Inner Balance Alternatives: 6 Options Compared, and How to Switch Without a Gap

Among the leading Inner Balance alternatives, the right one depends on why you’re leaving. Choose Hers for shipped FDA-approved medication from $79 a month, Midi Health for insurance, Sesame for live video care, or Winona for an $89 compounded body cream. Nothing replaces Oestra exactly, so your medication route, uterus status, state, and prescription plan decide the safest fit.

We may earn a commission if you start care through some links on this page. Providers do not pay for placement or a better verdict. We earn nothing from Inner Balance.

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.

Is this page for you?

This page is for a woman deciding whether to leave Oestra, what she would actually be replacing, and which care model removes the specific friction that made her search. It is not a dose-conversion guide, and it does not tell anyone to change prescription therapy without a clinician.

This page is for you if	This page is not for you if
You use Oestra and want another route	Oestra is working, the terms still fit, and you are not looking to change
You were about to order and got cold feet	You only want non-hormonal treatment options
You want an FDA-approved manufactured medication instead	You want to change a prescription without a clinician reviewing it
You want insurance, a live visit, clearer dosing, or a lower published price	You have bleeding 12 months or more after your final period — arrange an evaluation before letting a provider comparison delay it

Start here: which Inner Balance alternative fits the reason you are leaving?

The best Inner Balance alternative is not one company for everyone. Hers is the cleanest shipped option for someone prioritizing FDA-approved manufactured medication; Midi Health is the insurance route; Sesame is the live-video route; Winona preserves a one-cream routine but remains compounded. Your own clinician can be the lowest-cost route when covered generics and follow-up are available.

Why you are leaving	Start with	Current published price	The catch
“I want FDA-approved manufactured medication.”	Hers	Oral plan from $79/month; patch plan from $134/month, each tied to a 12-month plan	The public page does not state the exact amount charged today or complete prepaid-cancellation terms; confirm at checkout
“I want my insurance to help with visits.”	Midi Health	$250 first self-pay visit; $150 self-pay follow-ups	Prescriptions and any labs are separate; plan coverage varies
“I want a scheduled video visit and basic labs when needed.”	Sesame	$59/month on the current menopause treatment page	Cash-pay care; medication is separate; confirm the live checkout price
“I want a simpler cream at a lower published price.”	Winona	$89/month for its estrogen body cream with progesterone	It is applied to skin, not vaginally; it contains estradiol, estriol, and progesterone; the finished medication is compounded
“I want to rebuild this through ordinary prescriptions.”	Your own clinician	Depends on visits, insurance, pharmacy, product, and dose	You need a clinician willing to prescribe and manage the regimen
“Honestly? I may stay.”	Inner Balance	$199/month for six months, then $99.50/month	Get the exact formula, pharmacy, dose, billing cadence, and refund answer in writing first

Prices above are provider-published and were checked in August 2026. They are not equivalent packages: some include medication and shipping; some are visit fees; Sesame’s program fee excludes medication.^{[1] [2] [3] [4] [5]}

One rule runs through every route: none is a straight product swap. A change may alter the route into your body, formula, dose, FDA status, pharmacy, insurance handling, number of prescriptions, and follow-up model.

That is not a warning stapled onto the answer. It is the answer.

The right online HRT provider is not 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 cannot 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 is not the right starting point — before your first consult.

→ Match your reason for leaving to the right path — free, no email, and about 90 seconds. The tool gives you a match and two backups; it does not diagnose or prescribe.^[6]

Why are you leaving Inner Balance?

There is no single best alternative because the common reasons for leaving have different solutions. Wanting an FDA-approved manufactured product points somewhere different from wanting insurance, a lower price, a live appointment, or the same one-cream rhythm. Naming the real friction first turns a long provider list into a short decision.

Seven reasons come up again and again. See which one is actually yours.

1. The card was charged again while product was still in the house. Inner Balance says it ships a 90-day supply and bills monthly. Your cupboard and your credit card are on different clocks. A fresh charge can feel wrong even when it follows the published cadence.^[1]

2. Someone explained what “compounded” means, and the distinction landed. A compounded medication is made for a prescription by a compounding pharmacy. The finished product is not FDA-approved, and FDA does not verify its safety, effectiveness, or quality before it is marketed.^[7]

3. Another clinician asked what dose you were taking, and the answer was not obvious. That is not a memory failure. Inner Balance’s current product page and help center publish materially different Oestra strengths. You need the formula on your prescription, not a guess assembled from marketing pages.^{[1] [8]}

4. You wanted insurance, or you wanted each cost separated.

5. You had bleeding. Go to the bleeding section before you make a subscription decision.

6. You do not have a uterus and began wondering why a fixed combination includes progesterone. That is a fair question. A fixed product cannot be un-combined; separate prescriptions can be adjusted independently.

7. It did not work, or it did not feel right. That is a complete reason. You do not owe a platform a more persuasive one.

Reasons 3 and 6 point to information you should collect while you still have portal access. Reason 5 goes ahead of the provider decision.

What exactly are you replacing when you leave Oestra?

Oestra is marketed as a compounded, daily vaginal cream containing estradiol and micronized progesterone, with a published price of $199 a month for six months and $99.50 a month after that. Inner Balance says no lab or scheduled visit is required to start, a 90-day supply is shipped, and the treatment is intended for systemic menopause symptoms—not only local vaginal symptoms.^[1]

Four features define the product. You probably want to keep some and leave others.

Oestra feature	What it means	What changes when you leave
Compounded finished medication	The finished cream is not FDA-approved	Hers and ordinary pharmacy routes can move you to FDA-approved manufactured products; Winona’s combined cream remains compounded
Two hormones in one product	Estradiol and progesterone are combined in one daily pump	Separate FDA-approved estradiol and micronized progesterone commonly require two products; Bijuva is an oral fixed-dose exception
Vaginal route with systemic intent	It is placed vaginally but marketed for whole-body menopause symptoms	Low-dose local vaginal estrogen is not an automatic substitute for systemic treatment
Bundled cash-pay model	Medication, shipping, and messaging sit inside one monthly price	Midi separates visits from medication; Sesame separates program fees from medication; ordinary prescriptions separate everything

Does vaginal automatically mean local?

No. The word vaginal describes a route, not a guaranteed treatment intensity. Low-dose local vaginal estrogen is designed mainly for genitourinary symptoms; a systemic vaginal ring is different; and Oestra is marketed for whole-body effects. Replacing it by route name alone can leave you treating a different problem.

