Online Menopause Clinics: 6 Questions Before You Subscribe

Online menopause services have made hormone therapy and other prescriptions easier to get, especially if you couldn’t find a local clinician who’d talk about hot flashes. Many charge a monthly membership on top of the medicine. Services vary widely in how they assess you, what they prescribe and what they charge. These six questions help you compare them before you subscribe.

1. Who will I see, and are they licensed where I live?

Ask for the clinician’s name and credentials, and whether they’re licensed in your state. You can look up most licenses on your state medical or nursing board’s website.

The Menopause Society¹ keeps a directory called Find a Menopause² Clinician. It lists members and clinicians who have earned its MSCP certification, and you can use it to check a name or find someone new.¹ The Society also suggests checking whether a clinician accepts commercial insurance or Medicare and offers telemedicine, and whether they listen and answer your questions.¹

2. Will they take a full history before prescribing?

The Menopause Society’s¹ 2022 position statement says hormone therapy should be individualized. Risks depend on the type, dose, route, how long you take it and when you start. For women under 60 or within 10 years of menopause without reasons to avoid it, the balance of benefits and risks is generally favorable for bothersome hot flashes. It’s less favorable for women who start later.²

A careful visit asks about your personal and family history of breast cancer, blood clots, stroke, heart disease and liver disease, any unexpected bleeding, and your other medicines. If a service offers a prescription after a short form with no questions back, that’s a warning sign.

3. Is the medicine FDA-approved or compounded?

ACOG³ advises against routinely prescribing compounded “bioidentical” hormones when FDA⁴-approved options exist.³ Ask which product you’d get, at what dose, and whether it’s FDA-approved. If it’s compounded, ask why an approved patch, gel, spray, ring or pill isn’t suitable.

4. Which pharmacy fills it?

The FDA⁴ says a safe online pharmacy always requires a prescription, has a U.S. physical address and phone number, has a licensed pharmacist available to answer questions, and is licensed by a state board of pharmacy.⁴ You can check the license through the FDA’s BeSafeRx tool.⁴ Warning signs include prices that seem too good to be true and pharmacies that sell your information to other websites.⁴ Ask whether you can send the prescription to your own local pharmacy instead.

5. What does it cost, and how do I cancel?

Before you enter a card number, find out:

• The membership fee, and whether it renews automatically
• What the medicine costs, and whether it’s included or billed separately
• Whether lab tests, follow-up visits and messages cost extra
• Whether the service bills your insurance or gives you a receipt you could submit yourself
• How to cancel, and whether a medicine shipment already in progress is refundable

Take a screenshot of the price and cancellation terms on the day you sign up.

6. Who follows up, and how do my records get to my regular doctor?

Hormone therapy needs periodic review of its benefits and risks.² Ask who you contact for side effects or bleeding, how quickly they reply, and how often they’ll review your treatment. Ask whether they’ll send visit notes to your primary care clinician or gynecologist, so your mammograms, bone health and other medicines stay in one picture.

Try: “Before I sign up, can you tell me who the clinician is, whether the medicine is FDA⁴-approved, which pharmacy fills it, the total monthly cost, and how I cancel?”

My Body Changed. Now What? includes a Visit Brief. Use it to list your symptoms, history and medicines before an online visit, and to record the answers to these six questions. See the book.