Inner Balance vs Winona: What We Verified About Cost, Eligibility, and FDA Status

Winona is the better starting point for most eligible women because it lists more routes and three FDA-approved product types: estradiol patches, estrogen tablets, and progesterone capsules. Inner Balance is the narrower fit for Oestra’s compounded combined vaginal cream. Winona serves ages 35–59 in 37 states plus Puerto Rico; Inner Balance costs $597 for the first 90 days.^[1][2]

A note on who’s paying us. We may earn a commission if you start with Winona. We earn nothing if you start with Inner Balance. Everything unflattering we verified about Winona is on this page anyway — including its 24-hour refund window, an insurance contradiction between its product pages and July 2026 terms, and inaccurate FDA language on its compounded creams. A provider can lose our recommendation while remaining an affiliate. Read our affiliate disclosure →

Quick decision table

Choose	Strongest reason	Main limitation
Winona — for most eligible women	More routes, lower cost in common setups, and three product types that Winona explicitly lists as FDA-approved	Ages 35–59 only, 37 states plus Puerto Rico, a 24-hour refund window, and conflicting insurance language
Inner Balance — for a narrow fit	One daily compounded vaginal cream combining estradiol and progesterone	$199/month for six months, compounded only, and unresolved 503A/503B and HSA/FSA claims
Neither, yet	Your real question is medical rather than commercial	You need a clinician or Find My HRT Path before choosing a subscription

Winona is likely the better fit if you…

• Are 35 to 59 and live in one of its 37 listed states or Puerto Rico
• Want a patch, an oral estrogen tablet, an oral progesterone capsule, a body cream, or a separate vaginal estrogen cream
• Want a product that Winona explicitly labels FDA-approved — and will verify the exact manufacturer and label when it is dispensed
• Want the lowest published monthly price among the common systemic combinations compared here
• Want a month-to-month subscription rather than waiting six paid months for a lower rate

Inner Balance is likely the better fit if you…

• Fall outside Winona’s published age range or state list and Inner Balance confirms it can treat you
• Specifically want a compounded combined vaginal cream rather than separate estrogen and progesterone products
• Prefer one HRT product over two and have received written answers to the pharmacy, refund, and endometrial-protection questions below
• Are exploring one of Inner Balance’s separately marketed pathways for PCOS, endometriosis, or postpartum symptoms — without treating that marketing as proof the treatment is medically right for you

Neither is your answer if you…

• Need a simple, unconditional trial period. Winona offers none; Inner Balance’s guarantee has conditions and conflicting HSA/FSA language.
• Need your insurance billed directly. Neither company does that.
• Have bleeding 12 months or more after your final period. That gets evaluated, not treated by subscription.
• Aren’t sure whether your symptoms call for local vaginal treatment or whole-body systemic treatment.
• Need an in-person exam, imaging, urgent evaluation, or specialist care before starting hormones.

Before you go further

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.

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.

Inner Balance vs Winona: which one is better?

Winona is the better starting point for most women who are eligible for it. It publishes a broader medication menu, its FAQ explicitly identifies three FDA-approved product types, and common Winona combinations cost less than Oestra during year one. Inner Balance remains the direct match for one narrow preference: a compounded vaginal cream combining estradiol and progesterone in one product.

We compare providers under The HRT Index Verification Standard on five pillars, always in this order: clinical legitimacy, care quality, medication fit, price transparency, and access. We do not assign numeric scores.

Pillar	Who is stronger?	Why
Clinical legitimacy	Winona, narrowly	Both say prescriptions are reviewed by licensed clinicians and filled by US pharmacies. Winona publicly explains that it owns two 503A pharmacies and publishes a physician page. Inner Balance currently displays both 503A and 503B pharmacy claims for Oestra.
Care quality	No winner	Both advertise ongoing portal messaging. We have not run a controlled response-time, prescribing-quality, or continuity-of-care test on either company.
Medication fit	Winona	Patch, tablets, capsules, body creams, a local vaginal cream, and oral DHEA. Inner Balance has one HRT product and one route.
Price transparency	Winona, narrowly	Winona lists a price for each product and has no six-month step-down. Its terms still allow the fee to change when dose or refill frequency changes. Inner Balance’s prominent “from” price is the month-seven price, not the first-month price.
Access	No winner	Winona publishes a clear state list but imposes a hard 35–59 HRT age band. Inner Balance markets broader age access but publishes conflicting state counts. Neither bills insurance.

Six things that can flip the answer

Read these in order. The first one that makes a provider unusable ends the comparison.

1. Your age. Winona’s HRT range is 35–59.
2. Your state. Winona lists 37 states plus Puerto Rico. Inner Balance’s public state claims conflict.
3. The route you want. Patch, pill, body cream, local vaginal cream, or combined vaginal cream.
4. Whether you want an FDA-approved finished product specifically. Winona lists three product types in that lane; Oestra is compounded.
5. Whether you have a uterus. Systemic estrogen usually requires adequate endometrial protection.
6. Whether your symptoms are local or whole-body. These are different treatment goals, not interchangeable product styles.

Will either Inner Balance or Winona actually treat you?

Winona publishes a firm HRT age range of 35 to 59 and a named list of 37 states plus Puerto Rico. Inner Balance markets Oestra to women 21 and older but publishes inconsistent state coverage — including “43 states plus D.C.” and “50 states” on the same article. Eligibility can end this comparison before price or product preference matters.^[1][3]

Winona’s age rule

Winona’s FAQ says its HRT treatment plans are for women ages 35–59. Its non-HRT products may have different eligibility rules, but that does not change the hormone-therapy limit.^[1]

That is a hard commercial limit, not a medical statement that hormone therapy must stop at 60. The Menopause Society says hormone therapy does not have to be routinely discontinued solely because a woman is older than 60 or 65; continued use can be considered after individualized evaluation.^[4]

Winona’s 37 states plus Puerto Rico

As of August 10, 2026, Winona’s FAQ lists:

Arizona · California · Colorado · Connecticut · Delaware · Florida · Georgia · Hawaii · Idaho · Illinois · Indiana · Iowa · Kentucky · Maine · Maryland · Massachusetts · Michigan · Minnesota · Missouri · Montana · Nebraska · Nevada · New Hampshire · New Jersey · New York · North Carolina · Ohio · Oklahoma · Oregon · Pennsylvania · South Carolina · Tennessee · Texas · Virginia · Washington · Wisconsin · Wyoming · Puerto Rico^[1]

Where Winona is not listed

Counting from that published list, these 13 states and the District of Columbia are not included:

Alabama · Alaska · Arkansas · Kansas · Louisiana · Mississippi · New Mexico · North Dakota · Rhode Island · South Dakota · Utah · Vermont · West Virginia · Washington, DC

State coverage can change as clinician and pharmacy licenses change. Check your state in the intake before relying on any static list.

