Women's Health
Menopause & Hormonal Health — Online Care, Same Day
Hot flashes, night sweats, sleep disruption, mood changes, vaginal dryness, hair thinning, or other hormonal symptoms? A licensed provider can evaluate what you are experiencing and discuss treatment options today. No waiting room, no six-week wait for a specialist.
Start a VisitAbout these conditions
🌡️ Menopause, hormones, and why symptoms happen
The menopause transition is one of the most significant hormonal shifts a woman's body goes through. As estrogen and progesterone levels decline, the effects can show up in dozens of ways: sleep, mood, temperature regulation, sexual health, urinary health, hair, skin, and more. The experience is different for every woman, and it often starts years before the last menstrual period.
Understanding what is driving your symptoms is the first step toward getting the right care. Many of these conditions are highly treatable, and you do not have to simply endure them. A licensed provider can evaluate your full picture and discuss what options make sense for your specific situation.
What we treat in this category
Menopause, perimenopause, hormone replacement therapy (HRT), hot flashes and night sweats, vaginal dryness and genitourinary syndrome of menopause (GSM), and hormonally driven hair loss. All evaluated by a licensed provider who tailors treatment to your specific symptoms, history, and goals.
The conditions we treat
📋 How these conditions are related
These conditions share a common root, declining or fluctuating hormones, but each presents differently and may call for a different treatment approach. Here is what each one is and how your provider thinks about it.
- 🌸 Perimenopause The transition phase before menopause, often lasting 4 to 10 years. Hormone levels begin to fluctuate, periods become irregular, and symptoms like hot flashes, sleep disruption, and mood changes often begin here, sometimes well before periods stop. You do not need a menopause diagnosis to seek treatment for perimenopausal symptoms.
- 🌸 Menopause Defined as 12 consecutive months without a menstrual period. Typically occurs between ages 45 and 55, though surgical removal of the ovaries or certain cancer treatments can cause it earlier. After menopause, estrogen and progesterone levels remain low, and symptoms may continue for years without treatment.
- 💊 Hormone Replacement Therapy (HRT) HRT replenishes estrogen and progesterone to reduce menopausal symptoms. It is the most effective treatment available for hot flashes, night sweats, sleep disruption, and mood changes, and for many healthy women under 60 who start within 10 years of their last period, the benefits may outweigh the risks when treatment is individualized and monitored. HRT is not one-size-fits-all. The right form, dose, and delivery method depend on your specific situation.
- 🔥 Hot Flashes / Night Sweats Sudden waves of intense heat, flushing, and sweating. One of the most common and disruptive menopause symptoms. When they occur at night, they are called night sweats and often cause significant sleep disruption. Both respond well to HRT. Non-hormonal prescription options are also available for women who cannot use estrogen.
- 💧 Vaginal Dryness / GSM Genitourinary syndrome of menopause (GSM) refers to the thinning, drying, and inflammation of vaginal tissue as estrogen declines. It causes discomfort, irritation, painful intercourse, and urinary symptoms including urgency, frequency, and recurrent UTIs. Unlike hot flashes, GSM symptoms typically do not improve on their own over time. They require treatment. Low-dose local vaginal estrogen is highly effective and carries minimal systemic absorption.
- 💇 Hormonal Hair Loss Hair thinning driven by hormonal changes is common during perimenopause and after menopause. It typically presents as gradual diffuse thinning across the top of the scalp, widening of the part, or a reduction in overall hair density. It is distinct from sudden shedding (which is usually stress-related) or patchy loss (which has different causes). Treatment is effective but requires patience. Improvement typically takes 4 to 6 months of consistent use.
Signs you may need treatment
🔥 Recognizing menopausal and hormonal symptoms
Hormonal symptoms range from mildly uncomfortable to significantly disruptive. Some women experience them for a year or two. Others deal with them for a decade or more. If your symptoms are affecting your sleep, your relationships, your work, or your sense of self, that is reason enough to explore treatment. You do not need to be in formal menopause to get help.
