$588	$85/month

The arithmetic is simple:

• Oral, Sesame at $54: ($948 − $648) ÷ 12 = $25/month
• Oral, Sesame at $59: ($948 − $708) ÷ 12 = $20/month
• Oral, Costco Sesame: ($948 − $588) ÷ 12 = $30/month
• Patch, Sesame at $54: ($1,608 − $648) ÷ 12 = $80/month
• Patch, Sesame at $59: ($1,608 − $708) ÷ 12 = $75/month
• Patch, Costco Sesame: ($1,608 − $588) ÷ 12 = $85/month

What that means in real life

Going oral? Hers’s $79 starting rate is hard for Sesame to beat unless your combined pharmacy cost stays below $20–$25/month at the current non-Costco public rates or below $30/month with Costco pricing. Insurance may make that possible. Cash pharmacy pricing may not.

Going patch? Sesame has much more room. Its medication can cost up to $75–$80/month at the current non-Costco public rates—or $85/month at the Costco rate—before total annual spending reaches Hers’s published $134 patch starting price.

But do not turn the break-even point into a promise. Hers’s figures are starting rates. Sesame’s prescription cost depends on what is ordered. Exact billing cadence, taxes, shipping, state, and pharmacy pricing may change the result.

The 90-day view, without fake 90-day pricing

Model	Three-month arithmetic	What it does—and does not—mean
Hers oral	$237 monthly equivalent	Three months of the $79 rate; not proof that Hers sells a cancellable three-month plan at this amount
Hers patch	$402 monthly equivalent	Three months of the $134 rate; not proof of the checkout charge or a three-month plan
Sesame at $54	$162 care fee	Three monthly care fees before medication
Sesame at $59	$177 care fee	Three monthly care fees before medication
Sesame Costco	$147 care fee	Three monthly Costco care fees before medication

The draft’s volatile GoodRx examples created false precision. The break-even model is more useful because a reader can insert her own pharmacy quote or insurance copay and know immediately which side is cheaper.

Can you use insurance with Hers or Sesame?

Neither company bills insurance for the menopause-care subscription. The medication is where the models split: Sesame sends the prescription to a local pharmacy, so your drug benefit may apply. Hers normally includes medication in a cash bundle, although its terms permit certain prescriptions to be sent to an outside pharmacy.

There are three separate questions:

1. Is the visit or subscription covered? Neither company submits the menopause-care fee to insurance.
2. Can the drug benefit cover the prescription? Potentially at Sesame because the prescription goes to a pharmacy you choose. Potentially through Hers only if the specific prescription can be routed outside the bundle.
3. Does the bundle price change if Hers sends the prescription elsewhere? Hers does not publish that answer for menopause.

The Hers outside-pharmacy clause most comparisons miss

Hers’s Terms and Conditions, last updated August 7, 2026, say certain prescriptions may be filled at any pharmacy the patient chooses when the platform offers that option or after a request to customer support. The patient then pays that pharmacy directly.

That is a real opening—not a guarantee. The terms do not say every menopause prescription qualifies, and they do not explain whether the Hers subscription price falls when medication is removed from platform fulfillment.

Ask this before paying:

“Can this exact menopause prescription be sent to my local pharmacy, and what will the Hers charge become if I pay the pharmacy separately?”

HSA and FSA: Sesame’s own pages do not fully agree

Sesame’s menopause FAQ says most included services may qualify for HSA or FSA reimbursement and says it can provide an itemized bill. Sesame’s general terms say subscription fees are not covered under most health-insurance or healthcare-benefit plans, including many HSAs and FSAs.

The safe wording is: reimbursement may be available; confirm with your plan administrator before relying on it.

Hers does not publish a menopause-specific HSA/FSA determination. Treat it the same way: ask the account administrator, keep the receipt, and never assume “eligible” means the plan must reimburse it.

If keeping the drug at your own pharmacy is the deciding factor: check Sesame’s current availability and subscription (sponsored link).

Can you use Hers or Sesame with Medicare, Medicaid, or TRICARE?

Sesame and Hers do not have the same rule. Sesame’s terms require users to certify that they are not Medicare, Medicaid, or TRICARE beneficiaries. Hers’s terms do not state that beneficiary ban; instead, Hers says its services are cash-pay outside federal, state, and commercial insurance programs.

That correction matters.