Why we will not publish a single state count for Inner Balance

One Inner Balance article says the company serves 43 states plus D.C. The same article also groups Inner Balance with companies that serve 50 states. We found no public state-by-state list that resolves the conflict.^[3]

We are not choosing the more flattering number and presenting it as fact. Enter your state in the intake and get written confirmation before paying.

Check the constraint that can end this in one minute. Winona asks for age and location during intake. Check Winona’s current eligibility → (sponsored)

Prefer to check the narrower combined-cream route? Check Inner Balance’s current eligibility → (editorial link; we earn nothing)

What does each company actually sell?

Inner Balance has one HRT product: Oestra, a compounded daily vaginal cream containing estradiol and micronized progesterone. Winona lists FDA-approved patches, estrogen tablets, and progesterone capsules alongside compounded body creams, a compounded vaginal estrogen cream, and compounded oral DHEA. The difference is not a philosophy. It is a menu.^[2][5][1]

Two definitions stop most of the confusion:

Bioidentical describes molecular structure. It does not tell you whether a finished product is FDA-approved. FDA-approved estradiol and micronized progesterone products exist, and compounded products can contain hormones with the same molecular structures without the compounded finished product becoming FDA-approved.

Compounded means a pharmacy prepares a medication under federal and state compounding rules rather than marketing it under an FDA-approved finished-drug application. Compounded drugs can be lawfully prescribed, but FDA does not review them for safety, effectiveness, and quality before marketing in the same way it reviews approved drugs.^[6]

Product-level status and current published price

Product	Company	Route	Current published price	FDA status shown by provider	What we could independently establish
Oestra	Inner Balance	Vaginal cream, used daily	$199/month for six months, then $99.50/month	Compounded	Not an FDA-approved finished product
Estrogen patch	Winona	Transdermal patch, once or twice weekly as prescribed	From $149/month	FDA-approved	Winona does not publicly name the manufacturer or NDC before dispensing; verify the label you receive
Estrogen tablets	Winona	Oral	From $54/month	FDA-approved	Exact manufacturer and label are not publicly identified before dispensing
Progesterone capsules	Winona	Oral	From $39/month	FDA-approved	Exact manufacturer and label are not publicly identified before dispensing
Estrogen + progesterone body cream	Winona	Transdermal body cream	From $89/month	Compounded	Not an FDA-approved finished product
Estrogen body cream	Winona	Transdermal body cream	From $89/month	Compounded	Not an FDA-approved finished product
Progesterone body cream	Winona	Transdermal body cream	From $89/month	Compounded	Not an FDA-approved finished product
Vaginal estrogen cream	Winona	Local vaginal cream	From $89/month	Compounded	Winona says the finished medication is compounded, not FDA-approved
Oral DHEA	Winona	Oral capsule	From $27 per 3-month supply	Compounded	Winona says oral DHEA is not FDA-approved; FDA-approved prasterone is a different intravaginal product

Prices and status language verified from current provider pages in August 2026. “FDA-approved” in this table means the provider explicitly labels that product type FDA-approved; confirm the exact dispensed manufacturer, strength, and label before treating a category-level claim as product-level proof.^[5][1][7][2]

What Inner Balance has that Winona does not

Oestra combines estradiol and progesterone in one vaginal compounded cream. We found no FDA-approved finished vaginal product that combines those two hormones in one formulation. Bijuva is an FDA-approved estradiol-and-progesterone combination, but it is an oral capsule, not a vaginal cream.^[8]

That does not make Oestra equivalent to Bijuva or prove that its dose and route provide the same outcomes. It does explain the genuine gap Inner Balance is trying to fill: one combined vaginal product rather than separate prescriptions.

Inner Balance also markets separate treatment pathways for PCOS, endometriosis, and postpartum symptoms. Those are provider marketing claims about whom it evaluates, not proof that Oestra is appropriate for every woman with those conditions.^[9]

Is Inner Balance or Winona FDA-approved?

Companies are not FDA-approved; finished drug products are. Oestra and Winona’s creams are compounded and are not FDA-approved finished drugs. Winona currently states that its estradiol patches, estrogen tablets, and progesterone capsules are FDA-approved. That is three product types, not one — but the exact manufacturer and NDC still need to be confirmed when the prescription is dispensed.^[1][6]

The one rule that protects you

FDA approval belongs to a specific finished product, strength, dosage form, label, and manufacturer — not to a hormone name in the abstract.

An ingredient appearing in an approved drug somewhere does not make a different compounded mixture FDA-approved.

Winona blurs that line on its compounded creams

Winona’s combined body-cream page says ingredients “such as estriol and progesterone USP” are FDA-approved, then correctly says the final cream is compounded. FDA states that it has not approved any drug containing estriol. The finished cream is not FDA-approved, and calling estriol an FDA-approved ingredient is inaccurate.^[10][11]

Winona’s FAQ also says every 503A pharmacy is required to compound only with “FDA-approved ingredients.” FDA’s actual 503A framework is broader: qualifying bulk substances may meet USP/NF standards or appear on an FDA bulks list. “FDA-approved ingredient” is not the governing category Winona’s sentence implies.^[1][12]

Inner Balance borrows authority from an FDA announcement that did not approve Oestra

Inner Balance displays the line “Estrogen is one of the most effective longevity interventions for women” beside an attribution to an “FDA announcement, November 2025.” The FDA’s November 2025 announcement addressed label changes for approved menopausal hormone-therapy products. The sentence does not appear in that announcement, and the action did not change the regulatory status of compounded Oestra.^[2][13]

FDA approved the first six updated menopausal hormone-therapy labels in February 2026. That process applied to products with FDA-reviewed labels. A compounded preparation does not acquire FDA approval because approved products receive new labeling.^[14]

No call to action belongs in this section. Both companies use language that can make a compounded product sound closer to FDA approval than it is.

What does “compounded” actually change for you?

Compounded medicines are legal and sometimes medically necessary. What changes is the evidence and verification burden: the finished formula has not undergone FDA premarket review, the exact product may not have standardized public prescribing information, and coverage is uncommon. You need to know which pharmacy made it, under which pathway, at what dose, and why that formulation is being chosen.^[6]

503A and 503B, plainly

• 503A pharmacy: generally compounds for an identified patient based on a prescription and is primarily overseen by state pharmacy boards, while remaining subject to applicable federal law and FDA authority.
• 503B outsourcing facility: registers with FDA, can compound certain drugs in larger batches, must follow current good manufacturing practice requirements, and is subject to risk-based FDA inspection.

