Your free starter kit

Everything you need before your first HRT appointment

Four short resources to help you walk into your provider visit prepared, confident, and ready to get care that actually fits. Bookmark this page, or print the sections you need.

Symptom checklist

15 questions to ask

Treatment comparison

First 30 days

Print tip: Use your browser's print function (Ctrl/Cmd + P) to save any section as a PDF or bring a paper copy to your appointment.

Perimenopause symptom checklist

Check every symptom you've noticed in the last 6 months, even if you think it's unrelated. Many women are surprised by how many symptoms are actually hormonal. Bring this to your appointment.

Vasomotor

Hot flashes
Night sweats
Cold flashes
Heart palpitations
Dizziness

Sleep

Trouble falling asleep
Waking at 3 AM
Unrefreshing sleep
Sleep disruption from sweats

Mood & cognition

Anxiety
Depression
Irritability or rage
Mood swings
Brain fog
Memory problems
Loss of confidence
Panic attacks

Physical

Joint pain
Muscle tension
Frozen shoulder
Fatigue
Weight gain (especially belly)
Headaches & migraines
Electric shock sensations
Tingling in extremities
Tinnitus

Skin, hair, nails

Dry skin
Itching skin
Thinning hair
Brittle nails
Burning mouth

Menstrual & sexual

Irregular periods
Heavy bleeding
Vaginal dryness
Painful intercourse
Low libido
Recurrent UTIs
Urinary incontinence

Other

High cholesterol (new)
Blood pressure changes
New allergies or food sensitivities

Want a deeper read on any of these? See our full symptoms library.

15 questions to ask any HRT provider

A good provider welcomes questions. Their answers will tell you a lot about whether they're genuinely experienced with HRT or just dabbling. If they dodge, push back, or seem annoyed, that's your answer.

What HRT formulations do you most often prescribe, and why?
Do you prescribe bioidentical hormones? FDA-approved or compounded?
How do you decide between patches, pellets, creams, and oral?
Do you prescribe testosterone for women? Under what circumstances?
How do you monitor hormone levels during treatment?
What's your approach to progesterone for women with a uterus?
What side effects should I watch for in the first 3 months?
How do you adjust dosing if symptoms don't improve?
What's your stance on the WHI study and current HRT safety evidence?
Do you accept insurance, and which plans?
What's the typical cost out-of-pocket for the treatments you recommend?
How often will we have follow-up appointments?
Are you certified by the Menopause Society (MSCP/NAMS)?
How do you handle vaginal dryness and urinary symptoms specifically?
If HRT isn't right for me, what non-hormonal options do you offer?

Green flags to listen for: references to recent guidelines (2022 NAMS position statement or later), acknowledgment that the WHI study was misinterpreted for two decades, willingness to individualize dosing, and comfort with testosterone for women.

Treatment comparison

Here's a quick, honest snapshot of the main HRT options. Each has trade-offs. The right choice depends on your symptoms, health history, and preferences.

Estrogen Patches

Full guide

Pros

Steady dose; lowest blood clot risk; skip the liver

Cons

Can irritate skin; visible on body

Best for

Women whose clinician recommends systemic estrogen and considers a transdermal route appropriate. Estradiol patch labels still list a current or past blood clot, stroke or heart attack as reasons not to use it.

Bioidentical Hormones (FDA-approved)

Full guide

Pros

Identical to what your body makes; well-studied when FDA-approved

Cons

Compounded versions lack FDA oversight

Best for

Women who want the natural-molecule approach, via FDA-approved products.

Pellet Therapy

Full guide

Pros

Convenient - every 3-6 months; no daily routine

Cons

Cannot adjust dose once inserted; cash-pay usually; supra-physiological levels common

Best for

Women who want set-and-forget, can pay out of pocket, and accept dose limitations.

Creams & Gels

Full guide

Pros

Easy to adjust; absorbed through skin; avoids liver

Cons

Can transfer to others via skin contact; daily application

Best for

Women who want flexible dosing and prefer transdermal.

Oral HRT

Full guide

Pros

Simple; widely available; often covered by insurance

Cons

Higher blood clot risk vs transdermal; processed by liver

Best for

Women without clot risk factors who prefer a pill.

Testosterone for Women

Full guide

Pros

Can improve sexual desire in some postmenopausal women diagnosed with hypoactive sexual desire disorder (HSDD)

Cons

Off-label in US; few providers prescribe; requires monitoring

Best for

Postmenopausal women with persistent, distressing low sexual desire after a full clinical assessment.