Sesame

Sesame’s terms say the user certifies that she is not a federal healthcare-program beneficiary and state that Sesame does not accept Medicare, Medicaid, or third-party insurance. Under those terms, Sesame is not the route for a Medicare, Medicaid, or TRICARE beneficiary.

Hers

Hers says Hims & Hers and its medical groups are not enrolled in federal or state healthcare programs or commercial insurance. By using the service, the customer chooses cash payment outside those programs and is responsible for the cost.

That means:

• Hers will not submit the care or platform-pharmacy product to Medicare, Medicaid, TRICARE, or commercial insurance.
• You should not expect reimbursement.
• A beneficiary should confirm that cash purchase is permitted under her plan and that no coordination issue applies to the specific prescription.

The draft said both companies categorically exclude all federal-program beneficiaries. That was too broad for Hers and could send a reader away from an option its own terms do not ban.

For covered care, start with an in-network primary-care clinician, OB/GYN, or a practitioner in The Menopause Society’s directory. Your plan’s drug benefit may cover commercial generic estradiol or progesterone even when a cash telehealth bundle does not.

Find My HRT Path also flags insurance and federal-program fit before you enter a card.

What can Hers and Sesame actually prescribe?

Hers publishes a focused three-part menopause kit: an estradiol pill or patch, a progesterone pill, and estradiol vaginal cream. Sesame publishes a broader menu of hormonal and nonhormonal options. A medication appearing on either page does not guarantee that a clinician will prescribe it.

Medication category	Hers publishes	Sesame publishes
Systemic estrogen	Estradiol pill or patch	Estradiol, with Estrace, Climara, and Divigel named as examples
Progestogen	Progesterone pill	Progesterone products and combined estrogen-progestogen products
Combined product	None listed	Prempro, Bijuva, Mimvey
Local vaginal treatment	Estradiol vaginal cream	Intrarosa (prasterone); estradiol vaginal cream is not named on the main menopause list
Nonhormonal options	None listed in the menopause kit	Gabapentin, clonidine, paroxetine, sertraline, trazodone, ospemifene
Bone / skin / hair options	Not part of the published kit	Vitamin D, calcium, alendronate, risedronate, and minoxidil are listed
Testosterone	Not listed	Not available online under Sesame’s controlled-substance policy

The Bijuva fork

Bijuva is an FDA-approved capsule containing estradiol and progesterone. Sesame names it in its published medication list. Hers does not list a combined estrogen-progesterone product.

That does not mean every Sesame clinician will prescribe Bijuva or that it will be covered. It means the published Sesame formulary gives a reader seeking a one-capsule commercial product a path Hers does not publicly show.

The vaginal-treatment fork

Hers places estradiol vaginal cream inside the same published program as systemic estradiol and progesterone. That can be useful for a woman whose hot flashes and vaginal symptoms both need attention.

Sesame’s main menopause list names Intrarosa, a prescription vaginal prasterone insert, but does not name estradiol vaginal cream. A Sesame clinician may have other options, but the public page does not establish them.

The peanut-allergy fork

Hers’s patient drug guide warns that the progesterone capsules described in that guide should not be used by someone allergic to peanuts or peanut oil. Do not turn that into the broader claim that every micronized progesterone product contains peanut oil.

A peanut allergy is a reason to tell the prescriber and ask for the exact product and excipients before the prescription is finalized. Sesame’s wider list may give a clinician more published alternatives, but the clinician still has to decide what is safe and appropriate.

Testosterone: neither program is the route

Testosterone is a Schedule III controlled substance in the United States. Hers does not list it in its menopause program. Sesame says providers on its platform cannot prescribe controlled substances online.

That does not mean federal law requires every testosterone prescription to begin in person under every circumstance. Telemedicine rules and state law can permit remote controlled-substance prescribing when their conditions are met. It means these two programs do not offer the route. You need a licensed prescriber and service that can legally prescribe and monitor it.

Are Hers and Sesame medications FDA-approved or compounded?

Neither telehealth platform is “FDA-approved.” FDA approval applies to specific drug products. Hers says a treatment plan may contain commercially available medication, custom-compounded medication, or both. Sesame lists commercial products and generics, while separately stating that compounded BHRT may be prescribed.

The categories must stay separate.

FDA-approved drugs

An FDA-approved drug has been reviewed for safety, effectiveness, and manufacturing quality for its approved use. Commercial estradiol and progesterone products can be FDA-approved even when they are described as “bioidentical.” Bioidentical does not automatically mean compounded.