Registration is not approval. Inspection is not approval. Neither pathway turns a compounded finished drug into an FDA-approved drug.^[6][15]

Winona gives one public answer

Winona says it owns and operates two 503A compounding pharmacies. Its FAQ also correctly states that its compounded creams are not FDA-approved.^[1]

That is useful disclosure, even though the same FAQ contains the overbroad “FDA-approved ingredients” claim described above.

Inner Balance gives two public answers

Inner Balance’s current Oestra pages display a 503A U.S. pharmacy badge while an FAQ on those pages says Oestra is made by a 503B FDA-registered compounding pharmacy. Those are different pathways. The company needs to identify the dispensing pharmacy and classification for the prescription you would actually receive.^[2][16]

When compounded can be a reasonable route

FDA and major menopause organizations describe a legitimate role when a patient needs a dosage form, strength, or ingredient combination that an approved product cannot provide, or cannot use an approved option because of a specific ingredient.^[6][4]

Oestra’s combined vaginal format fits a real form-factor gap. Whether you medically need that gap filled is a prescribing decision — not something a comparison page can establish.

Use this exact intake note if it applies:

“I have tried [exact product and dose] for [length of time]. I stopped or need an alternative because [specific problem]. I am considering a compounded option because [form, ingredient, or dose need]. What approved options remain, and why is this compounded formulation the better fit?”

Already know you want an FDA-approved route? Winona currently lists a patch, estrogen tablets, and progesterone capsules in that category. See Winona’s current treatment menu → (sponsored)

How much do Inner Balance and Winona cost?

Inner Balance costs $597 for the first 90 days and $1,791 for year one at its published schedule. Winona costs $267 for 90 days of its $89 combined cream, $279 for estrogen tablets plus progesterone capsules, or $564 for a patch plus progesterone capsules. Winona is cheaper in common cream and oral setups, but its patch-plus-capsule example costs more over a year.^[2][5]

The numbers, calculated from published prices

Example setup	Published monthly price	First 90 days	Year one	The catch
Inner Balance — Oestra	$199 for months 1–6, then $99.50	$597	$1,791	Compounded. Inner Balance says dose adjustments may cost more. Lab pricing is not published.
Winona — progesterone capsules only	$39	$117	$468	Progesterone only; not an estrogen treatment.
Winona — estrogen tablets + progesterone capsules	$93	$279	$1,116	Oral setup. A clinician decides whether both are appropriate.
Winona — combined body cream	$89	$267	$1,068	Compounded. Do not assume the transdermal progesterone component provides adequate endometrial protection without asking.
Winona — patch + progesterone capsules	$188	$564	$2,256	The most expensive example here. Both product types are listed by Winona as FDA-approved.

Calculated by The HRT Index from provider-published rates, August 2026. These are arithmetic examples, not treatment quotes. Your actual total depends on what a clinician prescribes, whether progesterone is needed, and whether the price changes with dose or refill frequency.

Three things a “starts at” price hides

1. Inner Balance’s lowest advertised monthly figure is not the first-month price. Oestra is $199 a month for the first six paid months, then $99.50. The blended first-year average is $149.25 per month.^[2]

2. Winona is cheaper until the route changes. The $89 combined cream and $93 tablet-plus-capsule example both cost less than Oestra in year one. The $188 patch-plus-capsule example costs $465 more than Oestra over the same year.

3. “FDA-approved” does not automatically mean cheaper. Among these examples, the all-FDA-approved patch-plus-capsule route is the most expensive.

What the public prices do not settle

• Routine labs: neither company requires routine hormone testing to begin, but a clinician may decide you need testing or in-person evaluation. Inner Balance does not publish a lab-panel price.^[1][2]
• Dose changes: Winona product pages say adjustments are free, while its July 2026 terms say the subscription fee may increase or decrease when dose or refill frequency changes. Inner Balance says dose adjustments may incur an additional cost.^[10][17][2]
• Outside pharmacy pricing: Winona’s July 2026 terms say you may request that certain prescriptions be sent to a pharmacy of your choice, but you would pay that pharmacy directly and the subscription fee would no longer include medication fulfillment. Confirm how that works before relying on it.^[17]

Estradiol patch supply is constrained, not universally unavailable

ASHP lists the estradiol transdermal system as a current shortage and, as of August 7, 2026, reports back orders or allocations for several manufacturers and strengths while other products remain available. That does not mean Winona cannot fill a patch. It means you should ask which manufacturer, strength, and application schedule its pharmacy can currently supply.^[18]

See the price for the route you would actually choose. Winona lists product-level prices before intake, but the final amount still depends on the prescription. See Winona’s current pricing → (sponsored)

Are you buying local treatment or whole-body treatment?

Local vaginal estrogen and systemic hormone therapy are different treatment categories. Low-dose local vaginal estrogen targets vulvovaginal and urinary symptoms with minimal systemic absorption. Systemic therapy reaches the bloodstream at levels intended to treat symptoms such as hot flashes and night sweats. A product being applied vaginally does not automatically tell you which category it belongs to.^[4]

Local treatment

Low-dose vaginal estrogen is used for genitourinary syndrome of menopause, including dryness, burning, painful sex, and some urinary symptoms. The Menopause Society describes it as a low-dose treatment with very little entering the circulation.^[4]

Winona’s vaginal estrogen cream is marketed as a local compounded treatment. Its product page says it is distinct from the systemic body cream.^[19]

Systemic treatment

Systemic estrogen is delivered by routes such as pills, patches, sprays, gels, or some vaginal rings at doses that reach the bloodstream and treat whole-body symptoms such as hot flashes and night sweats.^[4]

Inner Balance markets Oestra as a vaginally applied product with systemic effects. That makes it fundamentally different from a low-dose local vaginal estrogen cream.^[2]

Why the distinction changes both cost and risk

A woman whose only problem is vaginal dryness may not need a systemic subscription. A woman whose main problem is hot flashes should not assume a low-dose local cream is designed to treat them. The wrong category can mean paying more, taking more systemic hormone than intended, or receiving too little systemic treatment for the symptoms driving the search.

Ask the prescriber directly:

“Is this prescription intended to treat my local vaginal and urinary symptoms, my systemic symptoms, or both? What dose and absorption data support that goal?”

Not sure which category you are shopping for? Find My HRT Path separates local from systemic needs and flags when the next step should be an in-person clinician rather than an online subscription.

If you still have a uterus, what protects the lining?