| 🔥 Hot flashesSudden waves of intense heat, flushing, and sweating, often in the face, neck, and chest. Can happen at any time of day or night. | 🌙 Night sweatsHot flashes during sleep that soak through clothes or bedding. One of the leading causes of sleep disruption during the menopause transition. |
| 😴 Sleep disruptionDifficulty falling or staying asleep, often tied to night sweats or hormonal shifts that directly affect sleep architecture and quality. | 🧠 Brain fogDifficulty concentrating, forgetfulness, or a sense of mental cloudiness. Common and often alarming, but typically hormonal in origin. |
| 😢 Mood changesIrritability, anxiety, low mood, or emotional swings. Often more pronounced during perimenopause when hormones fluctuate rapidly rather than declining steadily. | 💧 Vaginal drynessThinning and drying of vaginal tissue causing discomfort, irritation, painful intercourse, or recurrent urinary symptoms. Does not improve on its own without treatment. |
| 💔 Low libidoDecreased interest in sex, often connected to hormonal shifts, vaginal dryness, fatigue, or mood changes, or all four at once. | ⚡ FatiguePersistent tiredness beyond what poor sleep explains. A direct effect of declining hormones on energy metabolism. |
| 🦴 Joint pain & muscle achesEstrogen has anti-inflammatory properties. As it declines, joint discomfort and stiffness often increase, particularly in the hands, knees, and hips. | 💧 Urinary symptomsUrgency, frequency, or recurrent UTIs. Estrogen supports the health of the bladder and urethra, and its decline affects both. |
| 💇 Hair thinningGradual reduction in hair density across the top of the scalp or a widening part. Hormonally driven hair loss responds to treatment but requires consistent use over several months. | 🌡️ Irregular periodsChanges in cycle length, flow, or frequency are often the first sign of perimenopause, occurring years before the last period. |
⚠️ Some treatment approaches are not right for everyone
Systemic HRT is not appropriate for women with a history of breast cancer or estrogen-sensitive cancer, blood clots, stroke or TIA, active liver disease, unexplained vaginal bleeding, coronary heart disease, pregnancy, or uncontrolled high blood pressure. Your provider screens carefully for all of these before prescribing. Pregnancy and breastfeeding also rule out most hormonal treatments for hair loss. Your provider evaluates your full history before recommending anything.
Experiencing any of these symptoms? A licensed provider can evaluate your situation and discuss treatment options today.
Start a VisitHow online care can help
💻 Menopause and hormonal health online, what you need to know
Menopausal and hormonal health care is well-suited for telehealth. A provider can evaluate your symptoms, review your health history, screen for contraindications, and discuss treatment options, all through an online visit. No physical exam is required to start most of these conversations. If labs are needed, your provider will let you know which ones and where to get them.
What telehealth cannot skip is the intake itself. A thorough understanding of your symptoms, health history, family history, current medications, and goals is essential before anything is prescribed. We do not shortcut that step.
| What online care can do | What it cannot replace |
|---|---|
| Evaluate your full symptom picture and health history | Pelvic exam, Pap smear, or mammogram (your provider will ask about these and refer if needed) |
| Screen for contraindications to HRT and other treatments | Endometrial biopsy when clinically indicated for abnormal bleeding |
| Prescribe estrogen, progesterone, or combination HRT | In-person care for high-risk patients or those more than 10 years past menopause |
| Prescribe treatments for hot flashes, vaginal dryness, or hair loss | Management of complex medical conditions that affect treatment safety |
| Order baseline labs if indicated (thyroid, iron, metabolic panel) | Adjunct hair loss therapies such as PRP, laser, or microneedling (specialist referral needed) |
| Send your prescription to your local pharmacy same day |
- ⏰ No six-week wait for a gynecologist. Same-day appointments. You describe your symptoms today and hear from a provider today.
- 🏪 Your prescription goes to your local pharmacy. Your neighborhood pharmacy fills it. No mail-order required.
- 💰 No monthly subscription. We charge a flat fee per visit. No required memberships to access our telehealth services.
- 🩺 A real clinical evaluation. A licensed provider reviews your intake, meets with you, and makes an individualized clinical determination. Your health journey is unique to you, and your visit should reflect that.
★★★★★ Patient review
"I had no idea what was happening to me. The night sweats, the brain fog, the mood swings. I thought something was really wrong. My provider walked me through everything, and within three weeks I felt like myself again. The whole thing took less time than a waiting room."
Patient, MyPhysician360
Treatment options
💊 How menopause and hormonal conditions are treated
Treatment is individualized. The right approach depends on which symptoms you are experiencing, their severity, your health history, and your personal preferences. Your provider uses shared decision-making. You understand the options and the reasoning before anything is prescribed.
Hormone Replacement Therapy (HRT)
- 🌸 Estrogen therapy (for women without a uterus)Estrogen alone addresses hot flashes, night sweats, sleep disruption, mood changes, bone health, and genitourinary symptoms. Available as oral pills, transdermal patches, gels, creams, or sprays.
