LifeMD vs Alloy for Menopause: Costs, Medications, Insurance and Which One Fits You

That last line matters more than it sounds. Alloy shows monthly prices but ships and bills its estradiol patch every three months, so the patch's first-period subtotal is three months of medicine plus a $49 doctor fee. LifeMD publishes three different price descriptions on its own pages. We sorted both out below.

Alloy is likely the better fit if you:

• Pay cash and want to see every medicine's price before you start
• Want an estradiol pill, gel or spray (LifeMD doesn't list a pill or spray)
• Are fine with doctor messaging instead of a video visit
• Want a non-hormonal option or a low-dose birth control pill for perimenopause

LifeMD is likely the better fit if you:

• Want a live video visit with a clinician
• Might use insurance for a video visit; confirm that your plan covers this Women's Health visit
• Want a clinician who can order labs at Quest or Labcorp
• Like one bundle price that ships a 90-day medicine supply at once

Look past both first if you:

• Need estrogen and progesterone and want to compare a flat cash price, if it covers both medicines (see Gala below)
• Want an in-network specialist through a PPO plan (see other options)
• Have unexplained vaginal bleeding, a past blood clot, stroke or heart attack, liver disease, or a history of breast or uterine cancer. Those belong with an in-person clinician first.

Neither LifeMD nor Alloy pays us. We may earn a commission if you choose Gala through a labeled link on this page. That doesn't change the facts we report. How we make money.

The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.

What we actually verified · Last verified October 2026 We read, on October 24, 2026: LifeMD's Women's Health page, its FAQ, its terms, and its two pricing and sign-up articles (both updated September 22, 2026). Alloy's HRT page, price list, individual product pages, terms (revised October 19, 2026) and help-center articles on labs, testosterone and prescription transfers. Gala's $69 HRT page, hormone-health page, non-hormonal page and linked cancellation policy. We confirmed: Alloy's $49 one-time consult, its per-medicine prices, and that its patch is "shipped and billed every 3 months." LifeMD's published $79 fee and two bundle price lists, which conflict with other LifeMD pages. LifeMD's own statement that its estradiol cream is compounded and not FDA-approved. Gala's advertised $69 monthly HRT price. We did not: sign up, pay, talk to a clinician or receive medicine at any of the three. This is a documentation review, not a patient test. We could not confirm: which LifeMD bundle includes which medicine, LifeMD's correct six-month price, your exact Alloy charge dates, either company's complete menopause state and age limits, or the maker of every generic product you'd receive. Where something is unknown, our tables say "unknown," never $0.

On this page: At a glance · Which fits you · Cost · Medications · No-hormone options · Insurance · After the first prescription · Where their pages disagree · Gala · Other options · Cancel and transfer · Health factors · Questions to ask · How we compared · FAQ

LifeMD vs Alloy for menopause at a glance

Alloy is a menopause-focused company that prices each medicine separately, charges a one-time $49 doctor fee, and ships most medicines in three-month supplies. LifeMD is a general telehealth company whose Women's Health Program offers medication bundles, video or message visits, and access to labs, but its pages describe different fees. Alloy lists more medicine forms; LifeMD offers video visits and some insurance help.

Here's how the two line up on the things that change your decision.

LifeMD vs Alloy, side by side (checked October 24, 2026)

	LifeMD Women's Health Program	Alloy
What kind of company	General telehealth: primary care, weight, mental health and women's health (LifeMD FAQ)	Menopause-focused women's health company (Alloy)
How you start	About a 2-minute assessment, ID check, then a message consult or a video visit (LifeMD)	5–10 minute intake; a doctor plan "in as little as 12 hours" (Alloy)
Start fee	$79 (one page calls it one-time; another says $79 a month — see conflicts)	$49 one-time doctor consult for hormone therapy; $0 doctor access for the vaginal cream route (Alloy)
Ongoing price	Bundle 1: $66/mo, $199 per 3 mo, or $359 per 6 mo. Bundle 2: $99/mo, $249 per 3 mo, or $449 per 6 mo (LifeMD)	Per medicine: pill from $39.99/mo, gel or Evamist spray $69.99/mo, patch $100/mo, progesterone from $23/mo (Alloy)
How medicine is billed	Bundles include a 90-day supply shipped at once; published payment terms vary	Usually bills and ships every 3 months, with some exceptions; confirm your order dates
Medicine included in price?	Yes in bundles; no in Pay-As-You-Go	You pay for each medicine prescribed
Estrogen forms listed	Patch, gel, vaginal insert, and a compounded cream	Pill, patch, gel, Evamist spray, vaginal cream
Compounded estrogen	Yes — LifeMD discloses its estradiol cream is compounded	None on the hormone menu we read
Progesterone	Micronized progesterone (may be inside a bundle)	Separate, from $23/mo
Non-hormonal hot-flash option	None listed	Paroxetine 10 mg, $34.99/mo
Birth control for perimenopause	Not listed	Low-dose pill, $39.99/mo
Video visit	Yes, $79 initial; more visits billed separately	Not advertised on the pages we read
Labs	Can be ordered at Quest or Labcorp (who pays: confirm)	Doesn't order or arrange labs (Alloy help center)
Insurance	Can add insurance for video visits; coverage depends on your plan	No direct insurance billing for visits or prescriptions (Alloy help center)
HSA/FSA	Eligible, per LifeMD	Eligible prescriptions and services, per Alloy; check your plan rules
Testosterone	Not on the women's menu	"Not prescribing Testosterone" (Alloy help center)
Extras	LifeMD+ 24/7 urgent and primary care, group coaching, dietitian access	Separate skin, hair, sexual-health and weight programs
Age and state access	No complete menopause-specific age/state rules found; ask about your age, state and prescription	U.S. residents; no complete menopause-specific age/state rules found; confirm before paying
Our link	Direct, not monetized	Direct, not monetized

In one sentence each (our editorial read): Alloy is the clearer menu. LifeMD is the bigger care package with messier pricing.

Which one fits you: LifeMD, Alloy or neither?

Your payment method, the medicine form you want, and whether you want to see a clinician on video settle this faster than any star rating. Find the row that sounds most like you. If two rows fit, use the one that names your main blocker; unexplained bleeding or a complex health history comes first.