If you have a uterus and use systemic estrogen, the regimen generally needs adequate progestogen protection against endometrial overgrowth. The route, dose, and schedule matter. Winona’s oral progesterone capsules fit an established route. Its compounded transdermal cream and Oestra’s proprietary compounded vaginal dose should not be assumed equivalent to studied regimens without a prescriber explaining the evidence and monitoring plan.^[20][21]

What current guidance actually supports

The British Menopause Society’s May 2026 guidance recommends a progestogen dose proportionate to the estrogen dose for people with a uterus. It provides established oral micronized-progesterone schedules and says certain vaginal micronized-progesterone schedules have shown protection with low- or medium-dose estrogen for up to three years. It also says evidence is insufficient for other vaginal schedules and longer use.^[21]

That is more precise than saying all vaginal progesterone either works or does not work. Dose and schedule decide the answer.

How the three routes compare

Option	Progesterone route	What is publicly known	What remains unresolved before purchase
Oestra	Compounded vaginal cream	Inner Balance currently lists 3 mg estradiol plus 100 mg micronized progesterone per pump and markets it for systemic use	Whether that exact combined dose and daily compounded formulation has adequate long-term endometrial-protection evidence for your estrogen exposure and risk profile
Winona combined body cream	Compounded transdermal cream	Winona markets the progesterone component as protective	Current BMS dose tables and established regimens do not validate this exact proprietary transdermal formulation; ask what evidence supports the prescribed dose
Winona progesterone capsules	Oral	Winona lists them as FDA-approved; oral micronized progesterone is an established route for endometrial protection when appropriately prescribed	Exact manufacturer, strength, schedule, and whether it matches your estrogen dose

The question neither sales page answers well enough

Use this script:

“I have a uterus. If I use this product as my only progestogen, what specifically protects my endometrium? What evidence supports this exact route, dose, and schedule with my estrogen dose? What bleeding pattern should trigger evaluation, and how will the regimen be monitored?”

If the answer is vague, that is decision-relevant information.

If you have had a hysterectomy

No uterus usually means no endometrium to protect, so a progestogen may not be needed. Exceptions can exist, including some cases involving residual endometriosis or remaining uterine tissue. Ask why progesterone is being prescribed in your situation rather than assuming it is automatically necessary.^[20]

Bleeding after menopause is not a portal-only problem

Bleeding that occurs 12 months or more after the final menstrual period is postmenopausal bleeding and needs prompt evaluation. ACOG’s April 2026 update recommends a combination of transvaginal ultrasound and endometrial tissue sampling in the initial evaluation of most patients, with shared decision-making and individualized exceptions.^[22]

Most cases are not cancer. The reason to evaluate is to find out rather than guess.

More: bleeding after starting HRT.

What happens if you want out?

Winona’s refund window is 24 hours after an order processes; after that, its policy says the order cannot be canceled, refunded, or returned. Inner Balance advertises a six-month Oestra guarantee, but the written policy adds a second 14-day window, a one-refund limit, self-pay conditions, and conflicting HSA/FSA language. Neither policy is generous in the same way a retail trial is.^[23][24][25]

The two policies, side by side

Term	Inner Balance	Winona
Headline promise	Six-month / 180-day Oestra money-back guarantee	No trial guarantee
Refund request window	Within six months of the original Oestra order and within 14 days after cancellation	Within 24 hours after the order processes
After that window	Request is outside the published guarantee	Order cannot be canceled, refunded, or returned
Automatic when you cancel?	No. You must request it through secure portal messaging	No. You must cancel the processed order within the 24-hour window
Frequency	One refund per customer	Applied per qualifying order within the window
Cap	Up to six months of Oestra subscription fees	Full qualifying order amount
Exclusions	Supplements, lab tests, third-party services, Libida, NAD+, and other listed items; policy also requires self-pay	Processed prescription products after the window
HSA/FSA	Refund policy says eligible; HSA/FSA page says non-refundable and excluded from the guarantee	Accepted for payment; no separate refund promise
Pause option	Not publicly described	30, 60, or 90 days
Minimum term	No published minimum term; the lower $99.50 rate begins only after six paid months	No published minimum term

The damaging admission about the company that may pay us

Winona gives you 24 hours. Not 30 days. Not six months. Twenty-four hours from order processing, and after that its written policy says the order cannot be canceled, refunded, or returned.^[23]

If you need a real trial period, Winona is not it.

What Winona gives you instead is no published membership fee, no published consultation fee, no six-month introductory price, and no long-term agreement. You can cancel future renewals or pause for 30, 60, or 90 days. That is useful, but it is not a refund guarantee.

Inner Balance offers the longer guarantee, but the conditions matter. Its refund policy says HSA/FSA purchases are eligible; its HSA/FSA page says they are not refundable and do not qualify. Get the answer in writing before paying with a benefits card.^[24][25]

Two things to do before paying either company

1. Save the dated terms you are relying on. Screenshot the price, refund policy, cancellation deadline, and next processing date.
2. Find your next automatic processing date. A cancellation that happens after processing can become one more non-refundable shipment.

Two honest paths: if a 24-hour window or Inner Balance’s conditional guarantee is a dealbreaker, use Find My HRT Path to compare other care models. If month-to-month access matters more than a trial guarantee, see Winona’s current pricing and cancellation terms → (sponsored)

Is Inner Balance or Winona legitimate?

Both are operating telehealth businesses that say prescriptions are reviewed by licensed clinicians and filled through US pharmacies. The sharper question is not whether a website exists. It is whether the assigned clinician is licensed in your state, whether the dispensing pharmacy is clearly identified, whether the exact product’s FDA status is stated correctly, and whether the company’s policies agree with one another.

Is the company real?

Yes. Inner Balance Health PLLC lists a Boise, Idaho address and has a BBB profile. Winona says it was founded in 2021 and identifies its affiliated medical practice and pharmacies in its terms and FAQ.^[26][1][17]

Inner Balance displays LegitScript, NABP, and PCAB-related pharmacy badges. Those are relevant trust signals, but they do not resolve the 503A/503B conflict or make Oestra FDA-approved.

Is the clinician licensed?

Winona publishes a physician page with clinician biographies. It still does not tell you in advance which physician will be assigned to your case. Inner Balance does not publish a full intake-clinician roster that we could verify.^[1]

Ask for the assigned clinician’s name and check the license on your state medical board’s website. Do it for either company.

Is the pharmacy disclosed?

Winona states that it owns two 503A pharmacies. Inner Balance currently says both 503A and 503B on live Oestra pages. Ask Inner Balance for the pharmacy’s legal name, state license, and federal classification before checkout.^[1][16]

Do the marketing claims hold up?

