Methodology

The evaluation framework

Every provider we cover is evaluated against the same seven-criterion framework: hormones offered and delivery methods; clinical model and training; lab and monitoring requirements; pricing transparency and unit economics; state availability; practice management and user experience; and cancellation and continuation policies. The framework is identical to the one we publish at the top of each comparison report. We do not score against criteria that are not in the framework, and we do not weight criteria differently for providers with whom we have an affiliate relationship.

Scoring rubric

We score provider comparisons on a 100-point framework. The score is used internally to structure the review and award decisions; we do not publish a numerical ranking unless the underlying evidence is strong enough to support it.

• Clinical safety and appropriateness — 25 points. Contraindication screening, licensed clinician involvement, informed-consent process, progesterone/endometrial-protection handling for patients with a uterus, follow-up cadence, escalation guidance, and clarity around who is not a good candidate.
• Clinician access and qualifications — 15 points. Type of clinician access, menopause-specific training, MSCP or other relevant credentials where available, ability to message or schedule follow-up, and clarity about who manages care.
• Hormone/formulary transparency — 15 points. FDA-approved options, compounded options, route options, vaginal/local therapy options, progesterone options, testosterone policy, non-hormonal alternatives, and clarity about what is and is not offered.
• Pricing and insurance transparency — 15 points. Visit cost, membership fees, medication cost, lab cost, insurance billing, FSA/HSA eligibility, cancellation terms, refill costs, and whether pricing is publicly visible before intake.
• Continuity and follow-up — 10 points. Follow-up schedule, refill management, symptom tracking, ability to change dose/formulation, clinician continuity, and support between visits.
• Availability and operational fit — 10 points. State availability, pharmacy fulfillment, shipping/local pharmacy options, appointment availability, onboarding friction, and accessibility of support.
• Policies, trust, and patient control — 10 points. Refund/cancellation policy, prescription portability, privacy posture, affiliate/commercial transparency, complaint handling, and clarity around limitations.

The HRT Index Path Framework

The HRT Index Path Framework is the structured decision logic behind Find My HRT Path. It organises the pre-consult decision into an ordered sequence of gates: symptom profile and primary goal; safety flags that indicate when online care is not the right starting point; uterus and progesterone status; systemic versus local route; FDA-approved versus compounded preference; provider model (insurance-billed specialist, subscription, pay-per-visit); and cost, insurance, and state availability. Each gate filters and routes before the next one is applied. The output is a primary provider match and two ranked backup routes — expressed as a plain-language Decision Verdict, not a numeric score.

The framework is implemented in the quiz at /find-my-hrt-path/ and documented in full at /find-my-hrt-path/how-it-works/. The routing logic is public and citable. The underlying 100-point provider scoring methodology is used internally to evaluate providers; per-provider output on public pages is expressed as a plain-language Decision Verdict, not a published number.

Minimum safety thresholds

A provider is not eligible for a “best” award if we cannot verify basic safety and trust signals. At minimum, a provider must disclose licensed clinician involvement, screen for contraindications before prescribing, provide a follow-up or support path, clearly distinguish FDA-approved and compounded options where relevant, and avoid presenting HRT as universally appropriate or risk-free.

A provider can be included in a comparison without receiving an award if it is relevant to readers but does not meet our award threshold.

Depth-of-evaluation labels

At the top of every provider review, we publish an honest depth-of-evaluation label. Allowed labels are:

• Documentation review. We reviewed public provider materials, pricing pages, FAQ pages, terms, clinical-policy language where available, and third-party reporting. This supports factual comparison but does not support claims about the full patient experience.
• Intake review. An editor completed the intake flow far enough to evaluate screening, pricing visibility, user experience, and next steps, but did not complete a clinician consult.
• Hands-on consult. An editor completed intake and had a clinician interaction or consult. We disclose what was completed and what was not.
• Customer interview. We interviewed a current or former patient and used the interview to understand experience, support, refill handling, and follow-up. We do not treat a single customer interview as proof of typical experience.

We do not claim a deeper evaluation than we actually conducted. Documentation reviews are not inferior for factual claims, but they are narrower and cannot support the same experience claims as hands-on testing.

Sourcing

Clinical claims are sourced from the major menopause-society guidance documents (the Menopause Society — formerly NAMS, the International Menopause Society, the British Menopause Society, the Endocrine Society where relevant), from peer-reviewed literature, and from FDA-approved prescribing information for the products discussed. Provider-specific claims are sourced from vendor materials and verified, where possible, against second sources. Pricing is sourced from the patient-facing pricing pages at the time of evaluation; pricing changes frequently and we update on a published cadence.

Provider source log

For each provider, we maintain an internal source log containing the provider pages reviewed, date checked, pricing or formulary details captured, and any uncertainty or conflicting information noted. Provider pricing, insurance participation, state availability, and formularies change frequently. Provider-specific data on the homepage and comparison table includes a last-checked date; readers should verify current details directly with the provider before making a purchase or care decision.

Editorial review

Every report is edited by at least one editor in addition to its writer. Where a piece is clinically reviewed, the reviewing clinician's name and credentials appear at the top of the page in the form “Clinically reviewed by [Name, Credentials].” Pages without clinical review carry an “Editorial research — not medically reviewed” label. See our medical review policy for the full rules.

Ranking and awards

Awards (Best Overall, Best for Perimenopause, Best for Compounded/ Bioidentical-Focused Options, Best Insurance-Covered Option, Best for Comprehensive Care, Best for Low-Friction Intake, Best Budget) are editorial judgements against the criteria and scoring rubric above. We do not sell or accept payment for any award placement. We are willing to leave an award category empty if no provider in our cohort merits it.

Affiliate relationships

As of May 2026, The HRT Index does not have active affiliate partnerships with the providers it covers. Provider links are non-affiliate editorial links unless labeled otherwise. If affiliate relationships are added, the full mechanics will be described in our affiliate disclosure. The short version of our standing policy: affiliate relationships do not influence rankings, we cover providers we do not have affiliate relationships with where it makes the comparison more honest, and we will not accept payment for inclusion or for a specific ranking.

Commercial override prohibition

Affiliate relationships do not change scores, award eligibility, inclusion decisions, criticism, or update timing. If a provider relationship creates a conflict that cannot be managed, we either disclose the conflict prominently or remove the provider from award consideration.

Conflict-of-interest policy

Editors and writers disclose to the editorial leadership any financial relationship — investment, employment, consulting, or family relationship — with any provider in our cohort. Anyone with a disclosable relationship is recused from the relevant assignment. No editor or writer has an equity position in any provider currently reviewed on the site.

Corrections

We expect to be wrong about some things and we expect to correct them. Every published correction is logged at /corrections/with the date, the correction, and a visible “Updated: [date]” stamp on the affected page.

Update cadence

The pillar comparison report is reviewed in full at least every six months and on an ad hoc basis when a covered provider materially changes its offering. The “Last reviewed” date in every byline is updated only on a real refresh, not as a publish-date trick.