Category	Intended reach	The decision it answers
Low-dose local vaginal estrogen — selected creams, inserts, and a local ring	Primarily vaginal and urinary tissue	“Are dryness, painful sex, or urinary symptoms the main problem?”
Oestra, as Inner Balance markets it	Systemic, whole-body menopause symptoms	“Can one compounded vaginal product cover systemic estrogen plus progesterone?”
FDA-approved systemic estrogen — patch, gel, spray, tablet, or systemic ring, with a progestogen when indicated	Whole body	“Which route and dose fit my symptoms and history?”
Bijuva	Systemic oral estradiol plus micronized progesterone	“Can I use one FDA-approved oral combination product if I qualify?”

Low-dose vaginal estrogen can be exactly right when the treatment goal is local. It is not dosed as a replacement for systemic therapy used for vasomotor symptoms. A clinician needs to identify what Oestra was intended to treat before choosing the next route.^[9]

What will you genuinely miss?

The simplicity.

That is the damaging admission other alternatives pages avoid. Oestra collapses two hormones, one route, shipping, and messaging into one daily routine. Nearly every FDA-approved route changes some part of that convenience.

The honest question is not whether convenience matters. It does. The question is what you are willing to trade for a finished product with FDA-reviewed labeling, a dose another clinician can identify immediately, possible pharmacy-benefit coverage, or a live care model.

What should you do before canceling?

Ask for your actual prescription record.

Inner Balance’s current product page states 3 mg estradiol plus 100 mg micronized progesterone per pump. A help-center article dated May 7, 2026 describes Oestra Menopause as 0.5 mg estradiol plus 50 mg progesterone and Oestra Start as approximately 2 mg estradiol plus approximately 80 mg progesterone.^{[1] [8]}

Those may describe different products, eras, doses, or dispensing instructions. The public pages do not reconcile them for an individual patient.

Ask for this in writing while you still have portal access:

• Exact product name
• Exact estradiol and progesterone strength
• Amount delivered per pump
• Current pumps per day
• Date and details of every dose change
• Dispensing pharmacy name and address
• Copy of the prescription label or medication record

Your next clinician should not have to reverse-engineer your dose from a web page.

Is there an FDA-approved version of Oestra?

No FDA-approved estradiol-plus-micronized-progesterone vaginal cream exists in the United States. Bijuva is an FDA-approved fixed-dose oral capsule combining estradiol and micronized progesterone, but it is not vaginal. A route that preserves transdermal or vaginal delivery generally requires a different product design and often more than one prescription.

Bijuva’s current labeling lists oral estradiol/progesterone capsules for moderate-to-severe vasomotor symptoms in a woman with a uterus. Current labeling includes 0.5 mg/100 mg and 1 mg/100 mg strengths, taken orally with food.^[10]

That makes the accurate answer narrower than “there is no approved combination”:

• There is an FDA-approved oral estradiol-plus-micronized-progesterone combination.
• There is no FDA-approved vaginal estradiol-plus-micronized-progesterone cream.
• There is no one-for-one approved Oestra replacement.

Job Oestra is marketed to do	FDA-approved route that may cover that job	What it does not preserve
Systemic estrogen treatment	Estradiol patch, gel, spray, tablet, or systemic ring; other approved estrogen products	A separate progestogen is commonly needed when a woman has a uterus
Endometrial protection with systemic estrogen	FDA-approved oral micronized progesterone or an approved estrogen-progestogen combination, when clinically appropriate	It does not recreate a compounded vaginal cream
Both estradiol and micronized progesterone in one product	Bijuva	Oral only
Low-dose treatment for local vaginal and urinary symptoms	Approved low-dose vaginal estradiol products or vaginal prasterone	Not a replacement for systemic treatment
Both hormones delivered vaginally in one cream	No FDA-approved product	The exact format does not exist

What does “compounded” mean here?

Two federal pathways matter.

Section 503A generally covers patient-specific compounding based on a prescription, with state pharmacy oversight and specified federal conditions. Section 503B covers registered outsourcing facilities subject to current good manufacturing practice requirements and FDA risk-based inspection. Registration under either pathway is not FDA approval of the finished medication.^[7]

The clean sentence is this:

FDA approves finished drug products. A statement that an ingredient appears in an FDA-approved product does not make a compounded finished medication FDA-approved.

FDA states that compounded drugs are not FDA-approved and that the agency does not verify their safety, effectiveness, or quality before marketing.^[7]

Is there ever a legitimate reason to use compounded hormone therapy?

Yes—but “available online” is not itself the clinical reason.

The National Academies identified potential utility when a patient has a documented allergy to an ingredient in an FDA-approved product or needs a dosage form not available as an FDA-approved product. ACOG says compounded bioidentical menopausal hormone therapy should not be prescribed routinely when FDA-approved formulations exist, while acknowledging that access, cost, or an unavailable vaginal formulation can enter the discussion.^{[11] [12]}

Oestra occupies a real formulation gap: no FDA-approved vaginal cream combines estradiol and micronized progesterone. That does not make Oestra FDA-approved, equivalent to an approved product, or the right choice for every patient. It explains why a compounded product exists in that format.

The part we would rather not tell you

Moving to an FDA-approved route while keeping skin-delivered estrogen and micronized progesterone will usually mean more than one product.

That is the convenience cost.

One-product exceptions exist. Bijuva combines oral estradiol and micronized progesterone, and other approved combination hormone products use different estrogen/progestogen formulations. None recreates Oestra’s compounded vaginal estradiol-plus-micronized-progesterone cream.

Two prescriptions buy you something real: separate dose control, finished-product labeling reviewed by FDA, a strength another clinician can identify, and a better chance that a pharmacy benefit covers at least part of the medication.

If one-step cream simplicity is the feature you refuse to lose, Winona is the closest routine on this page—but it is a compounded body cream, not a vaginal product, and the progesterone-delivery question matters if you have a uterus.

If FDA-approved manufactured medication is the reason you are leaving, Hers is the shipped cash-pay route to compare first. → See current Hers menopause plans and check your state — the assessment determines eligibility and available treatment. (Sponsored link; we may earn a commission.)

Is Winona the same thing as Inner Balance with a different logo?

No. Winona’s $89-a-month estrogen body cream with progesterone is the closest routine, but it is applied to skin rather than vaginally and contains estradiol, estriol, and progesterone. The finished cream is compounded. Winona also publishes FDA-approved manufactured patch, estrogen-tablet, and progesterone-capsule options at separate prices.^{[2] [13] [14] [15]}

Where is Winona genuinely similar?