Find your situation

Your situation	Closer fit	Why	Next step
Paying cash and want an estradiol pill	Alloy	Alloy lists a pill from $39.99/mo; LifeMD's women's menu lists none	Alloy's price list
Want a spray or gel	Alloy	Evamist and gel are priced at $69.99/mo; LifeMD lists gel but no spray	Alloy's price list
Want a video visit with a clinician	LifeMD	$79 initial video visit; Alloy doesn't advertise video	LifeMD Women's Health
Want to use insurance for visits	LifeMD, or Midi for an in-network PPO	LifeMD says video visits may be covered; Alloy is cash-pay	Confirm the clinician, visit and your plan
Want labs, thyroid or bone health addressed	LifeMD	Orders labs at Quest or Labcorp; lists thyroid medicine if labs show a need	LifeMD Women's Health
Still having periods and want birth control too	Alloy	Lists a low-dose birth control pill "for those in perimenopause"	Read health factors first
Can't or won't take hormones	Gala or Alloy	Gala lists fezolinetant; Alloy lists paroxetine; LifeMD lists neither	No-hormone options
Need estrogen plus progesterone and want one flat cash price	Compare Gala and a LifeMD bundle	Gala advertises $69/mo with visit, prescription and shipping; neither company confirms every two-medicine combination publicly	Gala, then confirm the complete quote
Will only take FDA-approved finished products	Alloy (or LifeMD, but not its cream)	LifeMD's cream is compounded; Alloy markets FDA-approved hormone options	Ask for the product name either way
Only vaginal dryness or painful sex	Alloy (clear vaginal-only price)	$119.97 per 3-month tube with no consult fee	Vaginal estrogen guide
You're 35 to 39	Unclear at both	No menopause age range found on the pages we checked	Ask before paying
Unexplained bleeding, past clot, stroke or heart attack, liver disease, breast or uterine cancer	Neither, first	These need an in-person evaluation	Your doctor or a Menopause Society practitioner

A 30-second self-check

Answer these honestly. Nobody sees them but you. Each answer points you somewhere specific.

1. Do I need insurance to help pay for visits? Yes → LifeMD or Midi. No → keep going.
2. Do I care which form I get? A pill or spray → Alloy. The clinician can choose → a LifeMD bundle or Gala.
3. Do I want to talk with someone on video? Yes → LifeMD. Messaging is fine → Alloy or Gala.
4. Do I have a uterus and expect to use systemic estrogen? Yes → ask how the uterine lining will be protected. If separate progesterone is prescribed, add its price at Alloy (from $23 a month) and confirm whether LifeMD or Gala includes it. Low-dose vaginal estrogen is different.
5. Is my real blocker the bill, the medicine, the care style, or whether online care is right for me at all? Name it. The section that answers it is the one to read next.

If the first four answers pointed clearly at Alloy, its menu shows every price before you start.

If a video visit, labs or insurance help matter most, start with LifeMD's program page, and ask which care and payment route applies before you pay.

Still between the two, or wondering if either is right? The right online menopause care isn't the same for every woman — it depends on your symptoms, what you've already tried, your age, your state and your health history. Some situations belong with an in-person clinician first. Use The HRT Index's Find My HRT Path tool to explore a featured care option for your situation — and to flag when online care isn't the right starting point — before your first consult.

It's free, takes about 60 seconds and doesn't ask for your email. It asks five questions: what's bothering you most, what you've tried, your age, your state and your health history. One honest note: it doesn't choose between LifeMD and Alloy. It shows a featured option (currently Gala or Winona) or guidance when online care isn't the right start. It isn't a medical test, and it doesn't decide whether you should take hormones. A clinician does that. We may earn a commission from the providers it features. How it works.

What will you pay at LifeMD vs Alloy in the first three months and the first year?

For a woman prescribed estrogen plus progesterone, Alloy's consult plus first three-month shipment starts at about $238 with the pill or $418 with the patch. LifeMD's published three-month bundle examples are $278 or $328 including its stated $79 initial fee, if the bundle covers both medicines. There is no confirmed annual winner because LifeMD's applicable plan and contents remain unclear. These are public-price examples, not quotes.

Why these two are hard to compare

Think of Alloy as a menu and LifeMD as a plan.

At Alloy, you pay a one-time $49 doctor fee. Then each medicine has its own price. The prices are shown "per month," but the medicine ships three months at a time. Alloy's patch page says it plainly: "Shipped and billed every 3 months" (Alloy patch page). The pill and Evamist pages also describe a "3-month supply" (pill, Evamist).

In LifeMD's pricing article, you pay a $79 fee, then a bundle price. The bundle includes a 90-day supply shipped at once (LifeMD pricing article). Your provider picks Bundle 1 or Bundle 2 "based on your clinical profile and state availability." LifeMD doesn't publish which medicines are in which bundle.

So "Can I afford the monthly average?" and "Can I afford the bill when it arrives?" are two different questions. The tables below answer both.

Alloy: what each bill looks like (prices checked October 24, 2026)

These rows use Alloy's posted prices, one $49 consult for systemic hormone therapy, no promo codes, and free shipping. Alloy's help center says orders usually bill every three months, with a few exceptions. The annual examples use four three-month shipments at unchanged prices. Confirm your exact order and renewal dates; any required outside labs or care are extra and remain unknown.

If you're prescribed…	Monthly equivalent	Each 3-month shipment	Consult + first shipment	12-month illustration (consult + 4 shipments)
Estradiol pill only	from $39.99	from $119.97	from $168.97	from $528.88
Estradiol pill + progesterone	from $62.99	from $188.97	from $237.97	from $804.88
Estradiol gel or Evamist only	$69.99	$209.97	$258.97	$888.88
Gel or Evamist + progesterone	from $92.99	from $278.97	from $327.97	from $1,164.88
Estradiol patch only	$100	$300	$349	$1,249
Estradiol patch + progesterone	from $123	from $369	from $418	from $1,525
Vaginal estradiol cream only (local)	$39.99	$119.97 per tube	$119.97 (no consult fee listed)	$479.88 if you use one tube every 3 months

Source: Alloy price list, patch, vaginal cream. The vaginal cream page says the route "includes $0 unlimited doctor access." "From" prices mean the lowest listed; your prescribed plan may cost more. Alloy's first-order discounts are left out on purpose. They change one bill, not the plan.

Here's the patch-plus-progesterone math at the lowest listed prices: 3 months × ($100 + $23) = $369 for the medicine, plus the $49 consult = $418. That is the combined subtotal for the consult and first shipment. We don't know whether Alloy charges them in one transaction or two.

LifeMD: three published price descriptions

LifeMD's own pages describe the Women's Health Program three ways. They can't all be the plan you get. Here's each one, with the math it supports and the question it leaves.

Where LifeMD says it	What it says	What the math gives you	What's still unknown
Pricing article, updated Sept 22, 2026 — Bundle 1	$79 one-time fee, then $66/mo, $199 per 3 months, or $359 per 6 months; 90-day medicine supply included	Monthly payments: $277 over 3 months, $871 over 12. Three-month plan: $278 first, $875 over 12. Six-month plan: $438 first, $797 over 12	Which medicines Bundle 1 covers
Same article — Bundle 2	$79 one-time fee, then $99/mo, $249 per 3 months, or $449 per 6 months	Monthly payments: $376 over 3 months, $1,267 over 12. Three-month plan: $328 first, $1,075 over 12. Six-month plan: $528 first, $977 over 12	Which prescriptions put you in Bundle 2
How to Join article, updated Sept 22, 2026	Message route "starts at $66 a month," billed "bi-annually at $399"; video route's first visit is $79	$399 prepaid covers 6 months; two payments = $798 over 12 months, or $877 if the $79 also applies	Whether medicine is included; whether $79 applies
Women's Health page FAQ	"Starting at $79 per month, plus the cost of your medication"	Care alone: $237 for 3 months, $948 a year, plus medicine	Medicine cost — so the total is incomplete

These are unchanged-price plan subtotals, before unknown required extras. A six-month plan means paying for six months, even if you stop after three; the payment date and any minimum commitment still need confirming. Four 90-day medicine supplies cover 360 days, so ask how refill dates line up with calendar-month billing.