Vaginal Estrogen

Full guide

Pros

Very low systemic absorption; safe for most, including after breast cancer in many cases

Cons

Only treats genitourinary symptoms

Best for

Any woman with vaginal dryness, painful sex, or recurrent UTIs.

Non-hormonal Options

Full guide

Pros

For women who can't or won't take HRT; Veozah (fezolinetant) is effective, though it carries an FDA boxed warning for liver injury and needs liver blood tests

Cons

Usually less complete symptom relief than HRT

Best for

Women with contraindications or personal preference against hormones.

Your first 30 days on HRT

Most women want to know: when will I feel better? The honest answer is that it varies, but here's a realistic timeline based on what most patients report.

Week 1

You may notice some breast tenderness, mild headaches, or bloating as your body adjusts. These typically pass within 1-2 weeks. Sleep may start improving for some women within days. Hot flashes usually take longer.

Week 2

Sleep continues to improve. Mood may start to stabilize. Some women report early relief in brain fog. Hot flashes may begin to decrease in intensity, though frequency often takes longer to drop.

Weeks 3-4

Many women notice a clear difference by now, though it can take up to three months to feel the full effect. If you're not noticing any improvement, message your provider: your dose or type of HRT may need adjusting.

Month 2-3

Joint pain, vaginal symptoms, and libido often take 2-3 months to meaningfully improve. Estrogen also helps slow bone loss while you take it. A follow-up appointment at the 3-month mark is standard.

Call your provider sooner if you experience: severe headaches, unusual leg pain or swelling (possible clot), chest pain, vision changes, or very heavy unexpected bleeding.

Start HRT online with Gala Health

Get a licensed clinician, a prescription if HRT is right for you, and treatment shipped to your door - without an in-person visit.

Start with Gala Health - from $69/mo Find a provider near you

LegitScript-certified
From $69/mo
All 50 states
Prescribed online

Not sure which platform fits you? Take the 60-second match quiz or compare the best online HRT of 2026.

How getting started works

1
Share your health history
A short online questionnaire, about 5 minutes. No appointment and no waiting room.
2
A licensed clinician reviews
A licensed provider checks your history and, if HRT is right for you, writes the prescription.
3
Delivered to your door
Your treatment ships to you, usually within days, with ongoing check-ins and dose adjustments.

Some links above are partnerships. If you start care through them, we may earn a commission at no extra cost to you. Partners we can earn from may be shown first in some lists, but commission never changes the facts we report about any provider.

Ready to find a provider?

Search 1,200+ HRT specialists by ZIP code, state, or telehealth availability. Free, no referral required.

Browse Providers

This starter kit is educational only and is not medical advice. Always consult a qualified healthcare provider before starting or changing any treatment.

Everything you need before your first HRT appointment

Four short resources to help you walk into your provider visit prepared, confident, and ready to get care that actually fits. Bookmark this page, or print the sections you need.

Print tip: Use your browser's print function (Ctrl/Cmd + P) to save any section as a PDF or bring a paper copy to your appointment.

Perimenopause symptom checklist

Check every symptom you've noticed in the last 6 months, even if you think it's unrelated. Many women are surprised by how many symptoms are actually hormonal. Bring this to your appointment.

Vasomotor

Hot flashes
Night sweats
Cold flashes
Heart palpitations
Dizziness

Sleep

Trouble falling asleep
Waking at 3 AM
Unrefreshing sleep
Sleep disruption from sweats

Mood & cognition

Anxiety
Depression
Irritability or rage
Mood swings
Brain fog
Memory problems
Loss of confidence
Panic attacks

Physical

Joint pain
Muscle tension
Frozen shoulder
Fatigue
Weight gain (especially belly)
Headaches & migraines
Electric shock sensations
Tingling in extremities
Tinnitus

Skin, hair, nails

Dry skin
Itching skin
Thinning hair
Brittle nails
Burning mouth

Menstrual & sexual

Irregular periods
Heavy bleeding
Vaginal dryness
Painful intercourse
Low libido
Recurrent UTIs
Urinary incontinence

Other

High cholesterol (new)
Blood pressure changes
New allergies or food sensitivities

Want a deeper read on any of these? See our full symptoms library.