• One combined cream used daily
• Prescription review through an online care model
• No separate consultation fee published for treatment
• Messaging with the clinical team
• Shipping included
• HSA/FSA cards accepted
• Insurance not billed for care

What is the first major difference?

The route.

Winona instructs patients to apply its combined cream to clean, dry, hair-free skin such as the forearms, abdomen, inner thighs, or backs of the knees. Oestra is used vaginally.^[2]

Winona’s combined cream contains estradiol, estriol, and progesterone. Oestra’s current product page lists estradiol and micronized progesterone.^{[2] [1]}

Winona separately sells vaginal estrogen products for local symptoms. Those are different products with a different treatment goal.

Closest routine. Genuinely different medication.

What is the second difference if you have a uterus?

The open question is whether progesterone delivered through a compounded skin cream provides adequate endometrial protection when systemic estrogen is used.

Winona’s educational material says progesterone cream can protect the uterine lining when used correctly. The British Menopause Society’s May 2026 clinician tool says transdermal micronized progesterone has variable absorption and is unlikely to provide sufficient endometrial protection; it also says compounded products may not provide adequate protection and are not recommended for that purpose.^{[16] [17]}

We are not turning that disagreement into a diagnosis, and we are not declaring Winona unsafe. We are telling you the disagreement concerns the exact job progesterone must do for a woman with a uterus.

Ask this before payment:

“I have a uterus. If I use this combined body cream with systemic estrogen, what specifically protects my endometrium, what evidence supports that route and dose, and how will bleeding or endometrial concerns be monitored?”

You are entitled to a direct answer.

What is the third difference in Winona’s FDA language?

Winona correctly identifies the finished combined cream as compounded, but some product language also describes its active ingredients as FDA-approved. That wording can blur two separate facts:

1. FDA-approved manufactured products contain estradiol and micronized progesterone.
2. No FDA-approved drug product in the United States contains estriol, according to FDA.^[18]

The combined Winona cream itself is not FDA-approved.

Winona also sells separately listed manufactured options:

Winona product	Published price	FDA status shown by product type	Route
Estrogen body cream with progesterone	$89/month	Compounded finished medication	Skin
Estradiol patch	$149/month	FDA-approved manufactured product	Skin
Estrogen tablet	$54/month	FDA-approved manufactured product	Oral
Progesterone capsule	$39/month	FDA-approved manufactured product	Oral

Prices checked August 2026. A clinician determines what is prescribed; listed products are not automatically combined into a regimen.^{[2] [13] [14] [15]}

Who is Winona actually for?

Winona is the strongest fit here for:

• A woman who accepts a compounded finished medication and wants the closest one-cream daily routine
• A woman who wants Winona’s FDA-approved manufactured patch, tablet, or capsule options instead of the cream
• Someone who values an asynchronous model with medication shipped
• Someone paying cash who wants published product-level prices before intake

It is a weaker fit for:

• A woman with a uterus who wants the combined skin cream as her sole endometrial-protection strategy without a clear prescriber answer
• Anyone who specifically wants insurance billed
• Anyone who requires a scheduled live video appointment
• Anyone whose state is not on Winona’s current service list

Winona currently publishes service in 37 states plus Puerto Rico. Confirm availability during intake because telehealth coverage changes.^[19]

If the one-cream routine is the thing you are trying to preserve, compare Winona with your eyes open—not as an Oestra clone. → Check Winona treatment availability in your state — intake shows the products available to you. (Sponsored link; we may earn a commission.)

Want the full provider breakdown first? Read our Winona HRT review.

Is Midi Health the right switch if you want insurance to help?

Midi Health is the clearest insurance-oriented alternative on this page. It operates in all 50 states, works with many PPO plans, and sends prescriptions to a pharmacy. Current self-pay prices are $250 for an initial visit and $150 for follow-ups. Medication, labs, deductibles, copays, and coinsurance are separate.^{[3] [20]}

If your reason for leaving was “I am paying cash for a bundled subscription while carrying usable insurance,” this is your section.

What changes versus Inner Balance?

• You schedule a clinical visit rather than relying only on an intake quiz
• Visit coverage and pharmacy coverage are handled separately
• Prescriptions can include patches, gels, pills, rings, and local vaginal products when clinically appropriate
• Labs can be ordered when the clinician considers them useful
• Your medication is not automatically included in the visit price

Does Midi only prescribe FDA-approved products?

No.

Midi’s standard care can prescribe FDA-approved manufactured medications sent to ordinary pharmacies, but Midi also has a separately labeled Custom Rx program involving compounded preparations. Those are different lanes.^[21]

If FDA-approved manufactured medication is your reason for switching, say that at the beginning of the visit and verify the exact finished product before filling it.

Who should not pick Midi first?

• Medicaid or Medi-Cal patients: Midi says it cannot treat Medicaid beneficiaries, even on a self-pay basis.
• Someone looking for the lowest cash entry price: $250 before medication is the highest initial self-pay visit price on this page.
• Someone who wants medication bundled into one subscription charge: Midi separates clinical care from pharmacy costs.
• Someone unwilling to verify network status: “Most PPO plans” is not the same as “your plan.”

For Medicare, the current Midi policy is narrower than “not available”: Medicare does not cover Midi visits, but Midi says Medicare beneficiaries may self-pay and cannot submit claims for reimbursement.^[3]

What happened with Midi’s “91% relief” advertising claim?

In February 2026, the National Advertising Division reviewed an Instagram claim that 91% of Midi patients found relief within two months, along with an implied symptom-elimination claim. Midi said it had permanently discontinued the challenged claims. Because the claims were discontinued, NAD did not review their merits.^[22]

That is not a finding that Midi’s care is ineffective. It is a concrete example of why we do not repeat provider outcome percentages as independent proof.

If you have a PPO plan, do the network check before you compare cash prices. → Check whether Midi works with your plan — verify your state, carrier, deductible, and expected visit cost before booking. (Sponsored link; we may earn a commission.)

Is Hers the simplest FDA-approved switch?

Hers is the closest delivered-to-your-door alternative for someone who wants FDA-approved manufactured medication without arranging a separate pharmacy relationship. Current public pricing starts at $79 a month for an oral plan and $134 a month for a patch plan, each tied to a 12-month plan. Menopause care is not available in every state.^{[4] [23]}

Why does Hers fit this decision?

• Access to manufactured estradiol products and oral micronized progesterone when prescribed
• Medication shipped
• Provider messaging included
• Oral and patch routes published
• No insurance billing required

Hers says its menopause kits may include an estradiol pill or patch, progesterone pill, and vaginal estradiol cream depending on clinical eligibility. That does not mean every patient receives every product.^[23]

What should you know before entering a card?