The point of this table is not to create drama. It is to show where a reasonable buyer cannot tell which version to rely on.

Inner Balance claim conflicts

Topic	One live version	Another live version	Why it matters
Pharmacy pathway	“503A U.S. pharmacy” badge	“503B” in the FAQ on the same product/treatment pages	Different federal compounding pathways
Ongoing price	$99.50 after six months on the product page	$99 on several comparison articles	Small difference, but the lower figure is repeatedly used in competitor math
Outcome figures	49% / 41% / 40% / 43% / 40% in an eight-week internal review	97% / 80.2% / 78.7% / 75.3% and other sets on other live articles	Different periods and measures are presented without a published study tying them together
Study count	“100+” studies	“200+” studies	The claim changes without a public bibliography supporting Oestra itself
Testosterone wording	Oestra contains no added testosterone	Other pages say one pump delivers testosterone “via conversion” or supports natural testosterone	Oestra does not dispense testosterone; a metabolic claim is not the same as prescribing it
Refund eligibility	HSA/FSA purchases eligible under the refund policy	HSA/FSA purchases excluded under the HSA/FSA page	Directly changes the value of the guarantee

Testosterone itself is a Schedule III controlled substance in the United States and requires a prescription. Oestra contains no added testosterone; language about metabolic “conversion” does not mean the product dispenses or prescribes testosterone.^[27]

Inner Balance’s percentages are company-reported outcome figures, not published randomized evidence for the exact product. We do not use them to prove efficacy.^[28]

Winona claim conflicts

Topic	One live version	Another live version	Why it matters
Insurance claims	Product pages say receipts can be used to file for possible reimbursement	July 2026 terms say the patient will not submit a claim to any third-party payer	A material payment contradiction
Dose-change price	Product pages say adjustments are free	Terms say the subscription fee may rise or fall with dose or refill-frequency changes	“Free clinical adjustment” may not mean unchanged medication price
Estriol status	Cream pages describe estriol among “FDA approved” ingredients	FDA says no estriol-containing drug is approved	Blurs ingredient language with finished-product approval
503A ingredients	FAQ says 503A pharmacies must use FDA-approved ingredients	FDA permits qualifying bulk substances under statutory standards and bulks-list pathways	Overstates the rule

About Inner Balance’s founder credential

Inner Balance describes founder Sarah Daccarett, MD, as board-certified through the American Academy of Anti-Aging Medicine. A4M’s certification body is the American Board of Anti-Aging and Regenerative Medicine. Its published requirements include an MD or DO, an active license, written and oral examinations, chart review, conference attendance, and at least 200 hours of qualifying CME; continued A4M membership is required to maintain the credential.^[29]

That is a real private certification. It is not the same as certification by an American Board of Medical Specialties member board. That distinction does not prove or disprove the quality of the clinician who will review your intake — which is why the assigned clinician’s state license and qualifications remain the practical check.

Can you use insurance, an HSA, or an FSA?

Neither company bills insurance directly. Both accept HSA and FSA cards. Inner Balance’s terms say patients will not submit insurance claims and must indemnify the company for claims they submit. Winona’s July 2026 terms now also say patients will not submit claims to third-party payers — directly contradicting Winona product pages that encourage patients to file for possible reimbursement.^[30][17][5]

Inner Balance’s no-claims rule

Inner Balance’s terms require the patient not to submit claims to Medicare, Medicaid, private payers, or other government programs and include an indemnification clause tied to a submitted claim.^[30]

Its refund policy separately requires the Oestra subscription to be self-pay rather than reimbursed.^[24]

Winona’s product pages and terms do not agree

Winona’s product pages say the company will provide receipts and documentation that may be used to submit a claim for possible reimbursement.^[5]

Winona’s terms, last updated July 15, 2026, say the patient will not submit a claim to a federal, state, or other third-party payer for the services or products provided through Winona.^[17]

The terms are the stronger contract document. Do not file a claim based on a product-page promise without getting written clarification from Winona.

Winona’s terms contain one useful outside-pharmacy option

The same July 2026 terms say you may ask the physician to send certain prescriptions to a pharmacy of your choice. You would pay that pharmacy directly, and Winona’s subscription fee would no longer include medication fulfillment. Not every pharmacy can fill every prescription, especially compounded ones.^[17]

That could matter if your priority is an FDA-approved prescription filled through your own pharmacy or insurance network. It is not a guarantee of coverage or a published lower price. Confirm the exact workflow before starting.

HSA and FSA payment

Both companies accept HSA/FSA cards. Eligibility and substantiation still depend on tax rules and your plan administrator. HSA users must keep records supporting qualified medical expenses; health FSA expenses generally require independent third-party substantiation.^[31]

One practical rule: if Inner Balance’s money-back guarantee is what makes you comfortable paying, do not use an HSA or FSA card until Inner Balance resolves its refund contradiction in writing.

More detail: Does Inner Balance take insurance? · HSA and FSA rules for HRT

Do not choose Winona because its product page says you can file an insurance claim. Its current terms say the opposite. Choose it only if the cash price and care model work without reimbursement. Check current payment terms with Winona → (sponsored provider; terms link)

How does each one actually work?

Inner Balance’s public flow moves from quiz to checkout and then clinician confirmation. Winona’s public flow starts with a free intake and physician review; its terms say completing payment or enrollment never guarantees a prescription. Both use asynchronous telehealth rather than a required video visit, and both ship medication after approval.^[2][17]

The order of the steps

Inner Balance:

1. Complete the health quiz.
2. If the flow says you may qualify, proceed to checkout.
3. A clinician reviews the information.
4. If approved, the prescription goes to the pharmacy.
5. Oestra ships as a 90-day supply while billing occurs monthly.^[2]

Inner Balance’s terms say it may decline the agreement and return subscription fees. The public pages do not state how quickly a declined payment is returned.^[30]

Winona:

1. Complete a free intake.
2. A physician reviews the intake and decides whether treatment is appropriate.
3. A prescription may be issued.
4. The order enters a 24-hour review period, then pharmacy processing and shipping.
5. Most product pages estimate delivery in about five business days after the prescription process begins.^[5]

Winona’s terms say registration, payment, consultation, or subscription enrollment does not guarantee a prescription or a specific medication.^[17]

Day-to-day comparison

Feature	Inner Balance	Winona
How you take it	One pump of vaginal Oestra daily, according to current product instructions	Depends on prescription: daily cream or pill, or patch once/twice weekly
Routine labs required to start	No	No
Required video visit	No published requirement	No; care is asynchronous unless the physician requires something else
Clinician messaging	Unlimited follow-up messaging is included	Portal messaging is available at any time; Winona says typical physician response is 24–48 hours
Shipping	Free; current page estimates about five business days and a 90-day supply	Free standard shipping; expedited options at extra cost
Cancel	Through the portal	Through account settings/contact flow

“24/7 messaging” means the portal is available around the clock. It does not mean a physician answers live at 3 a.m.^[1]

What are real customers saying?

