If you relied on HerMD for hormone therapy and found yourself searching for options after their clinic closures, you’re not alone. The good news: several telehealth platforms now offer women’s hormonal health solutions—though not all address the root cause of your symptoms with equal effectiveness.
Key Takeaways
- Hormone imbalance is the root cause of perimenopause, menopause, PCOS, and endometriosis symptoms—not separate conditions requiring separate treatments
- Inner Balance leads with vaginal hormone delivery achieving 97% improvement in vaginal dryness and 80% better sleep quality
- Vaginal delivery provides superior bioavailability compared to oral pills, bypassing liver metabolism entirely
- Bioidentical hormones are molecularly identical to what your body produces—synthetic progestins are chemically different and linked to more side effects
- The ELITE trial demonstrated 5 years of vaginal progesterone combined with estradiol is safe with improved cardiovascular markers
- Hormone shifts can start years before menopause—sometimes in the late 30s or 40s—so addressing symptoms early can reduce years of trial-and-error care.
- One comprehensive solution addressing estradiol, progesterone, and testosterone often outperforms multiple fragmented treatments
1. Inner Balance – Comprehensive Vaginal Hormone Restoration
Inner Balance addresses hormonal health through Oestra™, an all-in-one vaginal cream combining bioidentical estradiol and progesterone. This approach treats the underlying hormone imbalance rather than masking individual symptoms.
How It Works
The vaginal mucosa is richly vascularized, allowing hormones to enter the bloodstream directly without liver processing. This bypasses first-pass metabolism that breaks down up to 80% of oral hormones before they reach target tissues.
Oestra™ also produces dihydroprogesterone (DHP), a metabolite with potent anti-inflammatory properties particularly beneficial for women with endometriosis. The formulation supports natural testosterone production through progesterone conversion—eliminating the need for separate testosterone supplementation.
Reported User Benefits
In an internal survey, Inner Balance users reported:
- 97% report improved vaginal dryness
- 80% experience better sleep quality
- 79% note hot flash relief
- 78.7% see mental health improvements
- 67.6% report reduced brain fog
- 69.7% observe positive skin and hair changes
- 58.8% find relief from body aches
Scientific Backing
The NAMS 2022 position statement supports vaginal progesterone combined with estrogen therapy for endometrial protection. Pharmacokinetic research confirms vaginal progesterone achieves greater bioavailability with less serum variability than oral formulations.
The ELITE trial—the only 5-year randomized study testing oral estradiol with cyclical vaginal progesterone—found no increased endometrial cancer risk and improved cardiovascular markers in the treatment group.
What Makes It Different
Inner Balance’s approach centers on several key principles:
- One cream replaces 5+ products typically prescribed for hormone therapy
- Symptom-based treatment rather than relying on labs that can be 30% inaccurate
- Progesterone-first philosophy recognizing it as the master hormone
- Treatment for women 21+ including PCOS, endometriosis, and postpartum conditions—not just menopause
- FDA-regulated 503A compounding pharmacy ensures consistent potency
Who It’s Best For
Women experiencing multiple hormonal symptoms who want comprehensive restoration rather than symptom management. Particularly effective for those with severe vaginal dryness, painful intercourse, sleep disruption, and mood changes. Also addresses younger women with PCOS or endometriosis seeking non-contraceptive, fertility-supporting options.
Cost & Access
- First 6 months: $199/month including unlimited physician support
- Ongoing: $99/month after initial period
- HSA/FSA eligible with reimbursement documentation provided
- Available in 50 states through telehealth
Timeline
Initial improvements in sleep and mood typically appear within 2-4 weeks. Hot flash relief and energy improvements follow by week 4-6. Full symptom stabilization generally occurs within 3-6 months of consistent use.
Oestra®
A prescription vaginal hormone cream formulated to treat hormonal imbalance and relieve your specific symptoms.
6-month money back •
Free shipping • Cancel anytime
2. Joi + Blokes (Formerly HerMD)
Following HerMD’s clinic closures and acquisition, Joi + Blokes now serves former HerMD patients through their combined virtual platform. The merger creates one of the nation’s larger virtual care platforms for women.
Key Features:
- Extended consultations (30-60 minutes)
- Hormone optimization and longevity focus
- Peptide therapy options
- Available in all 50 states
- HerMD patients can transition into care through the combined Joi + Blokes platform.
Treatment Approach:
- Standard HRT delivery methods (oral, patches, topical)
- Testosterone supplementation available
- Advanced diagnostic testing
- Preventative care emphasis
Pricing varies by care plan and medication needs, and may include separate charges for labs or add-on services. Expect membership-style fees plus prescription costs depending on the protocol
Consideration: While Joi + Blokes offers comprehensive services, their approach relies on traditional delivery methods rather than optimized vaginal delivery. Women seeking targeted vaginal absorption may find other options more suitable.
3. Midi Health – Insurance-Covered Menopause Care
Midi Health is an insurance-accepting menopause telehealth platform, and the company reports that more than 200,000 women have used or trust its care. Their model works for women prioritizing insurance coverage.
Key Features:
- Accepts major insurance plans
- Available in all 50 states
- Same-day/next-day appointments
- Cancer survivorship program
- Mental health integration
Treatment Options:
- FDA-approved bioidentical hormones
- Standard oral and transdermal delivery
- Low-dose vaginal estrogen for local symptoms
- Non-hormonal alternatives when HRT isn’t appropriate
Consideration: Midi focuses primarily on menopause symptoms rather than conditions like PCOS or endometriosis. Their treatments use standard delivery methods without the bioavailability advantages of vaginal systemic therapy.