Compounded drugs

Compounded drugs are not FDA-approved. The FDA states that it does not verify their safety, effectiveness, or quality before they are marketed. Compounding can serve an individual need when an approved product cannot meet it, such as an allergy to an inactive ingredient or a needed dosage form that is not commercially available.

A compounded product must not be described as equivalent to an approved product, “clinically proven,” or automatically safer or more natural.

What Hers discloses

Hers’s commercial estradiol and progesterone patient guide, updated October 15, 2025, says the plan may include commercially available medications, custom-compounded medications, or a combination. It tells the patient to inspect the label to determine what was dispensed.

Hers’s terms name platform pharmacies that include traditional and compounding operations, and say prescriptions may be transferred among platform pharmacies without notice. That does not prove you will receive a compounded medication. It proves the formulation category is not settled by the sales page.

What Sesame discloses

Sesame names commercial products and generics on its menopause page. It also says compounded bioidentical hormone therapy may be prescribed if a clinician considers it appropriate and acknowledges that compounded BHRT is outside FDA approval and standardization.

Again: the list is not a guarantee, and “BHRT” is not a synonym for compounded medication. Ask for the actual product.

How to verify what you are receiving

Do not rely on an NDC number alone as proof of FDA approval. Ask for:

1. The exact product name
2. The manufacturer or compounding pharmacy
3. The dosage form and strength
4. The NDC, if one is assigned
5. Whether the product appears in FDA’s Drugs@FDA database or an official commercial label
6. Whether the label explicitly says “compounded”

A custom-compounded product can be clinically appropriate for an individual need. It is still not FDA-approved and should never be presented as interchangeable with an approved drug.

Are labs included with Hers or Sesame?

Sesame includes five basic lab panels when a clinician orders them: CBC, hemoglobin A1c, thyroid function, lipid panel, and comprehensive metabolic panel. Hers’s public menopause flow does not list included labs. Sesame has specific laboratory and payment exceptions in nine states.

State	Sesame lab arrangement
Most states	Order goes to Quest Diagnostics and is included when ordered
Arizona, Oklahoma, South Dakota, Wisconsin	Order goes to LabCorp
Hawaii	Order goes to Clinical Labs of Hawaii
New York, New Jersey, Rhode Island	Order goes to Quest, but the patient pays Quest directly
North Dakota	Patient may use any lab and pays the lab directly

Sesame also lets patients upload existing results. The clinician decides whether they are recent and relevant enough to use.

Included labs are useful—but they are not a hormone-panel requirement

Routine blood hormone testing is not usually required to diagnose the typical menopause transition. The federal Office on Women’s Health explains that hormone levels fluctuate unpredictably during perimenopause, making a single test hard to interpret. Testing may be appropriate for a medical reason, including periods stopping unusually early or symptoms that need another explanation.

Sesame’s included panels are not a routine estradiol-or-FSH panel. They can help a clinician look for conditions that mimic or complicate menopause symptoms, such as anemia, thyroid dysfunction, diabetes risk, lipid changes, or kidney and liver issues.

That can be valuable if you have not had primary-care bloodwork in years. It may add little if the same tests were recently completed and your clinician accepts them.

Want to know the exact lab rule before committing? Check Sesame’s current menopause program and ask how your state is handled (sponsored link).

Which is better if you do not want a video call?

Hers is the clearer fit if avoiding a scheduled video visit matters. Its published menopause flow uses an online intake followed by provider review. Sesame’s flow includes a video visit with the clinician you choose, followed by video care and messaging as needed.

A video call is not automatically better care for every woman.

If you want to explain symptoms out loud, answer follow-up questions in real time, and see the person treating you, Sesame’s scheduled visit is a real advantage.

If you work shifts, share a home without privacy, sit in an open office, or have delayed care because getting on camera feels like one more impossible task, an asynchronous intake is not a consolation prize. It may be the model that gets the intake finished.

One disclosure about Hers messaging

Hers describes ongoing support as unlimited provider messaging, regular check-ins, and treatment adjustments. Its terms also say artificial intelligence may be used to draft customer-care or clinician messages for review. Hers states that AI is not used to make clinical decisions and that care-team messages are reviewed and approved by a licensed professional before being sent.

That is not evidence that the care is unsafe. It is a material process disclosure about what “provider messaging” can include.

If a form beats a scheduled call for you: check Hers eligibility and state availability (sponsored link). A provider decides whether treatment is appropriate.