The monthly number is a plan-rate equivalent, not a promise about the charge that hits today.

Hers publishes the $79 and $134 rates in connection with 12-month plans. Its public menopause pages do not clearly state the exact amount charged at checkout, whether a particular plan is prepaid, or what happens to unused prepaid months after cancellation.

Confirm these four items on the live checkout screen:

1. Amount charged today
2. Renewal schedule
3. Cancellation cutoff
4. Refund treatment for any prepaid period

Do not calculate your cash flow from the monthly equivalent alone.

Also confirm:

• Menopause treatment is available in your state
• The exact medication and strength the clinician would prescribe
• Whether the product is eligible for HSA/FSA reimbursement
• Whether oral, patch, or local therapy matches your treatment goal

Hers does not bill insurance for this service.

Who is Hers wrong for?

Hers is a weaker fit for someone who needs:

• Insurance billed for the visit
• A scheduled live video visit as a condition of care
• Month-to-month care with no plan term
• A compounded one-cream product
• A treatment route not offered in her state

If a printed, pharmacy-recognizable manufactured dose is what you came for—and you still want medication shipped—Hers earns the first comparison. → See current Hers menopause plans and check your state — confirm the product, plan term, and amount charged before payment. (Sponsored link; we may earn a commission.)

Is Sesame better if you want a real video visit and labs?

Sesame is the live-care option in this comparison. Its current menopause treatment page displays $59 a month and says the program includes ongoing video calls, messaging, and basic lab work when needed. Medication is prescribed separately and sent to a pharmacy.^[5]

This is the route for the woman whose real complaint was: “Nobody ever actually talked to me.”

Why is Sesame a genuine alternative?

• Scheduled video calls
• Choice of available provider
• Ongoing messaging
• Basic lab work when the clinician considers it necessary
• Hormonal and non-hormonal prescription options
• Prescription sent to a preferred pharmacy

What are the honest limits?

The program fee is not the whole cost. Medication is separate.

The current menopause treatment page displays $59 a month. Confirm that rate at checkout rather than relying on an older review or a cached site snippet.

Sesame is cash-pay. Its current terms state that Sesame does not accept insurance for services or prescription payments made through the platform. When a prescription is sent to an outside pharmacy, ask that pharmacy and your plan whether pharmacy-benefit coverage applies; do not assume it.^[24]

“Labs included” does not mean every test is included. The treatment page says basic lab work is included when necessary. Ask which tests, where they are drawn, and whether any state or outside-lab charge applies.

If live conversation is the feature you refuse to lose, Sesame deserves the click—but use the rate shown at checkout, not a number copied from an old review. → See the current Sesame menopause program — verify the live monthly price, visit cadence, lab inclusion, and medication cost before booking. (Sponsored link; we may earn a commission.)

Should you rebuild the regimen through your own clinician?

Yes, when you have a clinician willing to prescribe and manage it. This route can produce the lowest medication cost when covered generics are available, and it gives you ordinary pharmacy records and portability. Total cost still depends on visits, insurance, pharmacy, product, dose, and follow-up—so there is no honest universal dollar figure.

The approved route can include:

• Systemic estradiol as a patch, gel, spray, tablet, or systemic ring
• A progestogen when indicated for a woman with a uterus using systemic estrogen
• Low-dose local vaginal therapy when the treatment goal is genitourinary
• A fixed-dose product such as Bijuva when clinically appropriate

The dose and route belong to a prescribing conversation. A page comparing companies cannot convert an Oestra pump into a patch dose safely.

What should you bring to the appointment?

• Oestra prescription label or medication record
• Exact pumps per day
• Start date and dose-change dates
• Symptom list: what improved, what did not, and what changed
• Bleeding history
• Uterus and hysterectomy details
• Personal and family risk history
• Current medications and supplements
• Your priority: FDA-approved status, route, cost, insurance, live follow-up, or simplicity

What if your clinician says no?

Ask what the clinical reason is and what alternative they recommend. If the problem is lack of menopause expertise rather than a contraindication, that is where a menopause-focused service such as Midi or a live cash-pay service such as Sesame may solve the access problem.

Read: What to do when a doctor will not prescribe HRT.

What will the first 90 days actually cost?

Inner Balance’s published first-90-day outlay is $597. Winona’s $89 combined cream equals $267 over three months. Hers’ published rates equal $237 for oral treatment or $402 for patch treatment, but those are 90-day rate-equivalents—not confirmed checkout charges. Midi costs $250 to $400 in visit fees before medication. Sesame’s current $59 rate equals $177 before medication.

Path	First-90-day figure	What it covers	What remains unknown or separate
Inner Balance / Oestra	$597 cash outlay	Oestra, shipping, messaging under current published plan	Any extra charge tied to dose adjustment; refund outcome
Winona combined body cream	$267 rate-equivalent	Compounded cream, online prescribing model, messaging, shipping	Any additional product
Winona patch + progesterone capsules	$564 rate-equivalent	Two published manufactured products, messaging, shipping	Whether both are prescribed; any other product
Hers oral plan	$237 rate-equivalent	Manufactured medication and messaging under published 12-month-plan rate	Exact charge today and prepaid cancellation/refund treatment
Hers patch plan	$402 rate-equivalent	Manufactured medication and messaging under published 12-month-plan rate	Exact charge today and prepaid cancellation/refund treatment
Midi self-pay	$250–$400 in visit fees	Initial visit; upper figure adds one follow-up	Medication, labs, pharmacy costs
Midi with insurance	Your plan’s cost-sharing	Covered visit services subject to plan	Deductible, copay, coinsurance, medication, labs
Sesame	$177 rate-equivalent	Program fee based on the current $59 menopause-page rate	Confirmed checkout price, medication, any non-included lab cost
Your own clinician	Variable	Depends on coverage and care model	Visits, medication, labs, pharmacy

How we calculated it: The HRT Index multiplied each current published monthly rate by three. The result is an editorial rate-equivalent, not a provider-published 90-day total, unless the table explicitly labels it “cash outlay.” Prices verified August 2026.^{[1] [2] [13] [15] [4] [3] [5]}

Three rules keep this comparison honest

We do not compare a visit fee with a medication-included subscription as though they are the same product. Midi and Sesame can look cheap or expensive depending on pharmacy coverage and follow-up.

We do not model insurance as free. Network status, deductibles, copays, coinsurance, prior authorization, and formulary rules can change the winner.