Customer reviews can show service friction, communication quality, and billing experiences. They cannot prove that a medication is effective or safe. We keep provider-hosted ratings, Trustpilot reviews, and BBB complaints separate because they are different, self-selected pools.

The pools should not be blended

• Provider pages: Inner Balance displays a 4.9/5 figure from 5,695 reviews; Winona displays a Trustpilot score on product pages. These are company-displayed figures.
• Trustpilot: Winona’s public profile has thousands of reviews. Counts change constantly and should be dated on build day.
• BBB: Inner Balance Health PLLC is not accredited and currently has a B− rating. The BBB profile showed 12 complaints when checked in August 2026, up from the 11 in the draft.^[26]

Complaints are allegations, not adjudicated medical facts. BBB itself says it does not verify third-party statements.

One attributable service-experience quote

“My experience with Winona has been wonderful! It was very communicative and simple.” — Sandy McDonough, Trustpilot, August 8, 2026^[32]

That quote supports only the reviewer’s reported experience with communication and simplicity. It does not support any claim about treatment efficacy or safety.

The useful review-policy verification loop

Inner Balance’s refund policy excludes Libida, lab tests, NAD+, and other listed products from the Oestra guarantee. Complaints from customers who expected the headline guarantee to apply to excluded products are consistent with the written exclusion — which is why the product-specific terms matter more than the headline.^[24][26]

We do not assign a review score to either provider. A single number would erase the exact constraints that change the decision.

What if my situation is different?

Choose by the constraint that would make the wrong provider unusable: age, state, route, FDA status, local versus systemic symptoms, uterus status, refund needs, or insurance model. When the constraint is medical rather than logistical, a comparison page should stop and hand the decision to a clinician.

“I want an FDA-approved product only.”

Winona is the only one of these two that publicly lists products in that category: estradiol patches, estrogen tablets, and progesterone capsules. Ask for the exact manufacturer, strength, NDC, and patient label when it is dispensed. Do not accept “the ingredients are FDA-approved” as the answer.

“I want a patch.”

Winona is the direct match. Its current price is from $149/month, and its page lists five strengths. Current ASHP shortages make manufacturer and strength availability worth confirming before the prescription is finalized.^[5][18]

“I want pills.”

Winona lists estrogen tablets from $54/month and progesterone capsules from $39/month. Inner Balance has no oral HRT option.

“I specifically want one combined vaginal cream.”

Inner Balance is the direct match. Oestra is compounded, costs $199/month for six months, and combines estradiol with progesterone. Read the uterus section and get the pharmacy pathway in writing before paying.

“My main symptoms are dryness, painful sex, or urinary symptoms.”

This may be a local-treatment question rather than a systemic-HRT question. Winona lists a separate compounded vaginal estrogen cream from $89/month. Oestra is marketed as systemic. Do not choose by the word “vaginal” alone. Start here: vaginal estrogen.

“I have a uterus.”

Ask what protects the endometrium, at what dose, by what route, and for how long. An all-in-one cream is not automatically a complete answer.

“I’m 60, or I’m 33.”

Winona’s HRT program will not take you under its published 35–59 rule. Inner Balance markets broader age access, but eligibility does not establish medical suitability.

“I need insurance billed directly.”

Neither company is your answer. Find My HRT Path can route you toward insurance-based and own-pharmacy models.

“I want the easiest refund.”

Winona’s rule is simpler and much harsher: 24 hours. Inner Balance’s window is longer but more conditional and internally inconsistent for HSA/FSA payments. Save the terms before paying.

“I have unexplained bleeding, a clotting history, a hormone-sensitive cancer history, liver disease, or I may be pregnant.”

Start with a clinician who can determine whether online asynchronous care is an appropriate first step. A subscription comparison cannot clear those risks.

“Can I switch from one to the other?”

Both say they can evaluate people who have used hormone therapy elsewhere. Do not compare doses by milligrams alone across vaginal, oral, transdermal, and compounded routes. Bring the exact product, strength, application schedule, last dose, duration, reason for switching, and next refill date to the new clinician.

More: Inner Balance alternatives.

What did The HRT Index verify — and what remains unresolved?

We read current product pages, FAQs, terms, refund policies, state lists, pharmacy disclosures, and medical guidance in August 2026. The value of this page is not pretending every provider claim is settled. It is showing which facts are confirmed, which statements conflict, and exactly what to ask before money changes hands.

The HRT Index Verification Standard

Our process is to:

• Read every published price
• Separate FDA-approved from compounded at the product level
• Verify state availability and insurance language
• Check cancellation and refill mechanics
• Compare provider claims with primary regulatory and medical sources
• Re-check top providers monthly and the full roster quarterly

It is a process, not a score. Read our methodology →

Provider-stated versus independently verified

Decision fact	Provider-stated	Independently verified or resolved	Status
Winona HRT age range	35–59	Published in Winona FAQ	Verified provider policy
Winona state list	37 states plus Puerto Rico	Recounted from the named FAQ list	Verified provider policy
Winona FDA-approved options	Patch, estrogen tablets, progesterone capsules	Explicit on Winona FAQ/product pages; exact manufacturer/NDC not public before dispensing	Verify exact dispensed product
Oestra FDA status	Compounded	FDA does not approve compounded finished drugs; Inner Balance does not claim Oestra itself is approved	Verified compounded
Oestra price	$199 for six months, then $99.50	Current product page	Verified price
Winona product prices	$39 capsules, $54 tablets, $89 combined cream, $149 patch	Current product catalog	Verified listed prices
Inner Balance pharmacy pathway	503A and 503B both appear	Conflict remains on live pages	Unresolved
Inner Balance HSA/FSA refunds	Eligible on one page; excluded on another	Conflict remains	Unresolved
Winona insurance filing	Product pages say yes; terms say patient will not file	July 2026 terms conflict with product pages	Unresolved — follow terms unless clarified
Endometrial protection with Oestra	Company markets progesterone as part of the formula	No public evidence found for the exact proprietary combined dose as a long-term endometrial-protection regimen	Clinician must justify
Endometrial protection with Winona body cream	Company markets progesterone as protective	Exact proprietary transdermal regimen is not established by the current guidance we reviewed	Clinician must justify
Patch availability	Product listed	ASHP reports current manufacturer/strength constraints	Confirm at fulfillment