Both articles show the same update date, so the date doesn't tell you which is current. The LifeMD FAQ adds a fourth path: Pay-As-You-Go, where medicines and appointments are priced separately and "many medications start as low as $10/week." That route can send a prescription to your local pharmacy if you use insurance.

Ask LifeMD this, word for word: "Which plan applies to my prescription: the $79 monthly program, the $399 six-month plan, or Bundle 1 or 2? Please confirm what you'll charge today, which medicines are included, my next renewal date, and any extra visit or lab fees."

Side by side: comparable prescription scenarios

This table compares prescription scenarios, with LifeMD and Gala coverage still to confirm. LifeMD rows use the pricing article's Bundle 1 three-month plan with the $79 fee. Gala uses three or twelve payments at its advertised $69 monthly price. These are known-price subtotals before unknown required extras, not confirmed equivalent prescriptions or checkout quotes.

Prescription (hypothetical)	Alloy: consult + first shipment / consult + 4 shipments	LifeMD Bundle 1: first 3-month payment + fee / 4 payments + fee	Gala: 3 monthly payments / 12 payments
Pill + progesterone (has a uterus)	from $237.97 / from $804.88	No pill listed — ask	$207 / $828, if $69 covers both
Patch + progesterone (has a uterus)	from $418 / from $1,525	$278 / $875, if the bundle includes both	$207 / $828, if $69 covers both
Pill only (no uterus)	from $168.97 / from $528.88	No pill listed — ask	$207 / $828, if the prescribed pill is covered
Vaginal cream or insert only	$119.97 / $479.88, if one tube lasts 3 months	Vaginal insert listed; $278 / $875 only if Bundle 1 covers the full prescription	$207 / $828, if vaginal estradiol is covered

Gala advertises monthly pricing; we found no support for assuming a shorter billing cycle. Three monthly payments are $207; twelve unchanged monthly payments are $828. Exact charge dates, the first amount due, coverage of your complete prescription and any lab costs remain unconfirmed. Source: Gala's $69 HRT page, read October 24, 2026.

Three worked examples

Example 1 — Maria, 51, has a uterus, pays cash, wants a pill. (Hypothetical.) At the lowest listed prices, Alloy's pill plus progesterone is $237.97 for the consult and first three-month shipment, then $188.97 per refill. LifeMD's women's menu doesn't list a pill, so she'd need to ask. Gala is $207 for three monthly payments if its $69 covers both medicines. Alloy is a strong, clear choice here because it publishes the two separate medicine prices; Maria still needs her exact prescription and quote.

Example 2 — Dana, 48, wants a patch and a video visit. (Hypothetical.) If she is prescribed separate progesterone too, Alloy's consult plus first shipment starts at $418, then $369 per three-month shipment, with no scheduled video visit advertised. LifeMD offers the video visit she wants. Its pricing article gives a $278 first-three-month Bundle 1 example; she should confirm that her quoted plan includes the video visit, patch and progesterone before comparing the two. She should get that in writing.

Example 3 — Kim, 55, had a hysterectomy and only wants a pill. (Hypothetical.) With no uterus, she typically wouldn't need progesterone; her clinician decides. Alloy's lowest listed pill price gives $168.97 for the consult and first shipment, or $528.88 for the consult and four shipments. That is below Gala's conditional $828 twelve-payment subtotal, while LifeMD does not list the pill she wants. Alloy is the clearest published fit here, if its prescribed product suits her.

What the numbers mean

• The patch is where Alloy gets expensive. It's $100 a month versus $39.99 for the pill, and you pay three months at once.
• Progesterone is a separate line at Alloy. That's another $23 or more each month. LifeMD's bundle may already include it; ask.
• LifeMD's six-month plans cost less per month, but they ask for $438 to $528 up front, and LifeMD's terms say subscription fees aren't refunded pro rata if you cancel early (LifeMD terms).
• Insurance can beat every cash number here. If your plan covers a video visit and your pharmacy covers generic estradiol, LifeMD's Pay-As-You-Go route, or your own doctor, may cost the least.
• Gala is worth a quote for two-medicine care, especially a patch plus progesterone. Its conditional $207 three-payment subtotal is below the two-medicine first-period examples above, but its $828 twelve-payment subtotal is higher than Alloy's lowest pill-plus-progesterone example ($804.88) and LifeMD's conditional six-month Bundle 1 example ($797).

If you need estrogen and progesterone, you're paying cash, and you're open to the clinician choosing pill or patch, Gala's advertised $69 a month is worth checking. It includes the visit, prescription and shipping; if both medicines are covered, three monthly payments total $207. Before you pay, confirm the complete prescription price, any lab cost and your billing date.

Affiliate link. Cash-pay. Availability and treatment depend on clinician review and your state.

Your quote worksheet

LifeMD and Alloy: Quote and Refill Worksheets

Use these records to compare the same costs, save a provider's answers, and plan who will handle your next prescription. Gala has a column if you are comparing its HRT offer too. Keep your completed copy private. A blank required cost is unknown, not zero; these worksheets do not choose a medicine or a dose.

Before you compare totals, get the same facts from each company. Copy this into a note or message. A blank required cost is unknown, not zero.

Ask for this	LifeMD	Alloy	Gala, if comparing
Exact medicine, form, strength and quantity	____	____	____
FDA-approved finished product, or compounded?	____	____	____
Start fee and when it's charged	____	____	____
Medicine charge and how many months it covers	____	____	____
Is progesterone included, or a separate charge?	____	____	____
Labs, extra visits, pharmacy fees, shipping	____	____	____
Amount charged today	____	____	____
Next charge amount and date	____	____	____
What happens to the price if my dose or medicine changes?	____	____	____
Cancel deadline and refund rule	____	____	____

MY FIRST-BILL CHECK (keep private)
Provider: ____________
Start fee: $____   Charged when: ____________
Medicine bill: $____ covering ____ months
Progesterone: included / separate $____ / unknown
Labs or extra visits: included / $____ / unknown
Due today: $____    Next charge: $____ on ________
FIRST 3 MONTHS = every charge from start date up to (not including) the 3-month anniversary + required extras
FIRST YEAR = every charge from start date up to (not including) the 12-month anniversary + required extras
Count the start fee once, even if it is already inside a charge. Record each charge date.
Anything "unknown"? Then my total is INCOMPLETE. Don't write $0.

Which medications do LifeMD and Alloy prescribe, and are they FDA-approved?

Alloy describes its hormone options as FDA-approved: estradiol pill, patch, gel, Evamist spray, vaginal cream and progesterone. LifeMD lists an estradiol patch, gel, vaginal insert, progesterone, and an estradiol cream that LifeMD itself says is compounded and not FDA-approved. Alloy names Evamist. For the generic products, the public pages we read do not establish the exact maker you would receive.