Can you choose your own clinician with Hers or Sesame?

Sesame lets you browse named clinicians and choose one. Hers assigns a licensed provider through its menopause flow and does not publish a comparable selection directory. This is Sesame’s cleanest advantage for a reader who wants to see credentials before committing.

Sesame displays provider photographs and credentials that may include MD, DO, NP, PA-C, DNP, FNP, or APRN designations. Availability depends on state licensure and scheduling.

Hers says its providers are trained in women’s health. Its public menopause program features Dr. Jessica Shepherd, a board-certified OB/GYN and company medical leader, but the expert who represents a program is not necessarily the clinician assigned to an individual patient.

Neither company’s public menopause storefront promises that every treating clinician holds The Menopause Society’s MSCP credential. If menopause-specific certification matters to you, ask for the treating clinician’s name and credentials before the first paid step.

What should you know about the FTC lawsuit against Hims & Hers?

On July 29, 2026, the Federal Trade Commission, Utah, and California through Los Angeles County Counsel sued Hims & Hers Health in federal court. The complaint alleges deceptive billing and cancellation practices and unlawful sharing of sensitive health information. These are allegations, not findings. The case is pending, and Hims & Hers denies them.

This is material to a Hers buying decision, so it belongs on the page. It also needs proportion.

What the FTC alleges

According to the FTC’s case announcement and complaint, the plaintiffs allege that Hims & Hers:

1. Collected payment information while presenting intake language that led consumers to expect a consultation and no charge unless medication was prescribed
2. Enrolled many consumers into recurring prescription plans shortly after intake without a meaningful opportunity to review or approve the treatment
3. Failed to disclose refill timing clearly enough for consumers to cancel before another charge
4. Made online cancellation difficult to find
5. Shared sensitive health information with advertising platforms including Meta and Snap despite privacy assurances

The complaint invokes the FTC Act, the Restore Online Shoppers’ Confidence Act, and state consumer-protection laws. The FTC says the case will be decided by the court.

What Hims & Hers says

In its official response, Hims & Hers calls the suit baseless, says the FTC ignored evidence and applicable telehealth standards, and says it will defend the case vigorously.

What this does—and does not—establish

The complaint concerns the broader Hims & Hers platform. It does not establish that the menopause program caused the alleged conduct, and it is not a finding about the quality of menopause medication or clinical decision-making.

It does change what a careful customer should document at checkout.

The Hers menopause page currently uses the button text “Begin free consult.” The FTC complaint challenges “free” consultation and billing representations elsewhere on the platform. That overlap is not proof of a violation in the current menopause flow. It is a reason to ask exactly what is free and when a charge becomes final.

Six things to do before paying either company

1. Screenshot the page showing the price, plan term, and amount due today.
2. Write down the monthly equivalent, total commitment, and billing cadence separately.
3. Put the contractual cancellation deadline and a conservative reminder in your calendar.
4. Cancel in writing and save the confirmation, even when you also use an account button.
5. Ask when the first renewal can be processed and which date controls the cancellation deadline.
6. Review the privacy controls and avoid entering more information than the intake actually requires.

Does the lawsuit automatically disqualify Hers? In our editorial judgment, no. It is a serious pending consumer-protection case, not a final finding and not a medication-safety action. It is also a reasonable reason to prefer Sesame if billing or privacy friction is your deciding concern.

What happens if you want to quit in month three?

Hers and Sesame both require advance cancellation, but Sesame publishes a formula for prepaid multi-month plans. Hers says partially used subscription periods are not refundable except at its discretion. Hers requires cancellation at least two days before the renewal processing date; Sesame requires up to 48 hours.

We read both current contracts side by side. Hers’s terms were last updated August 7, 2026. Sesame’s were last updated August 11, 2026.

The question you would actually ask	Hers	Sesame
How early must I cancel?	At least 2 days before the applicable renewal processing date	Up to 48 hours before the applicable renewal processing date
How do I cancel?	In app, online account under “My Subscriptions,” Help Center, or phone	Terms name email or phone; menopause FAQ says self-cancel is available
Can a renewal charge early?	Yes. The first renewal may charge early; later renewals may charge up to 2 days early	No comparable menopause-specific early-charge clause identified
Refund for a partly used recurring period?	No, except at Hers’s discretion	No prorated refund for the current monthly or annual term
Prepaid multi-month cancellation	No menopause-specific refund formula published	Used months are repriced at the current standard monthly rate; remaining balance, if any, is refunded
Initial full-refund window	No menopause-specific public rule identified	Cancel at least 3 hours before the initial visit

Sesame’s multi-month formula

If you cancel a discounted prepaid multi-month plan early, Sesame’s terms say each month used—including a partial active month—is repriced at the then-current standard month-to-month rate. Any balance left after that adjustment is refunded. The terms warn that the recalculated value can equal or exceed the amount paid, which means no refund may remain.