Before you pay, get these in writing

Question	Why it is unresolved	Company
Who is the clinician reviewing my intake, and are they licensed in my state?	Assigned clinician is not known from the sales page	Both
What exactly protects my endometrium, and how will it be monitored?	Route- and dose-dependent	Both, if you have a uterus and use systemic estrogen
What is the legal name and classification of the dispensing pharmacy?	503A/503B conflict	Inner Balance
What does any ordered lab panel cost?	Not publicly priced	Both
Will a dose change alter my monthly price?	Provider pages and terms do not fully agree	Both
Will an HSA/FSA payment remain eligible for the Oestra guarantee?	Two Inner Balance pages conflict	Inner Balance
Can I file an insurance claim?	Winona product pages and terms conflict	Winona
Which patch manufacturer, strength, and schedule can you fill now?	Current shortage constraints	Winona
What happens to my payment if the clinician declines treatment?	Timing is not publicly stated	Inner Balance
When will my next order process?	Refund and cancellation timing depend on it	Both

Send us a correction →

If Winona clears your hard constraints: ages 35–59, listed state, cash-pay model, and the exact route you want — it offers the broader menu and three product categories it labels FDA-approved. Check current eligibility and pricing → (sponsored)

Inner Balance vs Winona: frequently asked questions

Is Inner Balance better than Winona?

For most women who satisfy Winona’s age and state rules, no. Winona offers more routes, lower prices in common cream and oral examples, and three product types it labels FDA-approved. Inner Balance is the better fit only when its combined compounded vaginal cream or broader commercial eligibility solves a constraint Winona cannot.

Is Winona cheaper than Inner Balance?

Usually, but not in every setup. Winona’s $89 combined cream and $93 estrogen-tablet-plus-progesterone-capsule example cost less than Oestra’s $199 first-six-month rate. A $188 patch-plus-capsule example costs $2,256 in year one, versus $1,791 for Oestra.

Is Oestra FDA-approved?

No. Oestra is a compounded prescription and is not an FDA-approved finished drug. Its estradiol and progesterone ingredients do not make the compounded final product FDA-approved.

Is Winona FDA-approved?

A company is not FDA-approved. Winona currently says its estradiol patches, estrogen tablets, and progesterone capsules are FDA-approved. Its body creams, vaginal estrogen cream, and oral DHEA are compounded or otherwise not FDA-approved finished products. Verify the exact product dispensed.

What states does Winona serve?

Winona’s August 2026 FAQ names 37 states plus Puerto Rico. It does not list Alabama, Alaska, Arkansas, Kansas, Louisiana, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, Utah, Vermont, West Virginia, or Washington, DC.

Can I use Winona if I am over 60?

Not for its HRT program under the current published rule. Winona limits HRT treatment plans to ages 35–59. That is a company eligibility policy, not a universal medical rule about hormone therapy after 60.

Is Inner Balance available in all 50 states?

Do not assume that. Inner Balance publishes “43 states plus D.C.” and “50 states” language on the same article. Confirm your state in writing before checkout.

Does either company take insurance?

Neither bills insurance. More importantly, both companies’ terms contain no-claim language. Winona’s product pages still say patients can file for possible reimbursement, but its July 2026 terms say patients will not submit claims to third-party payers. Get written clarification before filing anything.

Can I use an HSA or FSA card?

Both say yes, subject to your plan’s rules. Inner Balance’s refund policy says HSA/FSA purchases are eligible for its guarantee, while its HSA/FSA page says they are excluded. Resolve that before paying with a benefits card.

Do either of them require blood tests?

Neither requires routine hormone bloodwork to start. A clinician can still require testing, imaging, an exam, or a different workup based on your history and symptoms.

Which company is easier to cancel?

Both allow future cancellation through an account or portal. Refunds are the harder issue: Winona gives 24 hours after processing; Inner Balance offers a longer but conditional guarantee that must be separately requested.

Is vaginal estrogen the same as systemic HRT?

No. Low-dose local vaginal estrogen targets vaginal and urinary tissue with minimal systemic absorption. Systemic therapy is intended to reach the bloodstream and treat whole-body symptoms. Oestra is vaginally applied but marketed as systemic; Winona’s separate vaginal estrogen cream is marketed as local.

Which is better if I still have a uterus?

The provider name does not answer that. The correct question is whether the exact progestogen route, dose, and schedule adequately protect the endometrium alongside the prescribed estrogen. Oral progesterone has established regimens; proprietary compounded cream regimens need specific justification.

Do I need progesterone after a hysterectomy?

Usually not for endometrial protection because the uterus has been removed. Exceptions can exist, including some cases involving residual endometriosis or remaining uterine tissue. Ask why it is being prescribed in your case.

Can I switch from Winona to Inner Balance or the other way around?

You can ask either provider to evaluate a transfer. Do not stop, overlap, or convert doses without clinician guidance. Bring the exact product names, strengths, routes, last-use date, and refill timing.

Who writes the prescription?

A licensed clinician working through each telehealth program, after reviewing the intake. Winona publishes a physician page; Inner Balance does not publish a full assigned-clinician roster. Ask who is reviewing your case and verify the license with your state medical board.

The bottom line

If you are eligible for both, Winona is the better starting point for most women. It has the broader medication menu, lower prices in common configurations, a published state list, a public physician page, and three product types it explicitly labels FDA-approved.

That verdict does not erase Winona’s problems. Its refund window is only 24 hours. Its product pages tell patients they can seek insurance reimbursement while its July 2026 terms say they will not submit claims. Its compounded-cream pages inaccurately describe estriol as FDA-approved. Those are real trust defects, and they belong on the page before the click.

Inner Balance is a legitimate narrow commercial choice for a woman who specifically wants one compounded vaginal cream combining estradiol and progesterone, or who falls outside Winona’s age or state rules and is accepted by Inner Balance. Before paying, get the pharmacy pathway, state availability, HSA/FSA refund status, endometrial-protection plan, and any dose-change cost in writing.

And if your real question is medical rather than commercial — local versus systemic therapy, unexplained bleeding, cancer or clot history, pregnancy, or what should protect your endometrium — neither provider is the next answer. A clinician is.