We do not turn a monthly equivalent into the amount charged today. Hers ties its rates to a 12-month plan. The checkout—not multiplication—tells you the real cash requirement.

What cost disappears from most tables?

Transition friction.

Inner Balance bills monthly and says it ships a 90-day supply. Another provider may bill per visit, monthly, by plan term, or at the pharmacy. Before you cancel, write down:

• Current product run-out date
• Next Inner Balance billing date
• New-provider intake date
• Expected clinician response date
• Pharmacy fill date
• Exact stop/start instructions from the prescriber
• Refund-request deadline

The cost is not only dollars. It is the risk of canceling access before the replacement plan is real.

Which Inner Balance alternatives work with insurance?

Midi is the only featured platform here built around billing many commercial PPO plans for clinical visits. Hers, Winona, Inner Balance, and Sesame are cash-pay care models. Sesame sends prescriptions to a pharmacy, but its platform terms say it does not accept insurance; pharmacy-benefit treatment must be confirmed separately. Coverage of any prescribed medication depends on the plan and formulary.^{[3] [24]}

The distinction that decides the arithmetic:

Visit coverage and medication coverage are separate.

• Midi: may bill an in-network commercial plan for visits; prescriptions go to a pharmacy where drug coverage is determined separately.
• Sesame: cash-pay program; prescription sent to a pharmacy; ask whether the pharmacy can process your drug benefit.
• Hers: cash-pay plan with medication bundled; no insurance billing.
• Winona: cash-pay care and shipped products; no insurance billing.
• Inner Balance: cash-pay bundled subscription; no insurance billing.
• Your own clinician: visit and medication may both be covered, but only under your actual plan terms.

Compounded medication is often excluded from pharmacy benefits. Many FDA-approved generics are covered, but “generic” does not guarantee coverage. Product, dose, prior authorization, and formulary tier still matter.

What are the Medicare and Medicaid hard stops?

Midi and Medicaid/Medi-Cal: Midi says it cannot treat Medicaid beneficiaries, even if they offer to self-pay.^[3]

Midi and Medicare: Midi says Medicare does not cover its visits, but Medicare beneficiaries may self-pay and cannot submit claims for reimbursement.^[3]

Sesame: current terms describe the service as cash-pay. Its current public menopause page and terms do not state a categorical Medicare, Medicaid, or TRICARE ban. Confirm eligibility directly rather than relying on an older exclusion claim.^[24]

Hers, Winona, and Inner Balance: these services do not bill Medicare or Medicaid. Cash-pay availability still depends on clinical eligibility, state, and each provider’s terms.

For covered care, start with your plan directory. A cash-pay platform may still be available, but it is not the same as using the benefit you already have.

If you have a PPO plan and have been paying cash, check the network before choosing another subscription. → See whether Midi works with your plan — confirm carrier, state, deductible, and pharmacy coverage. (Sponsored link; we may earn a commission.)

How do you cancel Inner Balance, and is that the same as getting a refund?

No. Inner Balance’s published policy treats cancellation and refund as separate actions. A refund is not automatic when you cancel; you must request it through secure chat. The request must fall within six months of the original order and within 14 days of cancellation. Both clocks must still be open.^[25]

That and is the whole thing.

A woman can cancel within the first six months and still miss the refund if she waits more than 14 days to ask. She can also request within 14 days of cancellation but be outside six months from the original order.

What is the safest seven-step switch?

Step 1 — Count product days before changing the account. Use the label and actual remaining quantity to estimate when the current supply ends. Do not use the billing date as a medication date.

Step 2 — Start the replacement process before canceling access. Book the appointment or complete the intake while you still have medication and portal access. Starting the process is not the same as starting a second regimen.

Step 3 — Get exact stop/start instructions from the new prescriber. Do not create a gap or an overlap on your own. Ask for the final day of the old prescription and the first day of the new one in calendar dates.

Step 4 — Treat cancellation and refund as two tasks. Cancel through the account process, then send the refund request in secure chat. Save the confirmation.

Step 5 — Calculate both refund deadlines. Write down six months from the original order and 14 days after cancellation. The earlier closed clock ends eligibility under the published policy.

Step 6 — Resolve the HSA/FSA contradiction in writing. Inner Balance’s refund policy says HSA/FSA card purchases are eligible. Its HSA/FSA page says they are non-refundable and not valid under the six-month guarantee. Both statements were live during this review.^{[25] [26]}

Step 7 — Request your prescription details and records before losing portal access. Ask for the exact formula, dose, pharmacy, prescription label, dose-change history, and any clinician instructions.

The published refund policy also states one refund per customer and a cap of up to six months of subscription fees. A customer who refunds and later re-subscribes is not eligible for another guarantee refund.^[25]

What should you copy into the portal?

I would like to cancel my subscription and request a refund under the published six-month guarantee. Please confirm in this thread:
1. My cancellation effective date
2. The deadline for my refund request
3. Whether my payment method affects eligibility
4. The exact estradiol and progesterone strengths and amount per pump in my current prescription
5. My current prescribed pumps per day
6. The name and address of the dispensing pharmacy
7. How I can obtain my prescription label and treatment record

One message. Seven answers. All in writing.

What happens to symptoms when you switch?

Symptoms can return after hormone therapy is stopped, but the timing and pattern vary. The safe transition goal is not “overlap at all costs.” Arrange the next prescription before the current supply ends, then follow the prescriber’s exact instructions for stopping one regimen and starting the other. Do not improvise duplicate hormone exposure.

A different route, dose, or formula can feel different. That does not prove the old product was uniquely effective or the new one failed. It means the regimen changed.

Report symptoms and side effects to the prescriber. Let the clinician decide whether the issue is timing, dose, route, adherence, a different diagnosis, or a reason to stop.

If you have had bleeding, read this before you do anything else

Bleeding 12 months or more after the final menstrual period gets evaluated. It does not get written off as a subscription side effect.

ACOG’s 2026 clinical consensus recommends that most patients with postmenopausal bleeding receive both transvaginal ultrasound and endometrial tissue sampling as the initial evaluation.^[27]

Most postmenopausal bleeding is not endometrial cancer. That is why it gets evaluated rather than guessed at.

If a platform message says light bleeding is your uterus “waking up,” ask for a proper evaluation anyway. A portal can start the conversation. It cannot perform an ultrasound or tissue sampling.

Do not let a provider switch delay the appointment.

What if your situation is different?

Four details can reverse the recommendation: whether you have a uterus, whether your symptoms are only vaginal or urinary, whether you need covered care through Medicare or Medicaid, and whether you have had bleeding. Those are not footnotes. They change the medication job, the provider list, or whether online care should wait.