Three words that get mixed up

• FDA-approved means the finished medicine, the actual pill or patch in the box, was reviewed by the U.S. Food and Drug Administration for safety, effectiveness and quality. Approval belongs to the finished product, not just its ingredient.
• Compounded means a pharmacy mixed the medicine. The FDA states that "compounded drugs are not FDA-approved," and it doesn't check their safety, effectiveness or quality before they're sold (FDA).
• Bioidentical means the hormone has the same shape as the one your body makes. It says nothing about approval. Many FDA-approved products are bioidentical. So are many compounded ones. Both LifeMD and Alloy use the word.

The Menopause Society says custom-compounded hormones aren't safer or more effective than approved bioidentical hormones (The Menopause Society). That doesn't make every compounded product wrong for every woman. It means you should know which one you're getting, and why.

Medication menu, side by side (checked October 24, 2026)

Medicine	Mainly used for	LifeMD	Alloy	What to know
Estradiol pill (systemic)	Hot flashes, night sweats	Not listed on the Women's Health menu	From $39.99/mo	FDA-approved generic forms exist
Estradiol patch (systemic)	Hot flashes, night sweats	Listed	$100/mo, billed every 3 months	Neither names the brand on its public page
Estradiol gel (systemic)	Hot flashes, night sweats	Listed in the FAQ	$69.99/mo	Alloy's page address mentions Divigel; confirm what's dispensed
Estradiol spray (Evamist)	Hot flashes, night sweats	Not listed	$69.99/mo	Named FDA-approved brand
Estradiol cream (applied to skin)	Hot flashes, per LifeMD	Listed	Not listed	Compounded, not FDA-approved, per LifeMD's own disclosure
Vaginal estradiol (local)	Dryness, painful sex, some urinary symptoms	Vaginal insert	Vaginal cream, $119.97 per 3-month tube	Low dose, mostly stays local
Micronized progesterone	Protecting the uterine lining during systemic estrogen	Listed; may be in a bundle	From $23/mo	Needed by most women with a uterus on systemic estrogen
Low-dose birth control pill	Perimenopause, still having periods	Not listed	$39.99/mo	A contraceptive with its own safety rules
Paroxetine	Non-hormonal hot-flash relief	Not listed	10 mg, $34.99/mo	The FDA-approved hot-flash form is 7.5 mg; see below
Thyroid medicine	Only if labs show a need	Listed	Not listed	—
Testosterone	Low libido (off-label in women)	Not on the women's menu	Not prescribing	Schedule III; no FDA-approved testosterone treatment for menopause symptoms

Source: LifeMD Women's Health, LifeMD FAQ, Alloy price list, Alloy paroxetine, Alloy testosterone answer.

Systemic or local: why it matters for your bill

Systemic treatment goes through your whole body. Pills, patches, gels and sprays are systemic. They're the ones that treat hot flashes and night sweats.

Local treatment mostly stays where you put it. Low-dose vaginal estradiol is local. It helps dryness and painful sex, but it won't fix hot flashes.

Here's why that matters. If your worst problem is night sweats and you're offered only a vaginal insert, that's a mismatch worth raising. If your only problem is dryness, you may not need systemic estrogen at all, and Alloy's vaginal cream route is $119.97 per tube, described as a three-month supply, with no separate consult fee listed. Tell the clinician which symptom bothers you most.

If you have a uterus

Most women who still have a uterus and take systemic estrogen also need a progestogen, such as micronized progesterone, to protect the uterine lining from cancer (The Menopause Society). Low-dose vaginal estrogen is different, and usually doesn't need an added progestogen.

At Alloy, that's a second line on your bill. At LifeMD, the FAQ says most women with a uterus "will also be prescribed micronized progesterone," and it may be inside your bundle. Confirm it either way. And don't let a sales page decide whether you need it. That's your clinician's call.

About LifeMD's compounded cream

Credit where it's due: LifeMD discloses this plainly in its own safety information. What it means for you is simple. No FDA review of that finished product's dose consistency. If you want FDA-approved products only, ask LifeMD for the patch or gel instead, and get the product name in writing. Our guide to compounded vs FDA-approved HRT explains the trade-offs, and our FDA-approved HRT medication list shows what's available.

About testosterone

Neither service lists testosterone as a menopause treatment on the current pages we read. Alloy's help center says it's "not prescribing Testosterone." LifeMD's women's menu doesn't list it, and LifeMD's FAQ says it doesn't prescribe controlled substances. In the U.S., testosterone is a Schedule III controlled substance that needs a prescription. No testosterone product is FDA-approved for menopause symptoms; using an approved testosterone product for those symptoms is off-label. One testimonial on LifeMD's page mentions testosterone, but LifeMD notes those reviews come "from verified LifeMD patients across various services," so it doesn't tell you what the women's program offers.

What if you can't or don't want to take hormones?

Alloy lists one non-hormonal option, paroxetine 10 mg, at $34.99 a month. LifeMD's Women's Health menu lists none. Gala lists non-hormonal options including fezolinetant, an FDA-approved non-hormonal pill for hot flashes. If hormones are off the table for you, that difference matters more than any price.

This applies to women with a history of breast cancer or blood clots, women told to avoid estrogen, and women who simply prefer not to use hormones. A clinician decides which option, if any, fits.

Non-hormonal options compared

	LifeMD	Alloy	Gala
What's listed	None on the Women's Health menu	Paroxetine 10 mg	"FDA-approved non-hormonal options (incl. fezolinetant)"
Price	—	$34.99/mo (page also describes a 3-month supply)	Not itemized; ask if it's within the $69 plan
FDA status for hot flashes	—	Paroxetine's FDA-approved hot-flash form is 7.5 mg, so 10 mg for hot flashes is off-label	Fezolinetant (Veozah) is FDA-approved for moderate to severe hot flashes
Monitoring to ask about	—	Interactions, especially with tamoxifen	Liver blood tests: who orders, reviews and pays

Source: Alloy paroxetine page, Gala non-hormonal page, Brisdelle label, Veozah label.

Paroxetine at Alloy

Paroxetine is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant. One low-dose form, paroxetine 7.5 mg capsules sold as Brisdelle, is FDA-approved for moderate to severe hot flashes of menopause (FDA label). Alloy's page lists a 10 mg dose. Paroxetine itself is an approved medicine, but using a 10 mg dose for hot flashes is off-label. That's common and can be reasonable. You just deserve to know it.

Two more things from the label. SSRIs carry a boxed warning about suicidal thoughts in children and young adults. And the label warns that tamoxifen may work less well when taken with paroxetine. If you take tamoxifen after breast cancer, raise this with your treating clinician before anything else.

Fezolinetant at Gala

Fezolinetant, sold as Veozah, is an FDA-approved non-hormonal pill for hot flashes. Its label carries a boxed warning, the FDA's strongest kind, about rare but serious liver injury. It calls for liver blood tests before treatment, monthly for the first three months, then at months 6 and 9 (DailyMed). The label also rules out use with cirrhosis, severe kidney impairment or kidney failure, and medicines that block the liver enzyme CYP1A2. Gala's page doesn't explain how the required liver tests are handled, so ask before you start. Our fezolinetant guide and non-hormonal options guide go further.

If you need a non-hormonal option, Gala is the only one of the three that lists fezolinetant, alongside its hormone options. Ask how the liver tests will be ordered and paid for.