15 questions to ask any HRT provider

What HRT formulations do you most often prescribe, and why?
Do you prescribe bioidentical hormones? FDA-approved or compounded?
How do you decide between patches, pellets, creams, and oral?
Do you prescribe testosterone for women? Under what circumstances?
How do you monitor hormone levels during treatment?
What's your approach to progesterone for women with a uterus?
What side effects should I watch for in the first 3 months?
How do you adjust dosing if symptoms don't improve?
What's your stance on the WHI study and current HRT safety evidence?
Do you accept insurance, and which plans?
What's the typical cost out-of-pocket for the treatments you recommend?
How often will we have follow-up appointments?
Are you certified by the Menopause Society (MSCP/NAMS)?
How do you handle vaginal dryness and urinary symptoms specifically?
If HRT isn't right for me, what non-hormonal options do you offer?

Treatment comparison

Here's a quick, honest snapshot of the main HRT options. Each has trade-offs. The right choice depends on your symptoms, health history, and preferences.

Estrogen Patches

Full guide

Pros

Steady dose; lowest blood clot risk; skip the liver

Cons

Can irritate skin; visible on body

Best for

Bioidentical Hormones (FDA-approved)

Full guide

Pros

Identical to what your body makes; well-studied when FDA-approved

Cons

Compounded versions lack FDA oversight

Best for

Women who want the natural-molecule approach, via FDA-approved products.

Pellet Therapy

Full guide

Pros

Convenient - every 3-6 months; no daily routine

Cons

Cannot adjust dose once inserted; cash-pay usually; supra-physiological levels common

Best for

Women who want set-and-forget, can pay out of pocket, and accept dose limitations.

Creams & Gels

Full guide

Pros

Easy to adjust; absorbed through skin; avoids liver

Cons

Can transfer to others via skin contact; daily application

Best for

Women who want flexible dosing and prefer transdermal.

Oral HRT

Full guide

Pros

Simple; widely available; often covered by insurance

Cons

Higher blood clot risk vs transdermal; processed by liver

Best for

Women without clot risk factors who prefer a pill.

Testosterone for Women

Full guide

Pros

Can improve sexual desire in some postmenopausal women diagnosed with hypoactive sexual desire disorder (HSDD)

Cons

Off-label in US; few providers prescribe; requires monitoring

Best for

Postmenopausal women with persistent, distressing low sexual desire after a full clinical assessment.

Vaginal Estrogen

Full guide

Pros

Very low systemic absorption; safe for most, including after breast cancer in many cases

Cons

Only treats genitourinary symptoms

Best for

Any woman with vaginal dryness, painful sex, or recurrent UTIs.

Non-hormonal Options

Full guide

Pros

For women who can't or won't take HRT; Veozah (fezolinetant) is effective, though it carries an FDA boxed warning for liver injury and needs liver blood tests

Cons

Usually less complete symptom relief than HRT

Best for

Women with contraindications or personal preference against hormones.

Your first 30 days on HRT

Most women want to know: when will I feel better? The honest answer is that it varies, but here's a realistic timeline based on what most patients report.

Week 1

Week 2

Sleep continues to improve. Mood may start to stabilize. Some women report early relief in brain fog. Hot flashes may begin to decrease in intensity, though frequency often takes longer to drop.

Weeks 3-4

Month 2-3

Joint pain, vaginal symptoms, and libido often take 2-3 months to meaningfully improve. Estrogen also helps slow bone loss while you take it. A follow-up appointment at the 3-month mark is standard.

Call your provider sooner if you experience: severe headaches, unusual leg pain or swelling (possible clot), chest pain, vision changes, or very heavy unexpected bleeding.

Start HRT online with Gala Health

Get a licensed clinician, a prescription if HRT is right for you, and treatment shipped to your door - without an in-person visit.

Start with Gala Health - from $69/mo Find a provider near you

LegitScript-certified
From $69/mo
All 50 states
Prescribed online

Not sure which platform fits you? Take the 60-second match quiz or compare the best online HRT of 2026.

How getting started works

1
Share your health history
A short online questionnaire, about 5 minutes. No appointment and no waiting room.
2
A licensed clinician reviews
A licensed provider checks your history and, if HRT is right for you, writes the prescription.
3
Delivered to your door
Your treatment ships to you, usually within days, with ongoing check-ins and dose adjustments.

Ready to find a provider?

Search 1,200+ HRT specialists by ZIP code, state, or telehealth availability. Free, no referral required.

Browse Providers

This starter kit is educational only and is not medical advice. Always consult a qualified healthcare provider before starting or changing any treatment.