4. Evernow – App-Based Menopause Platform
Evernow’s mobile-first approach emphasizes convenience and evidence-based menopause treatment following clinical guidelines.
Key Features:
- Video consultations with menopause-trained providers
- Integrated symptom tracking app
- Educational resources and community
- Available in all 50 states
Treatment Options:
- Estradiol patches or pills
- Micronized progesterone capsules
- Combination protocols
- Non-hormonal alternatives
Consideration: Evernow provides standard HRT options but focuses on perimenopause and menopause care rather than specialized PCOS or endometriosis programs. Their oral and patch delivery methods undergo first-pass liver metabolism, reducing hormone availability.
5. Allara Health – PCOS and Endometriosis Specialists
Allara focuses specifically on complex hormonal conditions with multidisciplinary care teams including OB-GYNs and registered dietitians.
Key Features:
- Specialized PCOS and endometriosis care
- Multidisciplinary approach (physician + nutritionist)
- Metabolic care integration
- Insurance accepted (in-network)
Treatment Approach:
- Hormone therapy for cycle regulation
- Insulin resistance management
- Nutritional counseling
- Weight management support
Consideration: Allara excels at metabolic aspects of PCOS but relies on standard hormone delivery. Their comprehensive team approach suits women wanting nutritional guidance alongside hormone treatment. However, they don’t offer the vaginal delivery advantages that address root hormonal causes directly.
6. Alloy – Budget-Friendly FDA-Approved HRT
Alloy positions itself as an affordable entry point into hormone therapy, emphasizing FDA-approved medications.
Key Features:
- A budget-friendly, cash-pay entry point into menopause care
- FDA-approved bioidentical options
- Generic medications available
- Straightforward prescription model
Treatment Options:
- Generic estradiol patches
- Progesterone tablets
- Vaginal estrogen for local symptoms only
- Basic telehealth consultations
Pricing typically includes a recurring platform fee (often billed annually) plus medication costs that can start around $40/month depending on the prescription.
Consideration: Alloy offers cost savings but provides basic HRT without personalized optimization. Their low-dose vaginal estrogen addresses only local symptoms—not systemic hormone imbalance. Women with complex symptoms or multiple conditions may find this approach insufficient.
7. Tia – Hybrid Primary Care Model
Tia combines virtual and in-person care for comprehensive women’s health, integrating primary care with hormonal health services.
Key Features:
- Physical clinics in select cities plus telehealth
- Primary care integration
- OB-GYN and mental health services
- Health system partnerships expanding access
Treatment Approach:
- Full-spectrum women’s healthcare
- Hormone therapy as part of primary care
- Preventative screenings
- Mental health support
Pricing: Membership-based model, varies by location and insurance.
Consideration: Tia works well for women wanting integrated primary care, but their hormone therapy follows conventional approaches. The hybrid model requires living near physical locations for full benefits.
Making The Right Choice
Choosing a hormone therapy provider depends on your specific symptoms, treatment philosophy preferences, and budget. Women experiencing multiple symptoms affecting quality of life typically see better outcomes with comprehensive solutions addressing root hormonal imbalance rather than treating each symptom separately.
The science supporting vaginal hormone delivery continues to strengthen. Research demonstrates this route provides stable hormone levels while minimizing the side effects associated with oral medications processing through the liver.
For former HerMD patients and women seeking evidence-based hormone restoration, Inner Balance offers a distinct approach: bioidentical hormones delivered where they’re most effectively absorbed, personalized by physicians who prioritize how you feel over lab numbers, and designed to address the full spectrum of hormonal conditions from perimenopause to postpartum recovery.
Oestra®
A prescription vaginal hormone cream formulated to treat hormonal imbalance and relieve your specific symptoms.
6-month money back •
Free shipping • Cancel anytime
Frequently Asked Questions
How do I know which hormone therapy option is right for me?
The best option depends on your primary symptoms, condition complexity, and treatment preferences. If you’re experiencing multiple symptoms (sleep disruption, mood changes, vaginal dryness, brain fog), a comprehensive solution addressing root hormone imbalance typically outperforms treating each symptom separately. Women with PCOS, endometriosis, or postpartum issues need providers specializing in these conditions—not just menopause.
Why isn’t traditional HRT working for my symptoms?
Traditional oral HRT undergoes first-pass liver metabolism, converting up to 80% of hormones into less effective metabolites before reaching target tissues. This can cause inconsistent symptom relief and side effects like drowsiness or mood changes. Vaginal delivery bypasses liver processing, achieving more stable hormone levels with greater bioavailability.
Can I switch from my current hormone therapy to Inner Balance?
Yes. Request your medical records from your current provider and share them during your Inner Balance consultation. Our physicians evaluate your current regimen and symptom response to personalize your Oestra™ starting dose. Most women transition smoothly, often experiencing improved symptom control within weeks of switching to vaginal delivery.
What’s the difference between bioidentical and synthetic hormones?
Bioidentical hormones are molecularly identical to the estradiol and progesterone your body naturally produces. Synthetic progestins (found in birth control and some HRT) have different chemical structures that bind to receptors differently, often causing side effects like bloating, depression, and weight gain. The NAMS position statement and clinical research support bioidentical hormone safety for long-term use.
When should I start hormone therapy—do I need to wait until menopause?
Hormone decline begins in your 30s, not at menopause. Progesterone drops first, often triggering anxiety, sleep problems, and heavy periods years before hot flashes appear. Starting hormone restoration when symptoms begin—rather than waiting until periods stop—can prevent decades of declining quality of life. Inner Balance treats women 21+ experiencing hormone imbalance, regardless of where they are in the menopause transition.