Affiliate link. A clinician decides whether any treatment is right for you.

Does LifeMD or Alloy take insurance, HSA or FSA?

LifeMD lets you add insurance during sign-up and says video visits may be covered. Its platform accepts Medicare for select services, but we could not confirm Medicare coverage for this Women's Health program. Alloy says it does not bill insurance directly for visits or prescriptions. The bundles and medicine menus are cash prices; local-pharmacy coverage or reimbursement must be checked separately.

Insurance can touch three different things. Keeping them apart prevents surprise bills.

Insurance, piece by piece

	LifeMD	Alloy
The visit	Video visits "typically covered"; your copay may apply (LifeMD)	Not billed to insurance
The medicine	Bundles are cash. Pay-As-You-Go can send the prescription to your local pharmacy, where your drug coverage may apply (LifeMD FAQ)	Cash price per product; filled by Alloy's partner pharmacy
Membership fee	LifeMD+ is included in Women's Health plans; do not assume the program fee is covered	No separate menopause membership fee advertised
HSA / FSA	Eligible, per LifeMD	Eligible prescriptions and services, per Alloy; check your plan rules
Medicare	Platform accepts it for select services; Women's Health coverage unconfirmed	Not billed directly
Medicaid	Not stated	Not billed

What this means in practice

If you have good coverage, LifeMD's video-visit route plus your local pharmacy could cost less than any cash plan on this page. Ask LifeMD, in writing, which parts your plan would cover and what you'd still owe.

If you have an in-network PPO and want a scheduled specialist visit, Midi Health is the stronger insurance-first check. Midi lists self-pay visits at $250 first and $150 follow-up and says it's in-network with most PPO plans (checked October 24, 2026). Its current policy lists Medicare as out of network and says it cannot accept Medicaid patients; check your exact plan and state. Compare in our Midi vs Alloy guide.

HSA or FSA isn't insurance. Paying with those accounts uses your own pre-tax money. It doesn't mean your insurer pays. Alloy says some patients may seek PPO reimbursement after paying, but approval is not guaranteed. If you might seek reimbursement, ask for an itemized receipt. And only count reimbursement in your math once it's actually approved.

Video visit or messaging: what happens after the first prescription?

Alloy is built around an online intake and ongoing doctor messaging while your prescription is active. LifeMD lets you choose a message consult or a video visit, then handles refills and check-ins through its portal, with some follow-up visits billed separately. The real differences show up later: labs, prescription changes, and what happens if you move pharmacies.

The care experience, step by step

Step	LifeMD	Alloy
Intake	About 2 minutes, plus a photo ID check	5–10 minutes
First clinician contact	Message consult, or a video visit of about 15 minutes	A doctor plan "in as little as 12 hours," by messaging
Who you see	"Women's health specialized clinicians." Leaders named: Dr. Tara Scott (Clinical Chair, Women's Health & Menopause Care), Dr. Doug Lucas (bone health and longevity), Lauren Cramer, PA-C	"Menopause-expert," board-certified physicians following ACOG and Menopause Society guidelines (Alloy's description)
Shipping	3–5 business days after processing	Free delivery
Labs	Can be ordered at Quest or Labcorp	Doesn't offer or arrange labs, and its clinicians don't order bloodwork
Refills	LifeMD recommends requesting renewal every 90 days; a follow-up visit may be needed and billed separately	Orders renew on the agreed cycle until refills run out; Alloy then prompts renewal; messaging continues while your prescription is active
Moving to your own pharmacy	Pay-As-You-Go can send prescriptions to your pharmacy	Allowed after at least one order; you lose member benefits, including unlimited doctor messaging
Extras	LifeMD+ 24/7 urgent and primary care, group coaching, dietitian access	Separate skin, hair, sexual-health and weight programs

Source: LifeMD join guide, LifeMD FAQ, Alloy HRT page, Alloy labs answer, Alloy transfer answer.

Do you need labs?

Routine hormone-level tests are often not needed at the usual menopause age. Menopause is usually assessed from your symptoms, age and periods, because hormone levels swing too much in perimenopause to guide treatment on their own (British Menopause Society). Tests may still be needed for younger or unusual symptoms, another condition, or medicine safety, such as fezolinetant liver monitoring. Alloy says you don't need labs to begin or continue, and it doesn't order them. That's simple, but it means if a clinician elsewhere wants tests, you arrange them yourself.

LifeMD can order labs, and its join guide says lab testing ordered by your provider is part of the membership. Its FAQ says lab costs vary outside the weight program. So ask: "If labs are ordered, who pays?"

Is either one legit?

Both offer clinician-led telehealth care. LifeMD is publicly traded (NASDAQ: LFMD) and describes an affiliated 50-state medical group; Alloy describes its care as delivered by board-certified physicians. Those are company descriptions, not a license check of the clinician you would see or proof that every treatment is offered in every state. Once you're assigned a clinician, you can look up their license on your state medical or nursing board's website.

What reviews can and can't tell you

Reviews can show you where a service gets bumpy: billing, shipping, slow replies. They can't tell you whether a medicine is right for your body or how fast you'll feel better. Be careful with big star ratings here. LifeMD's on-page reviews span many services, not just menopause care. So we don't compare ratings on this page.

Where LifeMD's and Alloy's own pages disagree

LifeMD's pages give conflicting answers on its start fee, its six-month price, whether medicine is included, and refunds. Alloy's pages are more consistent but mix "1-month" price labels with three-month shipments and billing. Some differences below are separate care routes or price units, rather than contradictions. Here's each gap, and the exact question that settles it.

Topic	One page says	Another page says	Ask this
LifeMD start fee	"One-time $79 program fee" (pricing article)	"Starting at $79 per month, plus the cost of your medication" (Women's Health FAQ)	"Is $79 one-time or monthly, and does it apply to the message route?"
LifeMD medicine included	Bundles include a 90-day supply	"Medication cost… is not included in this program"	"Is my medicine included in my plan price?"
LifeMD six-month price	$359 for Bundle 1	$399 billed bi-annually (join guide)	"What exactly will you charge today, and when next?"
LifeMD bundle contents	Provider chooses Bundle 1 or 2	No page lists which medicines are in each	"Which bundle would I be in, and what's in it?"
LifeMD insurance — routes differ	"No insurance required"	"Video visits are typically covered"	"If I add insurance, what will I still pay?"
LifeMD refund if not eligible	"You'll receive a refund" (join guide)	You "may be eligible for a pro rata refund of the unused portion" (terms)	"If I'm not prescribed anything, what exactly is refunded?"
LifeMD labs	Membership includes provider-ordered labs (join guide)	Lab costs vary outside the weight program (FAQ)	"Who pays if labs are ordered?"
Alloy billing	Price shown as "1-month supply"	"Shipped and billed every 3 months" (patch page)	"How much is charged on day one, and how often after?"
Alloy paroxetine	"FDA-approved, non-hormonal treatment"	Dose listed is 10 mg; the FDA-approved hot-flash form is 7.5 mg	"Which product and dose is this, and is it off-label for hot flashes?"
Alloy relief claim	"95% of Alloy customers taking HRT feel symptom relief in 2 weeks or less"	No supporting study or survey details found on the HRT page we read	Don't use it as a promise of your outcome.