That is not generous in every case. It is calculable.

The Hers early-renewal warning, stated accurately

Hers’s general subscription terms contain two separate rules:

• Cancel at least 2 days before the applicable renewal processing date.
• The first renewal may be charged early; later renewals may be charged up to 2 days early.

The contract does not say that every menopause customer’s legal deadline is four days before the date shown in the account. Our four-day reminder is a conservative operational buffer, not a contractual rule.

The reason for the buffer is simple: if the account displays a scheduled date but processing may begin early, waiting until two calendar days before the displayed date can create avoidable ambiguity. Check the actual renewal-processing date in the account and ask support which date controls.

Hers includes an “originally scheduled billing date” clarification in its weight-loss section. That sentence is not repeated in the general subscription section governing other programs. We are not claiming that Hers applies a different rule to menopause. We are saying the general section does not give menopause customers the same written clarification.

Sesame’s cancellation-channel contradiction

Sesame’s menopause FAQ says you can self-cancel. Its terms tell members to cancel by email or phone. Both were live when we verified this page.

Find the account control before you need it. If it is not present, email support and keep the reply.

What fine print matters before you choose?

The storefronts explain the care model. The contracts explain the operational risk: who can fill the prescription, whether AI may help draft messages, whether packaging is child-resistant, and how disputes are handled. These facts do not decide the medical choice, but they can decide whether the service fits your household and tolerance for subscription friction.

Fine-print issue	Hers	Sesame
Prescription fulfillment	Six platform pharmacies are named; prescriptions may transfer among them without notice	Menopause prescriptions are sent to the patient’s chosen local pharmacy
Child-resistant packaging	Terms say not every platform-pharmacy prescription uses child-resistant packaging	Packaging is determined by the retail pharmacy
AI in communications	AI may draft customer-care or clinician messages for licensed review; Hers says AI does not make clinical decisions	No equivalent menopause-specific drafting disclosure identified in the materials reviewed
Arbitration	Binding arbitration through NAM, class-action waiver, 30-day opt-out after first becoming subject to the agreement	Binding arbitration through AAA, class-action waiver, and a 60-day pre-arbitration notice process
Governing law	California	New York

The child-resistant packaging line is not trivia

Hers’s terms state that not all platform-pharmacy prescriptions use child-resistant packaging. If children or grandchildren are in your home, ask what container will arrive and plan storage before delivery.

The arbitration opt-out

Hers’s current terms give a person 30 days after first becoming subject to the arbitration agreement to mail an individually signed opt-out notice. Sesame’s terms contain arbitration and a class-action waiver but describe a 60-day notice-and-resolution process rather than a comparable opt-out window.

This is not legal advice. It is a reason to read the current dispute section before accepting either contract.

You have now seen the price, care model, pharmacy path, and contract friction. If the bundled asynchronous model still fits, start the Hers eligibility check (sponsored link). If clinician choice and local-pharmacy access win, see Sesame’s current menopause subscription (sponsored link). Still split? Use Find My HRT Path.

What do real customers say?

Sesame publishes menopause-specific patient testimonials on its own page. Hers does not publish a menopause-specific customer-review section on its menopause page. Company-hosted testimonials are useful for understanding the experience being promoted, but they are curated and are not evidence that medication will work for you.

One Sesame-hosted patient says:

“I was able to pick them up from my local Costco in a few hours.” — “Real Sesame patient,” published by Sesame

That supports an operational claim: a prescription reached a local pharmacy quickly in one patient’s experience. It does not prove a typical turnaround time or a medical result.

The fair way to weigh it:

• Sesame selected and published it.
• The patient is not independently identified on the page.
• It describes access and experience, not efficacy or safety.
• It is one experience, not a guaranteed result.
• We may earn a commission from Sesame.

We found no equivalent menopause-specific Hers customer testimonial on Hers’s current program page. We are not going to substitute a weight-loss, skincare, or general-platform review and call it menopause evidence.

