You can get hormone therapy from several types of providers, including your primary care doctor, specialists like endocrinologists and OB-GYNs, telehealth platforms, Planned Parenthood clinics, and dedicated hormone therapy clinics. The right starting point depends on why you need it and what’s available in your area. Here’s a breakdown of every major option.
Primary Care and Specialist Offices
For many people, the simplest path is through a doctor you already see. Primary care physicians can prescribe hormone therapy for menopause symptoms, low testosterone, and in many cases gender-affirming care. If your situation is more complex or your doctor isn’t comfortable managing hormones, they’ll typically refer you to a specialist.
The specialists most commonly involved include endocrinologists (hormone experts), OB-GYNs (for menopause and reproductive hormone concerns), reproductive endocrinologists (for fertility-related hormone issues), and urologists (for testosterone therapy in men). Board-certified urologists at dedicated men’s health clinics, for example, handle testosterone optimization and can help you avoid the cash-pay clinics that sometimes push treatments based on profit rather than your actual needs.
If you’re seeking hormone therapy for menopause, The Menopause Society maintains a searchable directory of certified menopause practitioners. You can filter by zip code or by telehealth availability. These are clinicians who’ve completed additional training in managing perimenopause and postmenopause, so they tend to be more up to date on current prescribing guidelines than a general practitioner might be.
Telehealth Platforms
Online hormone therapy has expanded significantly, especially for menopause-related prescriptions. Several telehealth platforms let you consult a licensed provider by video, get a prescription, and have medication sent to your local pharmacy or delivered by mail.
PlushCare offers same-day virtual appointments where you discuss symptoms with a doctor and pick up your prescription at any pharmacy. Evernow takes a more guided approach: you answer questions about symptoms and goals, get matched with a provider, approve a personalized plan, and choose between pharmacy pickup or mail delivery. Stella offers pay-per-visit pricing that includes a virtual doctor visit, a menopause management app, and prescription hormone therapy.
Telehealth works well if you live in an area with few specialists, want the convenience of not leaving home, or prefer more privacy around your care. Keep in mind that most platforms still require bloodwork at some point, which you’ll need to get done at a local lab.
Gender-Affirming Hormone Therapy
If you’re seeking hormone therapy as part of a gender transition, you have several dedicated pathways. Planned Parenthood clinics in many states offer gender-affirming hormone therapy on an informed consent basis, meaning you don’t need a therapist’s letter or a specific diagnosis to start. This makes them one of the most accessible entry points, particularly in areas without LGBTQ+ specialty clinics.
To find a provider experienced in gender-affirming care, the LGBTQ+ Healthcare Directory (run by GLMA, a national organization of LGBTQ+ health professionals, in partnership with the Tegan and Sara Foundation) lists over 2,700 providers across the U.S. and Canada. The directory is free, includes virtual care options, and covers providers in all 10 Canadian provinces. In its first year it handled more than 43,000 searches, making it one of the largest resources of its kind.
University-affiliated gender clinics, LGBTQ+ community health centers, and some endocrinology practices also provide gender-affirming hormones. Before starting, you’ll typically need baseline blood work. For testosterone therapy specifically, providers check red blood cell levels before prescribing, then monitor them every three months during the first year and once or twice a year after that.
What Hormone Therapy Costs
Cost varies enormously depending on the type of hormone, the delivery method, and whether you have insurance. Most insurance plans cover estrogen products, but out-of-pocket costs can still be significant for brand-name options.
At the low end, generic estrogen tablets can cost as little as $10 for a 90-day supply. Generic estradiol patches run under $40 a month. At the higher end, brand-name options climb quickly: a 30-day supply of Premarin tablets averages around $277 at cash price, and combination patches like Climara Pro can exceed $300 a month without savings cards.
Creams and gels fall in the middle. Generic estradiol cream averages about $111 per tube, while gel products range from around $40 (with discount coupons) to over $300 depending on the brand. Injections vary too, with generic estradiol vials around $130 and brand-name monthly injections averaging $300.
Manufacturer savings cards can cut costs substantially. Some bring brand-name prescriptions down to $25 per fill. Prescription discount tools like GoodRx often reduce prices by 50% or more compared to the cash price. If cost is a barrier, ask your provider about generic alternatives first, since they contain the same active ingredients and are far cheaper.
FDA-Approved vs. Compounded Hormones
You’ll likely encounter two categories of hormone products: FDA-approved medications and custom-compounded formulations. Understanding the difference matters for your safety.
FDA-approved hormone therapies have gone through rigorous testing for safety, efficacy, potency, and purity. They come with standardized dosing and detailed labeling about risks and side effects. These are what most mainstream providers prescribe.
Compounded bioidentical hormones are mixed by specialty pharmacies into custom doses and forms like creams, pellets, capsules, or injections. They’re not FDA-approved, which means they haven’t been tested the same way. Because each batch is custom-made, there’s a higher risk of inconsistent dosing, contamination, or getting too much or too little hormone. Compounded testosterone creams, for instance, aren’t required to carry the same warning labels as FDA-approved versions.
Some providers and clinics market compounded “bioidentical” hormones as safer or more natural than standard options. There’s no evidence supporting those claims. Several FDA-approved products already use bioidentical hormones (chemically identical to what your body produces) with the added assurance of standardized manufacturing. If a provider recommends compounded hormones, it’s worth asking why an FDA-approved alternative wouldn’t work for your situation.
How to Get Started
The first step is usually a conversation with a provider about your symptoms, health history, and goals. For menopause-related therapy, that might be as simple as describing hot flashes, sleep disruption, or vaginal dryness to your OB-GYN or primary care doctor. Providers generally prescribe the lowest effective dose to relieve symptoms.
For testosterone therapy, whether for low T or gender-affirming care, expect baseline blood work before you receive a prescription. This helps your provider set the right dose and establishes reference points for ongoing monitoring.
If you’re unsure where to start, these directories can help you find someone qualified: The Menopause Society’s practitioner search for menopause care, the LGBTQ+ Healthcare Directory for gender-affirming care, or your insurance company’s provider finder filtered by endocrinology or the relevant specialty. Many of these resources include telehealth options, so geography doesn’t have to limit your choices.