The takeaway: Two questions decide your bill. "Which exact medicine will I get?" and "What's charged today, and when next?" Get both in writing before you pay.

When is Gala Health worth comparing with LifeMD and Alloy?

Gala is a cash-pay online HRT service that advertises one flat $69 a month covering the telehealth visit, the prescription and shipping, with estradiol pill or patch, progesterone, vaginal estradiol and non-hormonal options. It is worth comparing for patch-plus-progesterone care, if $69 covers both; three monthly payments total $207. It doesn't take insurance, and the exact hormone products and complete combination price still need confirming.

Gala is our featured cash-pay HRT partner, and we may earn a commission if you choose it. Here's the case for it, and the case against, so you can decide.

What Gala offers

Gala lists four kinds of menopause treatment. Every one needs a clinician's approval, and all come through online care with prescription delivery and ongoing support (Gala).

Gala treatment	What it's for	Note
Estradiol pill or patch	Hot flashes, night sweats and other menopause symptoms (systemic)	Exact product and strength not named publicly
Micronized progesterone	Protects the uterine lining during systemic estrogen treatment; oral micronized progesterone may also help sleep	Ask which route is prescribed and whether it's within the $69; treating sleep symptoms is off-label
Vaginal estradiol cream or tablets	Vaginal dryness and painful sex; also used off-label to help prevent recurring urinary tract infections (UTIs)	Low-dose local care won't treat hot flashes on its own
Non-hormonal medicines, including fezolinetant	Hot flashes and night sweats without estrogen	Ask about liver-test monitoring and cost

Clinical sources: The Menopause Society, oral progesterone trial, recurrent-UTI guidance, and vaginal estradiol labeling. These describe treatment evidence, not Gala patient outcomes.

Where Gala has an edge

Gala advantage	vs. LifeMD	vs. Alloy	Source, date
One advertised price including visit, prescription and shipping	No separate initial visit fee advertised; actual LifeMD plan and inclusions vary	No separate $49 consult advertised; compare Gala's $69 with Alloy's patch-plus-progesterone subtotal from $123/mo only if both medicines are covered	Gala $69 page, Oct 24, 2026
Pill or patch	LifeMD lists no pill	Alloy has both, priced separately	Gala
Non-hormonal options including fezolinetant	LifeMD lists none	Alloy lists paroxetine only	Gala non-hormonal
No separate membership fee; Gala advertises no dose-related price rise	LifeMD+ is included in Women's Health plans; payment terms vary	Alloy prices each medicine separately	Gala $69 page
Plan and price shown before you pay	LifeMD's pages conflict	Comparable	Gala $69 page

In dollars: for patch plus progesterone, Alloy's consult plus first shipment starts at $418. LifeMD's Bundle 1 example is $278 for its first three-month payment plus the initial fee, if both medicines are included. Gala's advertised plan gives $207 for three monthly payments, if $69 covers both. That is a useful reason to get a Gala quote, not proof that Gala will always cost less. Its no-dose-increase promise is provider advertising, not a price guarantee we have independently tested.

Where Gala doesn't win

We'd rather you hear this from us than find it at checkout.

• No insurance billing. If you want coverage for visits, LifeMD or Midi fits better.
• Exact hormone products aren't named, and an alternate Gala HRT landing page carries a general compounded-medication notice (read October 24, 2026). That notice does not establish that your HRT prescription will be compounded. If you'll only take an FDA-approved product, ask for the exact product and maker before paying.
• A cancellation cutoff to confirm. Gala's HRT page links to a general refund policy requiring a request at least 72 hours before billing. The policy still uses weight-loss language, so confirm the terms for your HRT plan and write down your billing date.
• No video by default. Gala says some states require a short video visit. If you want one regardless, LifeMD offers it.
• Lower listed subtotals elsewhere for single local or pill-only needs. Alloy's vaginal cream and lowest-priced pill-only examples are below Gala's advertised monthly-plan subtotal (see the cost table).

Who Gala fits best

You pay cash and are comfortable with online messaging. You want a quote for estrogen plus progesterone—especially a patch—or want a non-hormonal option. For a hormone plan, you're open to the clinician choosing pill or patch and will confirm that $69 covers the complete prescription. Gala says it serves most U.S. states, but it does not publish a complete HRT state list or clinical age range on the pages we read; confirm both during intake.

Gala posts patient stories on its HRT page. One, from a 51-year-old named Allison, says "Gala's provider walked me through the options and I started HRT." Gala chose and posted that story; we can't verify it, and it isn't a typical result. We share it only because it describes the service, not the medicine.

If that profile sounds like you, Gala says its assessment takes about five minutes and your exact plan and price are shown before you pay. Keep this page open for the questions below.

Affiliate link. Cash-pay. Availability and treatment depend on clinician review and your state. For complaints, cancellation details and seven questions to ask, read our full Gala HRT review.

Other options when neither LifeMD nor Alloy fits

If insurance, a vaginal-only problem, your age or your health history doesn't match either company, one of these may be a better first stop. These limited provider facts were rechecked against their own pages on October 24, 2026.

• Want an in-network specialist through a PPO: Midi Health — says it is in-network with most PPO plans; $250 first visit and $150 follow-up self-pay. Check your exact plan and state. See Midi vs Alloy.
• Vaginal dryness only: Wisp advertises vaginal estradiol cream from $20. That headline does not establish the complete bill or a comparable supply; confirm the selected option, pharmacy charges and any consult cost. See the full provider comparison.
• Ages 35 to 39: Winona publishes an HRT age range of 35–59 in the states it serves; its creams are compounded. See Gala vs Winona.
• Membership with messaging plus insurance-eligible video visits: Evernow. See Gala vs Evernow.
• A complex history: a Menopause Society Certified Practitioner, found through The Menopause Society's public directory.
• Your own doctor: may cost less if your plan covers the visit and a generic prescription.

To see every provider we track side by side, open our comparison of online HRT providers or our HRT cost guide.

Can you cancel, get a refund or move your prescription?

Yes, but stopping future bills, stopping a shipment that's already scheduled, and keeping someone in charge of your refills are three separate tasks. Alloy's terms set two different cancel deadlines, and moving an Alloy prescription to your own pharmacy ends your doctor messaging. LifeMD's terms use an unclear eight-hour deadline and limit refunds.