When is online care not the right starting point?

Online care can be an appropriate starting point for many menopause symptoms, but it cannot replace every examination or diagnostic test. Bleeding after menopause needs prompt medical evaluation. A complex cancer, clotting, cardiovascular, liver, pregnancy, or unexplained-bleeding history needs individualized review before systemic hormone therapy.

Start with prompt clinical evaluation rather than a routine online HRT checkout when:

• You have vaginal bleeding after 12 months without a period
• You have new unexplained bleeding that has not been evaluated
• You have a history of breast or uterine cancer or another hormone-sensitive tumor and have not coordinated with the relevant clinician
• You have a history of blood clots, stroke, significant cardiovascular disease, or liver disease
• You are pregnant, may be pregnant, breastfeeding, or recently postpartum
• Your main problem is vulvar pain, severe itching, a visible skin change, a lesion, or recurrent infection symptoms that need an examination
• Symptoms are severe, sudden, or accompanied by emergency warning signs

The National Cancer Institute advises women to contact a clinician about bleeding after menopause. Our HRT benefits and risks guide explains the broader treatment trade-offs. The Menopause Society lists unexplained uterine bleeding, breast or uterine cancer, liver disease, blood-clot history, and cardiovascular disease among the histories that can make systemic hormone therapy a poor choice.

That does not mean every woman with a complex history is permanently excluded from all menopause treatment or all telehealth. It means a sales-page intake is not enough to settle the risk.

So which should you choose?

Choose Hers if convenience, asynchronous intake, delivery, and one bundled starting price matter most. Choose Sesame if clinician choice, video access, ordered basic labs, broader published medication options, and a local pharmacy matter most. Choose neither as your first step when you need examination, urgent evaluation, federal-program coverage, or a service that offers testosterone.

Choose Hers if…

• You want medication delivered
• You want a form and provider review rather than a scheduled video visit
• You want estradiol vaginal cream available through the same program as systemic treatment
• You prefer a bundled starting price over a separate care fee and pharmacy bill
• The oral starting-rate math works after you compare it with your pharmacy cost

Confirm before payment: state availability, exact amount due today, billing cadence, total commitment, exact medication, whether it is commercially available or compounded, and what happens to the price if a prescription goes to your own pharmacy.

Choose Sesame if…

• You want to select the clinician treating you
• You want a live video visit
• You want the five published basic lab panels included when ordered
• You want the prescription at your local pharmacy
• Your insurance or pharmacy pricing can keep the medication below the break-even point
• You want a broader published menu that includes Bijuva, Intrarosa, ospemifene, and nonhormonal options
• You prefer a published formula for early cancellation of a prepaid multi-month plan

Confirm before payment: whether your offer is $54, $59, or the eligible Costco $49 rate, medication cost, provider availability in your state, lab payment rules, and the actual cancellation channel in your account.

Choose neither if…

• You are a Medicare, Medicaid, or TRICARE beneficiary and need the service to work within that coverage; Sesame’s terms exclude beneficiaries, and Hers is cash-pay outside those programs
• You want testosterone; neither menopause program offers it
• You need a full all-in price before sharing medical information; Hers requires checkout confirmation and Sesame cannot know the pharmacy bill in advance
• You need an examination or prompt evaluation before treatment
• Your own clinician can prescribe an appropriate commercial medication and your only goal is the lowest possible total cost

That last one is the damaging admission most affiliate pages avoid: a telehealth subscription is not automatically the cheapest way to obtain menopause treatment. An in-network clinician or a single cash visit plus an inexpensive covered generic can cost less. Hers and Sesame earn their fee through convenience, access, continuity, delivery, labs, or clinician choice—not because a subscription is always the lowest price.

Why compounded-primary providers are not the comparison winner here

This page compares two mixed or commercial-product-access models. We also have affiliate relationships with compounded-primary providers, but putting one forward as the automatic winner would collapse a distinction the reader needs to see.

A compounded drug may meet an individual clinical need. It is not FDA-approved and should not be positioned as equivalent to an approved commercial product.

Your move: Check Hers eligibility and state availability (sponsored link) if the bundle fits. See Sesame’s current menopause plan (sponsored link) if clinician choice and your own pharmacy fit. If the answer still depends on symptoms, uterus status, route, risk history, insurance, or state, get your personalized path before paying.

What did The HRT Index actually verify?