“I do not have a uterus. Why was I given progesterone?”

A progestogen is generally added to systemic estrogen to protect the endometrium. Without a uterus, there is generally no endometrium to protect. Exceptions can include residual endometrium after a subtotal hysterectomy or some cases involving residual endometriosis.

Ask:

“What specific clinical reason justifies progesterone in my case?”

A fixed combination cannot be separated. A separate-product regimen lets the prescriber adjust estrogen and progesterone independently.

For Winona, the endometrial-protection concern about transdermal progesterone does not apply in the same way when there is no uterus. A different question remains: why use a fixed cream containing progesterone if it is not needed?

“My only real problem is dryness, painful sex, or urinary symptoms.”

Then you may be comparing systemic subscriptions when the actual decision is local treatment.

FDA-approved low-dose local vaginal estrogen exists as creams, inserts, and a local ring; vaginal prasterone is another approved local option. Low-dose local therapy is not automatically a systemic HRT replacement, and systemic vaginal rings are a separate category.^[9]

Start with:

• Vaginal estrogen options
• Using vaginal estrogen with systemic HRT

“I use Medicare or Medicaid.”

For covered care, use the plan directory first.

• Midi does not treat Medicaid/Medi-Cal beneficiaries, even self-pay.
• Midi permits Medicare beneficiaries to self-pay, but visits are not covered and claims cannot be submitted.
• Sesame, Hers, Winona, and Inner Balance are cash-pay models and do not turn into covered care simply because you have a federal plan.
• Cash-pay eligibility still depends on state and provider terms.

We would rather send you to a covered clinician than take a click that wastes your benefit.

“I am mid-jar and do not want to decide today.”

Then do not.

Do three things this week:

1. Write down the two refund clocks.
2. Ask for the prescription record.
3. Screenshot the current terms you are relying on.

Deciding later is fine. Losing records or missing a published deadline is not.

What does Inner Balance’s own website say two different ways?

During this review, Inner Balance’s current pages gave conflicting or unreconciled answers about the compounding pathway, HSA/FSA refunds, product strength, outcome percentages, and testosterone wording. None of those conflicts proves that Oestra is unsafe. They do prove that a patient should not rely on a single marketing sentence to document her prescription or refund rights.

Question	One current Inner Balance statement	Another current Inner Balance statement	What to do
Which compounding pathway makes Oestra?	Product-page trust badge says 503A U.S. pharmacy	FAQ lower on the product page says 503B FDA-regulated compounding pharmacy	Ask for the actual dispensing pharmacy and whether it compounded under 503A or supplied as a 503B outsourcing facility product
Is an HSA/FSA purchase refundable?	Refund policy says HSA/FSA purchases are eligible	HSA/FSA page says they are non-refundable and excluded from the guarantee	Get a written answer before cancellation
What is the dose?	Product page says 3 mg estradiol + 100 mg progesterone per pump	Help center lists 0.5 mg + 50 mg for Oestra Menopause and about 2 mg + 80 mg for Oestra Start	Use the prescription label and patient record, not the website alone
Does Oestra contain testosterone?	Ingredient list names estradiol and progesterone; another section says Oestra does not include testosterone	FAQ language says progesterone supports testosterone through conversion	Do not treat conversion language as prescribed testosterone; ask what is actually in the dispensed product
What outcome figure should a buyer rely on?	Product page publishes six-month internal-data figures including 98% for vaginal dryness	Other current pages publish 49% at eight weeks or 97% in other claim sets	Treat each as provider-stated internal marketing data, not independently validated evidence

Source: Sources checked August 2026.^{[1] [8] [25] [26] [28] [29]}

What does the testosterone wording mean legally and clinically?

Oestra’s current ingredient list does not list testosterone. A claim that progesterone may support endogenous hormone pathways is not the same as dispensing testosterone.

Testosterone is a prescription Schedule III controlled substance in the United States. Any actual testosterone therapy requires a prescription and must be described as controlled-substance treatment—not as an incidental ingredient hidden inside conversion language.^[30]

What did the FDA’s 2025–2026 labeling action change?

FDA began requesting removal or revision of broad boxed-warning language from certain FDA-approved menopausal hormone therapy labels. That action concerns products with FDA-reviewed labeling.^[31]

It did not:

• Approve Oestra
• Convert any compounded preparation into an FDA-approved product
• Review a compounded cream’s finished formulation
• Resolve whether an individual patient should use systemic therapy

A compounded product does not have FDA-approved labeling from which a boxed warning can be removed. The regulatory status stays compounded.

Why are we putting this on an alternatives page?

Because the day you leave is the day another clinician asks what you were taking.

The answer should be a prescription record, not a screenshot of whichever version of the product page happened to load.

What did The HRT Index actually verify?

The HRT Index checked provider prices, medication status, route, insurance language, state coverage, refund terms, and primary medical or regulatory sources in August 2026. Where provider pages conflict, we show both. Where checkout determines the number, we say “confirm at checkout.” The HRT Index Verification Standard is a documented process, not a score.

We evaluate providers on five things, always in this order:

1. Clinical legitimacy
2. Care quality
3. Medication fit
4. Price transparency
5. Access

Provider-stated versus independently verified

Item	Provider-stated fact	What The HRT Index verified	Status
Inner Balance price	$199/month for six months, then $99.50	Current product page displayed those prices	Verified on provider page
Inner Balance pharmacy pathway	503A in one place; 503B in another	Both statements appeared on the current product page	Conflict—get written confirmation
Inner Balance refund	Six-month guarantee with 14-day post-cancellation request window	Current refund policy states both deadlines and separate request	Verified on policy page
HSA/FSA refund treatment	Eligible on refund page; excluded on HSA/FSA page	Both pages remained live	Conflict—get written confirmation
Winona combined cream	$89, skin application, estradiol + estriol + progesterone	Current product page supports route, ingredients, price, and compounded status	Verified on provider page
Winona endometrial claim	Cream progesterone can protect when used correctly	BMS says transdermal micronized progesterone is unlikely to provide sufficient protection	Material evidence conflict
Midi price and insurance	$250 initial, $150 follow-up; many PPO plans	Current pricing page supports these numbers and exclusions	Verified on provider page
Midi 91% outcome claim	Previously used in advertising	NAD says Midi permanently discontinued it; merits not reviewed	Verified regulatory-advertising record
Hers price	$79 oral / $134 patch on 12-month plans	Current Hers article supports rates and term	Verified monthly equivalent; checkout charge unverified
Sesame price	$59 on the menopause treatment page	Current live treatment page supports $59; medication remains separate	Verified on provider page; confirm checkout
No approved Oestra equivalent	No approved vaginal estradiol-plus-progesterone cream	FDA labeling confirms Bijuva is oral; no approved vaginal fixed-dose counterpart found	Verified against FDA sources

What could we not verify from public pages?

