You can get hormone replacement therapy from several types of providers, including your primary care doctor, an OB-GYN, an endocrinologist, a telehealth platform, or a clinic like Planned Parenthood. The right option depends on whether you’re seeking treatment for menopause symptoms or gender-affirming care, your insurance situation, and how quickly you want to start.
Your Primary Care Doctor
For many people, the fastest route to hormone therapy is the doctor you already see. Primary care physicians can evaluate your symptoms, order blood work, and write prescriptions for standard hormone therapy. This is especially true for menopause-related treatment, where straightforward cases don’t typically require a specialist. If your symptoms are more complex or you have a history of blood clots, breast cancer, or other risk factors, your primary care doctor may refer you to a specialist rather than prescribing directly.
Specialists Who Prescribe HRT
OB-GYNs are the most common specialists for menopause-related hormone therapy. They’re trained in reproductive hormones, can manage more complicated cases, and often have the most experience fine-tuning dosages. If your primary care doctor isn’t comfortable prescribing HRT or your situation involves additional health concerns, an OB-GYN is the natural next step.
Endocrinologists specialize in the hormone system broadly. They’re a good fit if you have thyroid conditions, adrenal issues, or other hormonal imbalances alongside menopause symptoms. They also prescribe hormone therapy for gender-affirming care. Urologists sometimes manage testosterone therapy for men experiencing low testosterone, though this is a separate category from menopausal or gender-affirming HRT.
Telehealth Platforms
If getting to an in-person appointment is difficult, or if you’d rather handle things from home, several telehealth services now specialize in hormone therapy. PlushCare offers same-day virtual appointments where you speak with a doctor about your symptoms and then pick up your prescription at a local pharmacy. Evernow takes a more structured approach: you answer questions about your symptoms and goals, get matched with a licensed provider, and approve a personalized care plan before your medication ships. Stella offers pay-per-visit pricing with virtual doctor consultations and prescription management.
These platforms work best for relatively straightforward menopause cases. You’ll still need lab work, which usually means visiting a local lab for a blood draw. The convenience trade-off is that you may not build the same ongoing relationship with a provider, and complex cases may still need an in-person specialist.
Planned Parenthood and Community Clinics
Planned Parenthood is one of the most accessible options for hormone therapy, particularly for gender-affirming care. Many locations use an informed consent model, meaning you don’t need a therapist’s letter or a lengthy referral process. Your first visit typically takes one to two hours and includes a review of your medical history, a physical exam, baseline lab work, and a discussion of what to expect from treatment. Most patients are prescribed hormones that same day.
At your follow-up, usually about a week later, your provider reviews your lab results, answers remaining questions, and has you sign the informed consent document. If you’re prescribed injections, you’ll also get training from a nurse on how to self-administer them. Community health centers and university health clinics often follow a similar model. Western Michigan University’s Sindecuse Health Center, for example, provides gender-affirming hormone therapy through informed consent and serves both students and community members.
Gender-Affirming HRT Specifically
If you’re seeking hormone therapy as part of a gender transition, your options include Planned Parenthood, informed consent clinics, endocrinologists, and some primary care providers who specialize in LGBTQ+ health. The informed consent model is designed to empower you to make your own medical decisions. Your provider will discuss the risks, benefits, alternatives, limitations, and expected timelines of hormone therapy, then confirm you understand before prescribing.
During your initial visit, expect your provider to ask about your gender experience, determine your goals for therapy, review your full medical and family history, check current medications, and perform a physical exam with baseline labs. You’ll receive literature explaining what changes to expect and over what timeframe. Availability varies significantly by state, so searching for “informed consent HRT clinic” along with your city or state is the most reliable way to find a nearby option.
What You’ll Actually Be Prescribed
Hormone therapy comes in more forms than most people realize. For menopause-related treatment, the FDA has approved estrogen as skin patches (brands like Climara, Vivelle-Dot, and Minivelle), topical gels (Divigel, EstroGel, Elestrin), vaginal creams (Estrace), skin creams, and oral pills (Premarin). If you still have a uterus, you’ll also need a progestin to protect the uterine lining, which comes in combination patches like Climara Pro or as a separate pill.
Your provider will help you choose a delivery method based on your preferences and health profile. Patches and gels bypass the liver and carry a lower risk of blood clots compared to pills, which is why many providers prefer them, especially for women over 60 or those with cardiovascular risk factors.
Compounded vs. FDA-Approved Options
You may encounter clinics or pharmacies that offer “bioidentical” hormones made by compounding pharmacies. These are custom-mixed formulations that aren’t reviewed by the FDA for safety and effectiveness the way standard prescriptions are. The out-of-pocket cost for compounded hormone therapy runs roughly $42 to $55 per month, with a commonly cited average around $49 per prescription.
While some providers suggest compounded hormones can save money, the reality is mixed. Many insurance plans don’t cover compounded prescriptions, so you may end up paying more than you would for an FDA-approved generic. The bigger concern is consistency: FDA-approved products are tested to deliver a precise dose every time, while compounded formulations can vary between batches. Unless you have a specific allergy to an ingredient in all available commercial products, FDA-approved options are generally the safer and more predictable choice.
Cost and Insurance Coverage
Most insurance plans cover FDA-approved hormone therapy, though your copay depends on your specific plan and whether you choose a brand-name or generic product. Generic estradiol patches and pills are widely available and often cost under $30 per month with insurance. Without insurance, prices vary more widely, but generic options at major pharmacies are still typically affordable.
Telehealth platforms charge their own consultation fees on top of medication costs. Some accept insurance for the visit itself, while others charge a flat fee per appointment or a monthly membership. If cost is a barrier, Planned Parenthood and community health centers often use sliding-scale fees based on income.