We read the live provider pages, patient materials, and legal terms; checked the federal regulatory sources; and rebuilt the price comparison from current published rates. We separated provider statements from our calculations and left unresolved checkout details unresolved. That is the core of The HRT Index Verification Standard.

What we verified	Primary source	Date checked
Hers menopause flow, kit, state disclaimer, and provider messaging	Hers menopause page	August 13, 2026
Hers $79 oral and $134 patch starting rates with 12-month plan	Hers insurance guide	August 13, 2026; article updated December 23, 2025
Hers cancellation, outside-pharmacy, packaging, AI, federal-program, and arbitration clauses	Hers Terms and Conditions	August 13, 2026; terms updated August 7, 2026
Hers commercial/custom-compounded disclosure and medication guidance	Hers patient drug guide	August 13, 2026; guide updated October 15, 2025
Sesame’s $54/$59 public-price inconsistency, care model, medication list, labs, refunds, and safety language	Sesame menopause page	August 13, 2026
Sesame $49 Costco women’s-health offer	Sesame Costco perks page	August 13, 2026
Sesame cancellation, federal-program, HSA/FSA, multi-month refund, and arbitration terms	Sesame Terms of Service	August 13, 2026; terms updated August 11, 2026
FTC allegations, filing date, parties, and pending status	FTC case announcement and federal complaint	August 13, 2026
Hims & Hers response	Company investor statement	August 13, 2026
Compounded-drug FDA status	FDA compounding Q&A	August 13, 2026
Testosterone Schedule III status	DEA drug scheduling	August 13, 2026
Hormone-therapy risk framing and commercial-vs-compounded distinction	The Menopause Society	August 13, 2026
Routine hormone-testing limitation	Office on Women’s Health	August 13, 2026

What is still not publicly established:

• Hers’s menopause-specific month-to-month price and amount due at checkout
• Whether every Hers kit component changes the advertised starting price
• Whether a specific Hers prescription will be commercially available or custom compounded
• Whether an outside-pharmacy request is available for a specific menopause prescription and how it changes Hers’s fee
• A complete state-by-state menopause availability list for either company
• The exact pharmacy cost of a Sesame prescription before the clinician selects it
• Whether every treating clinician holds menopause-specific certification

This page follows The HRT Index Verification Standard: read every published price, separate FDA-approved from compounded, verify state availability and insurance, and re-check on a fixed schedule—top providers monthly and the full roster quarterly. We evaluate providers on five pillars, always in this order: clinical legitimacy, care quality, medication fit, price transparency, access. We do not assign invented numeric scores.

What should you ask before you pay?

The best protection is a written answer tied to your exact offer. Ask about the total charge, plan term, formulation, pharmacy, cancellation date, and what happens if the clinician does not prescribe. These questions turn a sales-page promise into a record you can use.

1. What is the total amount you will charge my card today?
2. What is the plan term, billing cadence, and month-to-month price?
3. What is my exact renewal-processing date?
4. Can a renewal be processed early, and which date controls the cancellation deadline?
5. Where exactly do I cancel, and will I receive written confirmation?
6. What happens to prepaid money if I cancel in month three?
7. Is my exact medication a commercially available FDA-approved product or a custom-compounded drug?
8. What is the product name, manufacturer or compounding pharmacy, strength, and NDC if assigned?
9. Can the prescription go to my own pharmacy, and does the platform charge change if it does?
10. Is medication included or billed separately?
11. Do you serve my state, and is the clinician licensed there?
12. Are labs included, who orders them, and who pays in my state?
13. What am I charged if the clinician decides not to prescribe?
14. Are care-team messages ever drafted with AI assistance before clinician review?

Question 13 protects against paying for a result you assumed was guaranteed. Questions 3 and 4 protect against a renewal date that is not as simple as the monthly number on the sales page.

Related menopause provider comparisons

Compare price structure, medication access, insurance, labs, and cancellation rules before you choose:

• Read the full Hers menopause review
• Read the full Sesame HRT review
• Review alternatives to Hers
• Compare Sesame and PlushCare HRT
• Compare Wisp and Sesame HRT
• Review the best online HRT providers
• Find your best-fit HRT path

Frequently asked questions

Is Hers or Sesame cheaper for HRT?

It depends on route and pharmacy cost. Hers starts at $948 over 12 months for oral medication and $1,608 for patches, medication included under the standard bundle. Sesame’s public non-Costco figures equal $648–$708/year, or $588/year for eligible Costco members, before medication. Sesame beats the Hers oral starting total only if medication stays below roughly $20–$25/month, or $30/month with Costco pricing.

