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Hormone therapy

Estrogen therapy, prescribed online

Prescription estradiol for hot flashes, night sweats and vaginal dryness. Choose a daily tablet, a patch, a gel or a low-dose vaginal cream, and a U.S.-licensed provider decides what fits your health history.

  • 100% online, confidential visit
  • Reviewed by U.S.-licensed providers
  • Filled by licensed U.S. pharmacies, shipped free
  • No insurance or membership needed

Select your medication

Estradiol Oral, 1 month Coming soon
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  • Prescription required, provider reviewed
  • No long-term contract
Upfront pricing Free delivery No membership fees U.S.-licensed providers No insurance needed

What is estrogen therapy?

Estrogen levels fall during perimenopause and menopause, which can bring hot flashes, night sweats, poor sleep and vaginal dryness. Estrogen therapy replaces some of that estrogen with estradiol, the same estrogen the ovaries make.

Estradiol comes in two broad types. Systemic forms (the tablet, patch and gel) raise estrogen throughout the body and are the most effective treatment for hot flashes and night sweats. Local low-dose vaginal cream works mainly in the vaginal and urinary tissue, with much less reaching the rest of the body.

A U.S.-licensed provider reviews your health history to decide whether estrogen is safe for you, which form to use and at what dose.

It may be prescribed for women with:

  • Moderate to severe hot flashes or night sweats
  • Sleep problems caused by night-time symptoms
  • Vaginal dryness, burning, irritation or painful sex
  • Urinary urgency or frequency linked to menopause
  • Early menopause (before 45) or primary ovarian insufficiency
Available forms

Estradiol, in the form that fits you

Every form contains the same hormone. They differ in how it gets into your body and which symptoms they treat best.

01

Patch & gel

Through the skin

The patch releases a steady dose and is changed once or twice a week. The gel is rubbed onto the skin once a day. Because they skip the liver on the first pass, providers often prefer them for women with certain clotting or migraine concerns.

02

Oral tablet

Once a day

A simple daily pill that treats hot flashes and night sweats throughout the body. Oral estrogen passes through the liver, which affects clotting factors and other proteins differently than skin forms.

03

Vaginal cream

Local, low dose

Applied inside the vagina on a schedule your provider sets. It treats dryness, irritation, painful sex and some urinary symptoms, with very little estrogen reaching the bloodstream. It is not meant to treat hot flashes.

How to use it

Use it exactly as prescribed

Instructions depend on your form: patches are changed on a set schedule, tablets and gel are usually used once a day, and vaginal cream follows the schedule on your label. Your provider checks in on blood pressure, bleeding and side effects after you start and periodically after that.

Good to know

  • With gel, let it dry, wash your hands, and keep others (especially children and pets) from touching the area
  • If you have a uterus and use systemic estrogen, take the progestogen your provider prescribes
  • Report any new or unexpected vaginal bleeding promptly
  • Never use more than prescribed

Get started in 3 steps

100% online, with free shipping if a prescription is approved.

1

Answer a health questionnaire

A short, confidential online intake about your symptoms and health history.

2

A provider reviews it

A U.S.-licensed provider decides whether estrogen is right for you, and which form and dose.

3

Get your medication

A licensed U.S. pharmacy fills your prescription and ships it to your door.

Estrogen therapy FAQs

What is estrogen therapy?
Estrogen therapy replaces some of the estrogen your body makes less of during perimenopause and menopause. Rx.com prescribes estradiol, the main estrogen the ovaries produce, as a daily tablet, a skin patch, a skin gel or a low-dose vaginal cream.
Which form is right for me?
It depends on your symptoms and health history. The tablet, patch and gel act throughout the body and are used mainly for hot flashes and night sweats. The vaginal cream acts locally and is used mainly for vaginal dryness, painful sex and some urinary symptoms. Your provider recommends a form and dose after reviewing your answers.
What is the difference between systemic and vaginal estrogen?
Systemic estrogen (tablet, patch or gel) raises estrogen levels throughout the body, which is what relieves hot flashes. Low-dose vaginal cream works mainly in the vaginal and urinary tissue and very little reaches the bloodstream, so it treats local symptoms rather than hot flashes.
Do I also need progesterone?
If you still have a uterus and use systemic estrogen, you generally need a progestogen too, because estrogen alone raises the risk of endometrial (uterine) cancer. Your provider will tell you whether this applies to you. Women who have had a hysterectomy usually do not need it.
What side effects can estrogen cause?
Common side effects include breast tenderness, bloating, headache, nausea and spotting or irregular bleeding, especially in the first few months. The patch can irritate the skin where it is applied. Tell your provider about any side effect that bothers you or does not go away.
When should I get urgent medical care?
Get emergency care right away for chest pain, shortness of breath, coughing up blood, pain or swelling in one leg, sudden severe headache, vision changes, trouble speaking, or weakness or numbness on one side of the body. These can be signs of a blood clot or stroke.
How long until it works?
Many women notice fewer hot flashes and better sleep within a few weeks, with the full effect often taking two to three months. Vaginal symptoms can take a few weeks to several months to improve. Your provider may adjust your dose along the way.
Do I need lab tests?
Most women do not need hormone blood tests to start estrogen therapy for menopause symptoms, since the diagnosis is based on symptoms and age. Your provider may ask about recent blood pressure readings, mammograms or other screening and may request labs if your history calls for them.
What if I miss a dose?
Use it as soon as you remember unless it is almost time for the next dose, then skip the missed one. Do not double up. For a patch, put on a new one and keep your usual change schedule. Follow your prescription label if it says otherwise.
Do I need a prescription?
Yes. Estradiol is prescription only. You complete an online health questionnaire, a U.S.-licensed provider reviews it, and if treatment is appropriate a U.S.-licensed pharmacy fills your prescription and ships it to you.
Does insurance cover it?
No insurance is needed. Rx.com estrogen therapy is cash pay with upfront pricing. If you have insurance that covers estradiol, compare your copay too: generic estradiol is often inexpensive at a local pharmacy, and you can check coupon prices on our estradiol price page. See estradiol coupon prices.

Relief that fits your life

Complete a short online visit and a licensed provider will decide whether estrogen therapy is right for you, and in which form.

Get Started

Important safety information

Estrogen-alone therapy increases the risk of endometrial (uterine) cancer in women who have a uterus; adding a progestogen lowers this risk. Estrogen, with or without a progestogen, should not be used to prevent heart disease or dementia. In studies of postmenopausal women, hormone therapy was linked to higher risks of stroke, blood clots, breast cancer and probable dementia in women 65 and older. Use the lowest effective dose for the shortest time that meets your treatment goals.

Do not use estrogen if you have unusual vaginal bleeding that has not been evaluated, have or have had breast cancer or another estrogen-sensitive cancer, have had a blood clot, stroke or heart attack, have liver disease, or are pregnant. Tell the provider about all your health conditions and medications during the online visit.

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Prescription required: Medications are only prescribed when clinically appropriate after a provider evaluation. This page is for information and is not a substitute for professional medical advice.

Medical services: All medical services, including clinical evaluations, treatment planning and prescribing decisions, are provided exclusively by licensed independent medical providers. Rx.com provides the technology platform and administrative coordination services, does not employ healthcare providers, and does not practice medicine.

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