- 🌸 Combined estrogen and progesterone (for women with a uterus)Estrogen must be paired with a progestogen to protect the uterine lining. Micronized progesterone is the preferred option and has the added benefit of supporting sleep when taken at bedtime.
- 🌸 Local vaginal estrogen (for genitourinary symptoms)Low-dose vaginal estrogen treats vaginal dryness, irritation, and urinary symptoms without significant systemic absorption. Highly effective for GSM and can be used alone or alongside systemic therapy.
- 🌸 Non-hormonal options (for those who cannot use estrogen)FDA-approved non-hormonal treatments are available for hot flashes for women who cannot or choose not to use hormones. SSRIs and certain other medications also have evidence for vasomotor symptom relief.
A note on HRT delivery methods
Estrogen is available as oral pills, patches, gels, sprays, and vaginal preparations. Transdermal delivery is often preferred for women with elevated blood pressure, clotting history, high triglycerides, or gallbladder concerns, as it bypasses liver metabolism. Your provider recommends the form that best fits your health profile.
Hormonal Hair Loss
Hair loss treatment is effective but requires consistency and patience. Improvement typically takes 4 to 6 months, and continued treatment is needed to maintain results. Your provider evaluates the pattern, extent, and likely cause of your hair loss before recommending treatment.
- 💊 Topical minoxidil (first-line for men and women)Applied directly to the scalp to stimulate hair follicles and improve density. An initial shedding phase may occur before regrowth begins. This is normal and expected. Available over the counter in 2% and 5% formulations.
- 💊 Oral finasteride (primarily for men, with off-label use in women)Reduces the hormone (DHT) that drives patterned hair loss. Requires 6 to 12 months to assess full effect. Continued daily use is necessary to sustain benefit. Should not be used by someone who is pregnant.
- 💊 Spironolactone (for women)An anti-androgen that can be used alone or alongside topical minoxidil in women with inadequate response to topical therapy alone. Requires at least 6 to 12 months of treatment to see full benefit. Should not be used by someone who is pregnant.
- 💊 Low-dose oral minoxidil (when topical is not tolerated)An alternative for women and men who cannot use or do not respond to topical minoxidil. Used with caution in patients with cardiac conditions.
⚠️ A note on compounded hormone therapy
FDA-approved hormone therapy products are the standard, first-line option and are appropriate for the great majority of patients. Compounded hormone preparations are not FDA-approved, meaning their safety, purity, and dosing consistency are not independently verified the way commercial products are. Any decision to use a compounded preparation is made at the provider's discretion, requires documented medical necessity, and is evaluated on a case-by-case basis.
Ready to find out which approach is right for you?
Start a VisitWhat to expect
🗓️ Your visit, start to finish
Here is what happens from your first intake through your follow-up visit.
|
1
Complete your intake
Describe your symptoms, menstrual and health history, current medications, family history, and whether you still have a uterus. About 10 minutes. Thorough by design. |
2
Meet with your provider
You speak with a board-certified provider who reviews your intake, asks follow-up questions, and makes an individualized clinical determination. This is a real clinical conversation, not a form review. |
3
Receive your treatment plan
Your provider explains their recommendation and the reasoning. If treatment is appropriate, your prescription is sent electronically to your preferred local pharmacy same day. |
4
Follow-up and adjustment
A follow-up visit at 4 to 6 weeks for HRT to assess symptoms, side effects, and response. Hair loss follow-up typically at 3 to 6 months. Dosing is adjusted as needed. |
When will I start feeling better?
HRT: many women notice improvement in hot flashes and sleep within 2 to 4 weeks. Full symptom relief typically takes 8 to 12 weeks. Vaginal symptoms take longer as local estrogen rebuilds tissue health. Hair loss: improvement takes 4 to 6 months of consistent treatment. Everyone responds differently, and your provider tracks your progress at follow-up visits.
Supporting your treatment
🌿 What you can do alongside treatment
Medication addresses the hormonal root cause. These lifestyle habits support your treatment and help with things medication does not directly fix.
- →Take your medication consistently. Skipping doses can cause symptoms to return or fluctuate.
- →Prioritize sleep hygiene. Keep your bedroom cool, reduce light exposure, and maintain a consistent sleep schedule.
- →Aim for 150 minutes of moderate exercise per week. Helpful for mood, sleep, bone density, and joint health.
- →Prioritize protein and calcium-rich foods to support muscle mass, bone health, and hair health during this transition.
- →Limit alcohol and caffeine. Both can worsen hot flashes, sleep disruption, and mood instability.