Cancel and refund rules, from the companies' own terms

	What the provider says	What it means for you
LifeMD — renewal	Recurring fees are "charged in advance," and programs "must be cancelled within (8) hours of the renewal subscription date" (LifeMD terms, updated Nov 17, 2025)	The wording doesn't say before or after. Cancel well ahead of renewal and ask for the exact deadline in writing
LifeMD — refunds	No prorated refund of subscription fees; a possible pro rata refund of the unused portion if you're found not clinically eligible; prescription medicines aren't returnable	A 6-month prepayment is mostly a 6-month commitment
LifeMD — join guide	"You can cancel anytime… if you don't end up qualifying for treatment, you'll receive a refund"	Friendlier than the terms; ask which applies
Alloy — subscription	Cancel at least 7 days before the end of your subscription period (Alloy terms, revised Oct 19, 2026)	Mark this date
Alloy — shipments	Cancel or pause at least 5 business days before your next shipment processes	Mark this date too; use whichever comes first
Alloy — refunds	Product refund requests within 30 days of receiving the first shipment of each product; later shipments aren't refundable; consult and service fees aren't refundable	A request is not a guaranteed refund; the $49 consult is not refunded
Gala	The general refund policy linked from its HRT page requires 72 hours' notice before billing and generally excludes cancellation refunds, with medical-disqualification exceptions (policy dated February 2026; read October 24, 2026)	The policy still uses weight-loss language; confirm the HRT terms, first-charge timing and what is refunded if nothing is prescribed

Moving an Alloy prescription to your own pharmacy

Alloy's help center lays out three conditions (Alloy, updated November 12, 2025):

1. You need an active subscription with at least one order of that product before you can transfer it.
2. Transferring doesn't stop billing. You must cancel your Alloy subscription separately.
3. Once you transfer, you lose member benefits, including unlimited doctor messaging.

So "get the prescription at Alloy, fill it locally with insurance, and keep Alloy's doctors" isn't one package. Plan for who will renew your prescription next.

Your refill-continuity checklist

These are paperwork steps, not medical ones. Don't stop, switch or change a dose on your own; your clinician handles that.

1. Ask your next clinician whether they'll take over the prescription.
2. Write down how much medicine you have left and your next processing date.
3. Confirm who will approve the next refill and what review they need.
4. Ask when messaging or other support ends.
5. Cancel each recurring order you mean to stop, and save the confirmation.
6. Take a screenshot of your checkout page and your billing date before you ever pay.

Health factors that change the answer, and when in-person care comes first

Whether you have a uterus, your age and time since your last period, and any history of blood clots, stroke, heart disease, liver disease or hormone-sensitive cancer change which treatment fits, and whether online care is the right place to start. A clinician weighs these, not a comparison page. Here's what to bring to that conversation.

• Timing matters. The Menopause Society says the benefits of hormone therapy generally outweigh the risks for healthy women with bothersome symptoms who are under 60 or within 10 years of menopause (The Menopause Society). Outside that window, the decision is more careful and personal. It's not an automatic no.
• Some histories usually rule systemic hormone therapy out. These include breast or uterine cancer, unexplained vaginal bleeding, liver disease, past blood clots, stroke, or heart disease. If one is yours, a non-hormonal option or an in-person specialist is the place to start. Low-dose vaginal estrogen is a separate decision; some cancer survivors can consider it with their oncology team (The Menopause Society).
• Unexplained bleeding comes first. Bleeding after menopause, or bleeding you can't explain, needs an in-person check before starting HRT.
• Route can matter. The Menopause Society notes clot risk may be lower with estrogen through the skin (patch, gel, spray) than by pill. That's one reason some women choose Alloy's gel or spray, or a patch at either company. Your history decides, not the price.
• Still having periods? Menopausal hormone therapy is not birth control. Alloy's low-dose birth control pill is a contraceptive with its own safety rules; clinicians check things like smoking at age 35 or older and migraine with aura before prescribing it. Our guide on switching from birth control to HRT explains the shift.
• Labels changed in 2026. On February 12, 2026, the FDA approved labeling changes for six menopausal hormone therapy products, removing boxed-warning statements about heart disease, breast cancer and probable dementia (FDA). That isn't a finding that hormones are risk-free, and it doesn't change the status of compounded products. Our 2026 label changes explainer has the details.
• Taking tamoxifen? Bring up paroxetine's interaction before considering it (see above).

None of this is advice to start, stop or change a medicine. It's what to mention so your clinician has the full picture. If something in your history gives you pause, see how Find My HRT Path handles those situations. It shows guidance only, with no provider links, for situations such as unexplained bleeding, but it can't clear a medical red flag.

Questions to ask LifeMD or Alloy before you pay

Six questions settle almost everything their public pages leave open. Send them by message before you enter a card, and keep the answers.

1. Medicine: "Which exact medicine would I get — brand, strength and maker — and is it an FDA-approved product or compounded?"
2. Today's charge: "What is charged today, and how often after that: monthly, every 3 months or every 6?"
3. Progesterone: (LifeMD) "Which bundle would I be in, and does it include progesterone?" (Alloy) "Is progesterone a separate charge, and on what cycle?"
4. Extras: "Are labs or extra visits ever extra? How much?"
5. If I'm not prescribed anything: "Is every dollar refunded, including the $79 fee or $49 consult?"
6. Leaving: "What's my exact cancel deadline, and is anything refunded if I cancel mid-plan?"

MY ANSWERS (private)
Provider: ________   Date asked: ________
1. Medicine / FDA-approved or compounded: ______________
2. Charged today: $____   Then: $____ every ______
3. Bundle or progesterone: ______________
4. Labs / extra visits: ______________
5. Refund if not prescribed: ______________
6. Cancel deadline / mid-plan refund: ______________
My choice:  LifeMD  /  Alloy  /  Gala  /  someone in person

How we compared LifeMD and Alloy

We read each company's public program pages, price lists, product pages, FAQs, terms and help articles on October 24, 2026, and checked medical points against the FDA, product labels and The Menopause Society. We compared them using The HRT Index Verification Standard. We didn't sign up or receive care, and we don't assign scores.

Pillar	LifeMD	Alloy
1. Clinical legitimacy	Publicly traded; describes an affiliated 50-state medical group and named clinical leaders	Board-certified physicians, per Alloy; assigned clinician licenses not independently checked
2. Care quality	Video or messaging; check-ins; recommends 90-day renewal requests; can order labs; extra visits may be billed	Messaging-based; advertises plans in as little as 12 hours; no labs; messaging ends if you transfer out
3. Medication fit	Patch, gel, vaginal insert, progesterone; compounded cream; no pill or non-hormonal listed	Pill, patch, gel, spray, vaginal cream, progesterone, paroxetine 10 mg, birth control pill
4. Price transparency	Prices published but pages conflict; bundle contents not published	Per-product prices published; "1-month" labels with 3-month billing
5. Access	Possible insurance for video visits; Women's Health Medicare coverage unconfirmed; treatments vary by state	Cash-pay; complete menopause state list and age limits not found on pages we read

What would change our view: LifeMD publishing what's in each bundle and fixing its conflicting prices. Alloy adding insurance, video visits or labs. A pattern of menopause-specific complaints or praise at either. Our full approach is in our methodology, and our affiliate disclosure explains how featured placement works.

LifeMD vs Alloy: quick answers

Is LifeMD or Alloy cheaper for menopause? It depends on the medicine and billing term. Alloy's consult plus first shipment starts at $237.97 for a pill with progesterone; its vaginal cream is $119.97 per tube with no consult fee listed. LifeMD's published three-month bundle examples are $278 or $328 versus Alloy's patch-plus-progesterone example from $418, but only if the quoted bundle includes both medicines. No universal annual winner is confirmed.