• The exact amount Hers will charge a particular reader today
• Which exact prescription any provider would choose for an individual
• Which Inner Balance formulation and dose a particular patient received
• Any individual outcome in advance
• Independent validation of Inner Balance’s on-site outcome percentages
• A universal all-in cost for insurance, pharmacy, and labs
• Response-time promises not published in current terms

We do not fill those gaps with estimates.

Why are there no customer testimonials here?

Customer testimonials are not used as evidence on this page. We did not find a third-party quote that cleared a complete source, identity, date, and current-page check at publication.

A testimonial is not decoration on a health page. If it cannot be traced, it does not ship.

What should you ask before paying for an Inner Balance alternative?

Before payment, confirm the exact finished medication, route, pharmacy, follow-up schedule, first-90-day cash requirement, insurance handling, and cancellation terms. The goal is not to interrogate the clinician. It is to stop the marketing page and the prescription you receive from becoming two different things.

Clinical legitimacy

• Who is the licensed clinician reviewing my intake?
• In which state are they licensed?
• Is the finished medication FDA-approved or compounded?
• If compounded, which pharmacy makes it and under which pathway?
• Can I receive the exact prescription label before the first shipment?

Care quality

• Is the first interaction live, asynchronous, or my choice?
• Who handles side-effect questions?
• What response time is published or guaranteed?
• When is the first follow-up?
• Is that follow-up included?

Medication fit

• What exact product, strength, route, and schedule would be prescribed if I qualify?
• Is the treatment intended to act locally, systemically, or both?
• If I have a uterus and use systemic estrogen, what protects my endometrium?
• If progesterone is delivered through skin, what evidence supports that route and dose for endometrial protection?
• If I do not have a uterus, what specifically justifies progesterone?
• What are the exact stop/start dates when moving from Oestra?
• Should there be any gap or overlap? Put the answer in writing.

Price transparency

• What is charged today?
• What is charged over the first 90 days?
• Is the advertised monthly rate a monthly payment or a plan-rate equivalent?
• Are medication, shipping, labs, and follow-ups included?
• Can a dose change alter the price?
• What pharmacy costs sit outside the program?

Access

• Is this available in my state today?
• Do you bill my insurance, give a superbill, or take cash only?
• Does my Medicare or Medicaid status change eligibility?
• How do I pause, cancel, and request a refund?
• Are cancellation and refund separate actions?
• Can I download my prescription details and records if I leave?

That last question is the one to keep if you only keep one.

Frequently asked questions

Is Oestra FDA-approved?

No. Oestra is a compounded finished medication. FDA has approved specific manufactured products containing estradiol and progesterone, but that does not approve Oestra. FDA does not verify a compounded drug’s safety, effectiveness, or quality before marketing.^[7]

What is the closest alternative to Oestra?

Winona’s $89 combined body cream is the closest daily routine. It is not the same product: it is applied to skin, contains estradiol, estriol, and progesterone, and is compounded. No alternative is a one-for-one vaginal estradiol-plus-micronized-progesterone cream.

What is the best FDA-approved alternative to Oestra?

There is no one-for-one replacement. Hers is the simplest shipped cash-pay route to manufactured estradiol and progesterone products; Midi is the insurance-oriented route; Sesame offers live video care; an ordinary clinician and pharmacy can be the lowest-cost route when coverage and access line up.

Is Bijuva the FDA-approved version of Oestra?

No. Bijuva is an FDA-approved oral capsule combining estradiol and micronized progesterone. Oestra is a compounded vaginal cream. They differ in route, dose, formulation, labeling, and clinical eligibility.^[10]

Is Winona cheaper than Inner Balance?

On current published monthly rates, yes: Winona’s combined cream is $89 a month; Inner Balance is $199 a month for six months and $99.50 after that. The products are not equivalent, so the price difference does not settle medication fit.

Does Inner Balance take insurance?

Inner Balance is cash-pay and does not bill insurance. It accepts HSA/FSA cards, but its current pages conflict over whether those purchases qualify for the refund guarantee. Get the answer in writing before relying on it.^{[26] [25]}

Can I cancel Inner Balance at any time?

You can request cancellation through the account process, but cancellation does not automatically create a refund. The current refund policy requires a separate secure-chat request within six months of the original order and within 14 days of cancellation.^[25]

Can I get an Inner Balance refund after six months?

The current published policy says no. It limits requests to the first six months after the original order and caps a refund at up to six months of subscription fees.^[25]

Can I use an HSA or FSA?

Inner Balance accepts HSA/FSA cards. Its refund policy says purchases made with those cards are eligible for a refund, while its HSA/FSA page says they are non-refundable and excluded from the guarantee. Get written confirmation before canceling.^{[25] [26]}

Can I switch directly from Oestra to an estradiol patch?

Not by matching the products yourself. A clinician needs your exact Oestra formula, treatment goal, uterus status, symptoms, risk history, and endometrial-protection plan. Ask for exact stop/start dates and do not create a gap or overlap without instructions.

Is local vaginal estrogen an alternative to Oestra?

Only when the treatment goal is local and a clinician agrees. Low-dose local vaginal estrogen treats vaginal and urinary tissue; Oestra is marketed for systemic effects. The shared route word does not make them substitutes.

Do I need progesterone if I do not have a uterus?

Usually progesterone is added to protect the uterine lining during systemic estrogen use, so it is generally unnecessary after total hysterectomy. Exceptions exist. Ask what specific reason applies to you rather than assuming.

Which alternative is cheapest over 90 days?

Among medication-included published rate-equivalents, Hers oral is $237 and Winona’s combined cream is $267. Hers’ amount charged today is not publicly clear, so $237 is not a guaranteed cash outlay. Sesame’s program-fee equivalent is $177 before medication. Midi is $250–$400 in self-pay visit fees before medication.

Which alternatives offer a live video visit?

Midi and Sesame provide scheduled clinical visits by video. Hers, Winona, and Inner Balance are built primarily around online assessment and messaging. Confirm the exact interaction before payment.

Which alternative works for Medicare or Medicaid?