- →Dress in layers and keep environments cool to manage hot flashes day to day.
- →Use a water-based vaginal moisturizer 2 to 3 times per week if vaginal dryness is a concern, alongside or while local estrogen takes effect.
- →For hair health: avoid harsh chemical treatments or excessive heat styling, and ensure adequate iron and protein in your diet.
- →Tell your provider about any new symptoms or side effects before stopping medication on your own.
What about supplements? Black cohosh, maca root, evening primrose oil, and most "menopause support" blends have not been shown effective for managing vasomotor symptoms in clinical trials. Oral biotin, frequently marketed for hair loss, is also not effective according to current evidence. If you find any of these helpful, that is fine, but do not replace prescribed treatment with them without talking to your provider first.
What about NAD+? NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in cellular energy metabolism that declines with age, and some women ask about injectable NAD+ during the menopause transition as a way to support energy, mental clarity, and overall vitality. The underlying biology is real — NAD+ plays a genuine role in mitochondrial function and DNA repair, and NAD+ levels do decline as we age. Evidence that compounded injectable NAD+ meaningfully improves fatigue or other symptoms in humans is still limited and does not come from large controlled trials. It is a compounded medication, not FDA-approved for wellness uses, and is not a substitute for addressing hormonal symptoms through HRT or other appropriate treatment. A licensed provider can discuss whether it may be worth considering for your situation after a proper evaluation. Full details, including safety information and prescribing considerations, are on our Energy & Hormonal Health page — this option is available to any patient, not only men.
🚨 Seek emergency care immediately if you experience:
Chest pain, shortness of breath, sudden one-sided weakness or numbness, sudden severe headache unlike any before, sudden vision changes, difficulty speaking, or new leg swelling or pain (which can signal a blood clot). These symptoms require emergency evaluation, not a telehealth visit.
⚠️ Contact your provider (non-emergency) if:
- You experience unexpected vaginal bleeding after starting HRT
- Symptoms are not improving after 8 to 12 weeks of HRT, or after 4 to 6 months of hair loss treatment
- You notice breast pain, nipple discharge, or a new breast lump
- You experience sudden or severe hair loss, scalp pain, or patchy hair loss. These may require a different diagnosis
- You develop persistent headaches, mood changes, or other side effects that concern you
Care connected to your pharmacy
🏪 Your prescription. Your pharmacy. Same day.
Pharmacies are the front door of healthcare in most communities. We built MyPhysician360 to respect that. When treatment is appropriate, your prescription goes to the pharmacy you already trust, filled by the pharmacist who already knows you.
Already at the pharmacy asking about menopause or hair loss treatment options? Many of our partner pharmacies have a MyPhysician360 QR code right at the counter. Start your visit from the aisle, and your prescription may be ready before you leave.
- ✓Prescription sent electronically to your pharmacy same day your visit ends
- ✓Pick up at your neighborhood pharmacy or any major chain
- ✓Home delivery available by request at many local pharmacies
- ✓We work with compounding pharmacies when a provider determines it is medically necessary
- ✓No required memberships to access our telehealth services
- ✓If we cannot treat you online, you will not be charged
Frequently asked questions
❓ Questions about menopause and hormonal health online
Honest answers to what women ask most before their first visit.
Is HRT safe?
For most women under 60 who start within 10 years of menopause and have no contraindications, current evidence supports that the benefits of HRT outweigh the risks. The North American Menopause Society (NAMS), the Endocrine Society, and ACOG all affirm this position. Much of the historical concern came from a 2002 study whose findings have since been significantly reinterpreted. Your provider reviews your personal risk profile before prescribing anything.
Can I start treatment during perimenopause, before my periods stop?
Yes. You do not need a formal menopause diagnosis to get help with symptoms. If you are experiencing significant hot flashes, sleep disruption, mood changes, or other hormonal symptoms during perimenopause, treatment is appropriate and often more effective when started earlier. Your provider will discuss what fits your stage and situation.
Do I need a blood test or hormone level before starting HRT?
Not usually. Hormone levels fluctuate significantly throughout the day and across the menstrual cycle, which may make blood testing an unreliable way to diagnose menopause or determine whether HRT is appropriate. Current guidelines do not recommend routine hormone level testing for this purpose. Your provider evaluates your symptoms, health history, and clinical picture instead, and may order other baseline labs, such as thyroid or blood count, if otherwise indicated based on your history.
What is the difference between estrogen-only and combined HRT?