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

Find My HRT Path →

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The HRT Index is an independent decision resource for online menopause and HRT care. This page is educational research, not medical advice, and has not been reviewed by a clinician. See our medical review policy. We may earn a commission from Winona if you use a labeled provider link; we have no commercial relationship with Inner Balance. Commission does not determine our recommendations, and a provider can lose our recommendation while remaining an affiliate. Affiliate disclosure · Editorial standards · Corrections

Related reading: Best online HRT providers for menopause · Inner Balance HRT review · Does Inner Balance take insurance? · Inner Balance alternatives · HRT cost in 2026 · Vaginal estrogen

Sources

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

1. 1. https://bywinona.com/faq" target="_blank" rel="noopener">Winona — Frequently Asked Questions, checked August 10, 2026. ↩
2. 2. https://www.innerbalance.com/product-page" target="_blank" rel="noopener">Inner Balance — Oestra product page, checked August 10, 2026. ↩
3. 3. https://www.innerbalance.com/p/learn/winona-alternatives-womens-health/" target="_blank" rel="noopener">Inner Balance — Winona alternatives article, checked August 10, 2026. ↩
4. 4. https://menopause.org/patient-education/menopause-topics/hormone-therapy" target="_blank" rel="noopener">The Menopause Society — Hormone Therapy and its 2022 Hormone Therapy Position Statement materials. ↩
5. 5. https://bywinona.com/product" target="_blank" rel="noopener">Winona — Current product catalog and prices, checked August 10, 2026. Product-specific pages were also checked for the patch, estrogen tablets, progesterone capsules, body creams, and vaginal estrogen cream. ↩
6. 6. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers" target="_blank" rel="noopener">FDA — Compounding and the FDA: Questions and Answers. ↩
7. 7. https://bywinona.com/product/dhea" target="_blank" rel="noopener">Winona — DHEA product page, checked August 10, 2026. ↩
8. 8. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/210132s001s003lbl.pdf" target="_blank" rel="noopener">FDA — Bijuva prescribing information. ↩
9. 9. Inner Balance treatment pages for https://www.innerbalance.com/treatment/pcos" target="_blank" rel="noopener">PCOS, https://www.innerbalance.com/treatment/endometriosis" target="_blank" rel="noopener">endometriosis, and https://www.innerbalance.com/treatment/postpartum" target="_blank" rel="noopener">postpartum support, checked August 10, 2026. ↩
10. 10. https://bywinona.com/product/estrogen-body-cream-with-progesterone" target="_blank" rel="noopener">Winona — Estrogen Body Cream with Progesterone, checked August 10, 2026. ↩
11. 11. https://www.fda.gov/consumers/womens-health-topics/menopause" target="_blank" rel="noopener">FDA — Menopause, including FDA’s statement that it has not approved any drug containing estriol. ↩
12. 12. https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" target="_blank" rel="noopener">FDA — Section 503A of the Federal Food, Drug, and Cosmetic Act. ↩
13. 13. https://www.fda.gov/news-events/press-announcements/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy" target="_blank" rel="noopener">FDA/HHS — November 2025 menopausal hormone-therapy labeling announcement. ↩
14. 14. https://www.fda.gov/news-events/press-announcements/fda-approves-labeling-changes-menopausal-hormone-therapy-products" target="_blank" rel="noopener">FDA — February 2026 approval of labeling changes for menopausal hormone-therapy products. ↩
15. 15. https://www.fda.gov/drugs/human-drug-compounding/registered-outsourcing-facilities" target="_blank" rel="noopener">FDA — Registered Outsourcing Facilities. ↩
16. 16. https://www.innerbalance.com/treatment/hrt" target="_blank" rel="noopener">Inner Balance — HRT treatment page, checked August 10, 2026. ↩
17. 17. https://bywinona.com/terms-and-conditions" target="_blank" rel="noopener">Winona — Terms of Service, last updated July 15, 2026; checked August 10, 2026. ↩
18. 18. https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=1206" target="_blank" rel="noopener">ASHP — Estradiol Transdermal System shortage bulletin, updated August 7, 2026. ↩
19. 19. https://bywinona.com/product/vaginal-estrogen-cream" target="_blank" rel="noopener">Winona — Vaginal Estrogen Cream, checked August 10, 2026. ↩
20. 20. https://menopause.org/wp-content/uploads/for-women/Misinformation-Surrounding-Hormone-Therapy.pdf" target="_blank" rel="noopener">The Menopause Society — Misinformation Surrounding Hormone Therapy. ↩
21. 21. https://thebms.org.uk/publications/bms-guidelines/management-of-unscheduled-bleeding-on-hormone-replacement-therapy-hrt/" target="_blank" rel="noopener">British Menopause Society — Management of unscheduled bleeding on HRT, May 2026. ↩
22. 22. https://www.acog.org/news/news-releases/2026/04/acog-publishes-updated-guidance-evaluation-postmenopausal-bleeding" target="_blank" rel="noopener">ACOG — Updated guidance on evaluation of postmenopausal bleeding, April 2026. ↩
23. 23. https://help.bywinona.com/en/articles/5364409-cancellation-and-refund-policy" target="_blank" rel="noopener">Winona — Cancellation and Refund Policy, checked August 10, 2026. ↩
24. 24. https://www.innerbalance.com/p/refund-policy" target="_blank" rel="noopener">Inner Balance — Refund Policy, checked August 10, 2026. ↩
25. 25. https://www.innerbalance.com/p/hsa-fsa" target="_blank" rel="noopener">Inner Balance — HSA/FSA page, checked August 10, 2026. ↩
26. 26. https://www.bbb.org/us/id/boise/profile/medical-doctor/inner-balance-health-pllc-1296-1000187170" target="_blank" rel="noopener">BBB — Inner Balance Health PLLC profile, checked August 10, 2026. ↩
27. 27. https://www.dea.gov/drug-information/drug-scheduling" target="_blank" rel="noopener">DEA — Drug Scheduling, listing testosterone as a Schedule III controlled substance. ↩
28. 28. Inner Balance’s current https://www.innerbalance.com/p/learn/winona-review/" target="_blank" rel="noopener">Winona review and other live comparison/treatment articles, checked August 10, 2026. ↩
29. 29. https://www.a4m.com/abaarm-requirements.html" target="_blank" rel="noopener">A4M — ABAARM requirements and https://www.a4m.com/certifications-abaarm-faq.html" target="_blank" rel="noopener">ABAARM FAQ, checked August 10, 2026. ↩
30. 30. https://www.innerbalance.com/p/terms-of-use" target="_blank" rel="noopener">Inner Balance — Terms of Use, checked August 10, 2026. ↩
31. 31. https://www.irs.gov/publications/p969" target="_blank" rel="noopener">IRS — Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans, current page checked August 10, 2026. ↩
32. 32. https://www.trustpilot.com/review/bywinona.com" target="_blank" rel="noopener">Trustpilot — By Winona reviews, checked August 10, 2026. ↩