For covered care, use the plan directory. Midi cannot treat Medicaid/Medi-Cal patients; Medicare beneficiaries may self-pay at Midi but cannot submit claims. The other featured services are cash-pay and do not bill federal insurance. Cash-pay availability still depends on provider terms and state.

Will symptoms return if I stop?

They can. Arrange the next clinical plan before the current supply ends, then follow written stop/start instructions. Do not assume that a self-directed gap or overlap is safer.

Is Inner Balance a scam?

The evidence reviewed here supports a functioning prescription telehealth offer with public pricing, an intake process, clinician-review language, and a compounded medication model. We found material transparency conflicts that deserve written answers. “Legitimate company” and “right medication and care model for you” are different questions.

Still deciding?

Here is the whole page in five lines.

If you want FDA-approved manufactured medication shipped, compare Hers. If you want commercial insurance applied to visits, compare Midi Health. If you want a scheduled video visit and basic labs when needed, compare Sesame. If you want to preserve a one-cream routine, compare Winona with the route and endometrial-protection differences in view. If your own clinician will prescribe and manage covered products, that can be the most portable and lowest-cost route.

Staying can be reasonable too. Get the formula, dose, pharmacy, refund answer, and billing dates in writing this week.

Still not sure which HRT program is right for you? Take our free matching quiz.

→ Find My HRT Path — about 90 seconds, no email, and no card. It matches your situation to one path plus two backups and flags when online care is not the right starting point.^[6]

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The HRT Index is an independent decision resource for online menopause and HRT care. We evaluate providers on clinical legitimacy, care quality, medication fit, price transparency, and access. Educational only — not medical advice or a substitute for a licensed clinician who knows your history.

Sources

The numbered sources below support claims cited throughout this article. Select a source number in the text to jump here.

1. 1. Inner Balance, “Oestra HRT & Menopause Treatment,” checked August 2026: https://www.innerbalance.com/product-page ↩
2. 2. Winona, “Estrogen Body Cream with Progesterone,” checked August 2026: https://bywinona.com/product/estrogen-body-cream-with-progesterone ↩
3. 3. Midi Health, “Pricing & Insurance,” checked August 2026: https://www.joinmidi.com/pricing-insurance ↩
4. 4. Hers, “Does Insurance Cover HRT?”, current menopause plan pricing, checked August 2026: https://www.forhers.com/blog/does-insurance-cover-hrt ↩
5. 5. Sesame, “Menopause Treatment,” checked August 2026: https://sesamecare.com/service/menopause-treatment ↩
6. 6. The HRT Index, “Find My HRT Path,” checked August 2026: https://thehrtindex.com/find-my-hrt-path/ ↩
7. 7. U.S. Food and Drug Administration, “Compounding and the FDA: Questions and Answers”: https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers ↩
8. 8. Inner Balance Help Center, “Oestra Menopause vs Oestra Start,” updated May 7, 2026: https://help.innerbalance.com/en/articles/15007725-oestra-menopause-vs-oestra-start ↩
9. 9. The Menopause Society, “The 2022 Hormone Therapy Position Statement”: https://pubmed.ncbi.nlm.nih.gov/35797481/ ↩
10. 10. DailyMed, current Bijuva prescribing information: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bc52489a-5149-411d-9665-2c75405ad15d ↩
11. 11. National Academies of Sciences, Engineering, and Medicine, The Clinical Utility of Compounded Bioidentical Hormone Therapy (2020): https://www.nationalacademies.org/read/25791/chapter/2 ↩
12. 12. American College of Obstetricians and Gynecologists, “Compounded Bioidentical Menopausal Hormone Therapy,” Clinical Consensus No. 6 (2023): https://pubmed.ncbi.nlm.nih.gov/37856860/ ↩
13. 13. Winona, “Estrogen Patch,” checked August 2026: https://bywinona.com/product/estrogen-patch ↩
14. 14. Winona, “Estrogen Tablet,” checked August 2026: https://bywinona.com/product/estrogen-tablet ↩
15. 15. Winona, “Progesterone Capsule,” checked August 2026: https://bywinona.com/product/progesterone-capsule ↩
16. 16. Winona Help Center, “Estrogen Body Cream with Progesterone,” checked August 2026: https://help.bywinona.com/en/articles/11931312-estrogen-body-cream-with-progesterone ↩
17. 17. British Menopause Society, “Progestogens and Endometrial Protection,” May 2026: https://thebms.org.uk/wp-content/uploads/2026/05/14-NEW-BMS-TfC-Progestogens-and-endometrial-protection-MAY2026-A.pdf ↩
18. 18. U.S. Food and Drug Administration, “Menopause”: https://www.fda.gov/consumers/womens-health-topics/menopause ↩
19. 19. Winona, “Frequently Asked Questions,” current state and territory list, checked August 2026: https://bywinona.com/faq ↩
20. 20. Midi Health, national availability statement, checked August 2026: https://www.joinmidi.com/ ↩
21. 21. Midi Health, “Custom Rx,” checked August 2026: https://www.joinmidi.com/custom-rx-express ↩
22. 22. BBB National Programs, National Advertising Division, “Midi Health,” February 25, 2026: https://bbbprograms.org/media/newsroom/decisions/midi-health ↩
23. 23. Hers, “Menopause Treatment,” checked August 2026: https://www.forhers.com/menopause ↩
24. 24. Sesame, “Terms of Service,” checked August 2026: https://sesamecare.com/terms-of-service ↩
25. 25. Inner Balance, “Refund Policy,” checked August 2026: https://www.innerbalance.com/p/refund-policy ↩
26. 26. Inner Balance, “HSA/FSA,” checked August 2026: https://www.innerbalance.com/p/hsa-fsa ↩
27. 27. American College of Obstetricians and Gynecologists, “Evaluation of Postmenopausal Bleeding,” Clinical Consensus (2026): https://pubmed.ncbi.nlm.nih.gov/41990335/ ↩
28. 28. Inner Balance, “Inner Balance vs Winona,” checked August 2026: https://www.innerbalance.com/p/learn/winona-review/ ↩
29. 29. Inner Balance pages displaying a separate 97% claim set, checked August 2026: https://www.innerbalance.com/p/learn/erykah-badu-menopause/ ↩
30. 30. Electronic Code of Federal Regulations, Schedule III anabolic steroids including testosterone: https://www.ecfr.gov/current/title-21/chapter-II/part-1308/section-1308.13 ↩
31. 31. U.S. Food and Drug Administration, menopause hormone therapy labeling update, November 2025–February 2026: https://www.fda.gov/news-events/press-announcements/fda-approves-labeling-changes-menopausal-hormone-therapy-products ↩