Estrogen-only therapy is for women who have had a hysterectomy. Combined therapy, estrogen plus a progestogen, is for women who still have a uterus. Using estrogen alone with an intact uterus increases the risk of endometrial cancer; adding a progestogen helps protect the uterine lining and significantly lowers that risk. Your provider confirms which approach is right for your situation.
Does HRT increase the risk of breast cancer?
The relationship is nuanced and depends on the type of therapy. Estrogen-only therapy in women without a uterus has not been shown to increase breast cancer risk and may reduce it in some studies. Combined estrogen-progestogen therapy is associated with a small increased risk with longer-term use; this risk varies by formulation, duration of use, and personal and family history, and is one of the factors your provider weighs with you. For many women starting within 10 years of menopause, the overall risk-benefit balance remains favorable. Women with a personal history of breast cancer are not candidates for systemic HRT.
How long will I need to take HRT?
There is no fixed duration. NAMS guidelines state there is no need to impose an arbitrary time limit as long as you use the lowest effective dose, stay informed about benefits and risks, and have regular follow-up. Many women take it for several years through the transition; some continue longer for quality of life or bone protection. Stopping is always your choice, and your provider can help you plan a thoughtful approach if you decide to discontinue.
My hair is thinning. Can a telehealth provider help with that?
Yes, for the right type of hair loss. We evaluate and treat patterned hair loss (androgenetic alopecia), which is the most common type in women during and after the menopause transition. It typically presents as gradual thinning on top of the scalp or a widening part. Hair loss that is sudden, patchy, or associated with scalp pain or itching may require a different diagnosis and in-person evaluation. Your provider assesses the pattern and extent during your visit and determines whether telehealth treatment is appropriate.
How long does hair loss treatment take to work?
Significantly longer than most people expect, and that is normal. Improvement typically takes 4 to 6 months of consistent treatment. An initial shedding phase may occur in the first few weeks when starting topical minoxidil; this is part of the process and resolves. Continued treatment is required to maintain results. Your provider sets realistic expectations at your visit and follows up at 3 to 6 months to assess response.
What about vaginal dryness? Is that something a telehealth provider can treat?
Yes. Vaginal dryness and genitourinary syndrome of menopause (GSM) are among the most effectively treated menopausal conditions. Low-dose local vaginal estrogen is highly effective and carries minimal systemic absorption, making it appropriate even for some women who cannot use systemic HRT. A provider can evaluate your symptoms and prescribe appropriate treatment in a single visit.
Is this visit HSA or FSA eligible?
Yes. MyPhysician360 consultations are HSA and FSA eligible. Your visit cost is reimbursable through your Health Savings Account or Flexible Spending Account, making this accessible through your existing health benefits even without insurance.
Helpful resources
📚 Learn more
Your provider may reference these materials during your visit. Links go straight to the source.
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🏥 Clinical guidelines The 2022 Hormone Therapy Position Statement North American Menopause Society (NAMS) Read the position statement |
📖 Patient education Menopause: symptoms, causes, and treatment overview Mayo Clinic Visit Mayo Clinic |
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🔬 Clinical practice guideline Treatment of symptoms of the menopause Endocrine Society, Journal of Clinical Endocrinology & Metabolism Read the guideline |
💇 Hair loss information Female pattern hair loss: overview and treatment American Academy of Dermatology (AAD) Visit AAD |
Ready to feel better? Let's get started.
Answer a few questions, meet with a licensed provider same day, and get a personalized treatment plan. No required membership. Offered nationwide. Your prescription, if appropriate, goes straight to your pharmacy.
HSA & FSA eligible | No required membership | No charge if we can't help
Medical disclaimer & sources: The information on this page is for general educational purposes only and does not constitute medical advice. Treatment eligibility requires clinical evaluation by a licensed provider. Not all patients are candidates for HRT or hormonal hair loss treatment. This page reflects guidance from the North American Menopause Society (NAMS) 2022 Hormone Therapy Position Statement, the Endocrine Society Clinical Practice Guideline on Treatment of Menopause Symptoms, the American Academy of Dermatology, and the MyPhysician360 HRT and Hair Loss Clinical Protocols. Women with a history of breast cancer, blood clots, stroke, coronary heart disease, or active liver disease are not candidates for systemic HRT. Hair loss treatment should not be used by anyone who is pregnant. Injectable NAD+ is a compounded medication not FDA-approved for wellness or energy uses; evidence supporting its use for these purposes in humans is limited; it is not appropriate as a substitute for evaluation and treatment of hormonal symptoms. MyPhysician360 is offered nationwide. Services are not currently available in Mississippi or Alaska.