Does Hers include medication in the price?

Yes, under the standard platform-pharmacy model. Hers’s terms say non-weight-loss prescription products filled through its platform pharmacies are included in the total service charge. Certain prescriptions may be sent to an outside pharmacy, where the patient pays separately, but Hers does not publish whether that option applies to a specific menopause prescription or lowers the bundle price.

Does Sesame’s menopause price include medication?

No. Sesame says medication costs are not included and vary by prescription, pharmacy, and insurance status. The subscription covers the care model and included services; the pharmacy bills the medication separately.

Do Hers or Sesame take insurance?

Neither bills insurance for the menopause subscription. Sesame sends the prescription to your chosen pharmacy, so drug coverage may apply. Hers is normally a cash bundle; its terms allow certain prescriptions to be sent to an outside pharmacy, but the menopause-specific pricing effect is not published.

Can I use Hers or Sesame if I have Medicare?

Sesame’s terms require users to certify that they are not Medicare, Medicaid, or TRICARE beneficiaries. Hers does not state the same beneficiary ban, but its care is purchased on a cash basis outside federal, state, and commercial insurance programs. Confirm plan rules before paying cash for any covered prescription or service.

Does Sesame include lab work?

Yes, if the clinician orders it. The published panels are CBC, A1c, thyroid function, lipids, and a comprehensive metabolic panel. Patients in New York, New Jersey, Rhode Island, and North Dakota pay the laboratory directly; different laboratories are used in Arizona, Oklahoma, South Dakota, Wisconsin, and Hawaii.

Does Hers require a video visit?

The standard public menopause flow does not list a scheduled video visit. It describes an online intake followed by licensed-provider review. State or case-specific clinical requirements may change what contact is needed during the actual intake.

Is Hers HRT FDA-approved?

A telehealth service cannot be FDA-approved in the way a drug is. Hers’s own guide says a plan may contain commercially available medication, custom-compounded medication, or both. Commercial products may be FDA-approved; custom-compounded drugs are not. Check the exact product before paying and again when it arrives.

Can I get Bijuva through Hers or Sesame?

Sesame names Bijuva on its current medication list. Hers does not list a combined estradiol-progesterone capsule. The list does not guarantee a prescription; a licensed clinician must decide whether Bijuva is appropriate and whether it is available in your state and pharmacy.

Can I get testosterone from Hers or Sesame?

Neither menopause program offers it. Testosterone is a Schedule III controlled substance. Hers does not list it, and Sesame says its online providers cannot prescribe controlled substances. A patient seeking testosterone needs a licensed prescriber and service able to meet federal and state prescribing and monitoring requirements.

How do I cancel Hers?

Hers says you can cancel in the app, through “My Subscriptions” in the online account, through the Help Center, or by phone. Cancellation must occur at least two days before the applicable renewal-processing date. Because renewals may process early, check the date shown in the account, set an earlier reminder, and keep written confirmation.

How do I cancel Sesame?

Sesame’s terms say to email support or call at least 48 hours before the renewal-processing date. Its menopause FAQ also says self-cancellation is available. For a full first-month refund, the menopause page says to cancel at least three hours before the initial visit starts.

What is the FTC lawsuit against Hims & Hers about?

The FTC, Utah, and California sued Hims & Hers on July 29, 2026. The complaint alleges deceptive billing and cancellation practices and unlawful sharing of sensitive health information with advertising platforms. These are allegations. The case is pending, and Hims & Hers denies wrongdoing.

Which states do Hers and Sesame serve for menopause care?

Neither publishes a complete menopause state list. Hers says treatment is not available in all 50 states. Sesame availability depends on the clinician’s license and the patient’s location. Confirm availability before entering payment information, and do not rely on an undated third-party state count.

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Still not sure which HRT program is right for you? Use Find My HRT Path for a personalized starting point. It also flags when online care is not the right first move.

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Research and verification by The HRT Index Editorial Team. Educational research — not medical advice, and not medically reviewed by a clinician. We may earn a commission from Hers and Sesame when readers use sponsored links; that does not change the findings or verification process. Prices, policies, formularies, state access, and legal proceedings can change. This page was last verified in August 2026 and is re-checked monthly. See our affiliate disclosure, methodology, and medical review policy.