Does Alloy take insurance? Alloy does not bill insurance directly for visits or prescriptions, though some patients may seek reimbursement. LifeMD says insurance may cover video visits; Medicare coverage for its Women's Health program remains unconfirmed.

Is LifeMD's HRT FDA-approved? LifeMD lists product types with FDA-approved options, but it says its estradiol cream is compounded and not FDA-approved. Ask for the exact finished product and maker; a route or ingredient alone does not establish approval.

Does LifeMD prescribe estradiol pills? Its Women's Health menu didn't list a pill when we checked on October 24, 2026. Ask before you sign up if you want one.

Can I have a video visit with Alloy? We didn't see one advertised. Alloy's care is built around messaging. LifeMD offers a $79 video visit.

Is progesterone included? At Alloy, it's a separate charge from $23 a month. At LifeMD, it may be inside your bundle; confirm it.

Does either prescribe testosterone for women? Neither lists it for menopause on the pages we checked. Alloy says it isn't prescribing testosterone, and LifeMD's women's menu doesn't list it.

Do I need blood tests? Routine hormone-level tests are often unnecessary at the usual menopause age, but other tests may be needed for your history or a medicine's safety. Alloy says it doesn't order labs. LifeMD can order them at Quest or Labcorp; ask who pays. Fezolinetant requires liver monitoring.

Can I move an Alloy prescription to my local pharmacy? Yes, after at least one order. But you must cancel separately, and you lose Alloy's unlimited doctor messaging.

Is there a cheaper option than both? Gala advertises $69 a month including the visit, prescription and shipping. If it covers both prescribed medicines, it is worth comparing with Alloy's patch route. It is not the cheapest in every scenario: Alloy's lowest pill-plus-progesterone annual example and LifeMD's conditional six-month Bundle 1 example are lower. Confirm the complete quote before paying.

Will Find My HRT Path choose between LifeMD and Alloy? No. It points to a featured option (currently Gala or Winona) or to guidance when online care isn't the right start. This page is the comparison for LifeMD and Alloy.

Bottom line: LifeMD or Alloy?

Both offer clinician-led care for menopause symptoms. The right one depends on what you need from them.

• Choose Alloy if you pay cash and want a pill, spray or gel you can see priced first, or if you only need vaginal treatment. Remember the bill arrives three months at a time.
• Choose LifeMD if you want a video visit, labs, or insurance help for visits. Get your care route, included medicines and today's charge in writing first.
• Compare Gala if you want a flat cash quote for estrogen plus progesterone—especially a patch—or a non-hormonal option like fezolinetant. Confirm that your complete prescription and any required monitoring fit the quote.
• Start in person if you have unexplained bleeding or a high-risk history.

Not sure which camp you're in? Take the free Find My HRT Path quiz. It asks about your symptoms, what you've tried, your age, your state and your health history, then shows a featured care option, or guidance when online care isn't the right start. It takes about 60 seconds and doesn't ask for your email.

And if you already have a doctor who knows your history, it's always fair to ask them first.

Sources

LifeMD (read October 24, 2026)

• LifeMD — Women's Health Program
• LifeMD — Frequently Asked Questions
• LifeMD — How Much Does Online HRT Actually Cost?, updated September 22, 2026
• LifeMD — How to Join the Women's Health Program, updated September 22, 2026
• LifeMD — Online HRT: How Telehealth Is Changing Access to Menopause Care, updated October 13, 2026
• LifeMD — Terms & Conditions, updated November 17, 2025

Alloy (read October 24, 2026)

• Alloy — Menopause Hormone Therapy
• Alloy — All solutions and prices
• Alloy — Estradiol Patch
• Alloy — Estradiol Pill
• Alloy — Evamist
• Alloy — Estradiol Vaginal Cream
• Alloy — Paroxetine
• Alloy — Progesterone
• Alloy — Estradiol Gel
• Alloy help center — insurance and HSA/FSA, updated November 18, 2025
• Alloy help center — billing cadence, updated November 18, 2025
• Alloy help center — how orders and renewals work, updated January 10, 2024
• Alloy help center — messaging care model, February 12, 2026
• Alloy help center — U.S. residence and shipping, updated November 10, 2025
• Alloy — Terms of Use, revised October 19, 2026
• Alloy help center — lab tests, updated May 19, 2025
• Alloy help center — testosterone, April 9, 2024
• Alloy help center — transferring a prescription, updated November 12, 2025

Gala Health

• Gala — HRT plan, $69 offer, read October 24, 2026
• Gala — Hormone Health, read October 24, 2026
• Gala — Non-hormonal options, read October 24, 2026
• Gala — Alternate HRT landing page and general compounding notice, read October 24, 2026
• Gala — Cancellation and Refund Policy, dated February 2026; read October 24, 2026
• Gala — Terms of Service, updated September 22, 2026; read October 24, 2026
• The HRT Index — Gala Health HRT review, read October 24, 2026; its own commercial check is dated October 10, 2026

Medical and regulatory

• FDA — Compounding and the FDA: Questions and Answers
• The Menopause Society — Hormone Therapy
• FDA — Brisdelle (paroxetine 7.5 mg) prescribing information
• DailyMed — Veozah (fezolinetant) prescribing information
• FDA — Labeling changes for menopausal hormone therapy products, February 12, 2026
• The Menopause Society — Find a Menopause Practitioner
• The Menopause Society — Genitourinary Syndrome of Menopause, May 2025; link to the original resource
• NHS — About vaginal oestrogen
• NHS — About HRT, contraception distinction
• NHS — Postmenopausal bleeding
• British Menopause Society — Hormone blood tests in the menopause transition, June 22, 2026
• CDC — Combined hormonal contraceptives, smoking and migraine criteria
• DEA — Anabolic steroids, Schedule III status
• FDA — Testosterone use in menopausal women, August 18, 2026
• Randomized trial — Oral micronized progesterone for perimenopausal night sweats and hot flushes, 2023, corrected 2024; self-reported sleep evidence, not Gala outcomes
• NHS Nottinghamshire APC — Recurrent UTI guidance, March 2025
• DailyMed — Estrace vaginal cream label, used to distinguish approved local indications from off-label UTI prevention
• FDA — Evamist prescribing information, historical approval identity only; not used for current warning wording

Other providers (limited facts rechecked October 24, 2026)

• Midi Health — Pricing and insurance
• Wisp — Vaginal estradiol cream, starting price only; complete comparable cost not established
• Winona — Frequently Asked Questions, HRT ages 35–59 and compounded treatment disclosures
• Evernow — Care models, messaging membership and optional insurance-eligible video visits
• The HRT Index — Best online HRT providers for menopause, broader comparison

The HRT Index is an independent editorial publication. We are not a healthcare provider, pharmacy or telehealth service. Nothing here is medical advice, a diagnosis or a treatment plan. For decisions about starting, stopping or changing hormone therapy, talk with a licensed clinician who knows your history. In an emergency, call 911.

Keep reading: Midi vs Alloy · Midi vs Alloy vs Winona vs Evernow · HRT cost in 2026 · Best HRT with medication included · Who needs progesterone · Estradiol patch reviews · Estradiol pill reviews · Vaginal estrogen