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.

Depth-of-evaluation labels

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

• Hands-on sign-up flow — an editor completed the patient intake, ordered the consult, and worked through the experience end-to-end.
• Customer interview — an editor spoke with a current or former patient of the service.
• Documentation review — an editor reviewed public clinical materials, vendor documentation, terms, prescribing information, and third-party reporting only.

We do not claim a deeper evaluation than we actually conducted. Reviews tagged “documentation review” are not weaker than those tagged “hands-on” on factual content; they simply rest on a narrower experiential base, and the reader is entitled to know that.

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.

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 Bioidentical HRT, Best Insurance-Covered Option, Best for Comprehensive Care, Best for Low-Effort Start, Best Budget) are editorial judgements against the criteria 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

The HRT Index earns commissions on some outbound links. The full mechanics are described in our affiliate disclosure. The short version: 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.

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.