For most healthy women starting within 10 years of menopause, modern bioidentical HRT is associated with reduced cardiovascular and all-cause mortality. Concerns from an early-2000s women's health study apply to older synthetic regimens started in older women, not to bioidentical estradiol and progesterone.

OPTML retail: progesterone $79/mo, estradiol tablet $79/mo, estradiol cream $199/mo. The most common protocol is the HRT bundle (estradiol + progesterone together) at $138/mo all-inclusive.

Hot flashes Brain fog Mood changes Low energy Low sex drive Night sweats Joint aches Weight gain

OPTML for Women

Prescribed by U.S.-licensed physicians

End the night sweats, brain fog, sleep loss. Bioidentical HRT.

Name: OPTML for Women, HRT (Estradiol + Progesterone)
Brand: OPTML
Price: 199 USD
Availability: MadeToOrder

Your estradiol and progesterone built your sleep, your mood, your skin, your bones, and your brain. Now they’re leaving. OPTML restores them, physician-led, lab-driven, calibrated to your baseline. Not menopause management. Optimization through restoration.

LegitScript CertifiedHealthcare Merchant

Bioidentical 17β-estradiol
Micronized progesterone
Tablet or topical cream
Licensed U.S. physicians

Get started Treatment options

Includes a consultation with a U.S.-licensed physician

Starting at $138/mo · Same protocol you’d build with a top menopause specialist, without the 6-month wait.

Scope: bioidentical estradiol (tablet or cream) and oral micronized progesterone. We don’t prescribe injectable estradiol or testosterone for women.

What gets restored

The hormones built you. We bring them back.

Estradiol and progesterone decline through your 40s and into your 50s. They built your sleep, your mood, your skin, your bones, your brain. The symptoms that follow are real, and restoring the hormones to your own baseline addresses them directly.

Sleep

In the menopause literature, estrogen and progesterone are associated with improved sleep — progesterone’s GABA-active metabolite supports sleep onset and estradiol supports sleep architecture. Individual results vary.

Hot flashes & night sweats

Vasomotor symptoms are among the most-studied responses to estrogen therapy in the menopause literature. Your physician will discuss what to expect for your individual case. Individual results vary.

Mood

Mood changes around menopause are commonly discussed in relation to hormonal shifts. Progesterone’s allopregnanolone metabolite is GABA-active. Individual results vary; your physician will discuss what fits your case.

Cognition

Cognitive changes around menopause are discussed in the literature in relation to estradiol decline, with the “window of opportunity” (within ~10 years of menopause) an active area of research. Individual results vary.

Bone health

Estradiol is well-studied in the literature for postmenopausal bone health, particularly when started within the menopause window. Individual results vary; your physician will discuss what fits your case.

Genitourinary

Topical estradiol is discussed in the literature for genitourinary symptoms of menopause, with relatively low systemic absorption. Individual results vary; your physician will discuss what fits your case.

What treatment
may look like

No one-size-fits-all solutions, just one kit with three potential parts for holistic support. After reviewing your intake, a provider will prescribe the combination that's right for you, if you're eligible.

See if I'm eligible

Bundle (estradiol + progesterone): $138/mo · Estradiol alone: from $79/mo · Progesterone: $79/mo

Ready to start

Get started.

5-minute online intake. A U.S. licensed physician reviews your symptoms and prescribes the right protocol — if appropriate. First shipment in under a week.

Get started → No insurance needed · HSA/FSA eligible · Cancel anytime

Not sure where to start?

Get your bloodwork first.

Your baseline estradiol, progesterone, FSH, LH, thyroid, and metabolic markers — in one draw at any Quest Diagnostics. Use the results to decide if you actually need HRT, and at what dose.

Order Optimized Health, Female — $229 → CLIA-certified labs · Written physician protocol in 48-72 hrs · See all panels

Start HRT in 4 simple steps.

Start your online visit

Answer a few questions about your symptoms, cycle, and history, all online—no in-person doctor's office visit necessary.

Provider evaluation

A U.S.-licensed provider reviews your intake and labs, then prescribes the right protocol, if appropriate.

Personalized plan

Compounded HRT and supplies arrive in 2–3 days. Molecule, format, and dose tailored to you.

Ongoing support

Message your provider anytime. Symptom and lab re-checks at week 8–12.

Want the full screening checklist? Read the HRT eligibility & contraindications →

Not sure if HRT is right for you?

Take the 3-minute Perimenopause Symptom Score →

Validated Greene Climacteric Scale. Scores symptoms across 4 domains. Routes to the right protocol.

Transparent pricing

Physician-directed care

A U.S.-licensed physician personally reviews every order before anything is prescribed.

U.S.-licensed physicians
Reviews every order
LegitScript Certified
503A pharmacy · USP <797>

Progesterone

$79/month— cancel anytime

Micronized, oral, bedtime.

100mg or 200mg
Provider-titrated
Free 2-3 day shipping

See progesterone details

Estradiol Tablet

$79/month

Most common starting format.

Bioidentical 17β-estradiol
Daily oral
Provider-titrated

See estradiol details

Side effects, told straight.

Bioidentical HRT (estradiol + micronized progesterone) has decades of safety data. Most patients tolerate it well, here's what to actually expect.

Common >10%

Mild breast tenderness (especially first 4-8 weeks)
Spotting or breakthrough bleeding (perimenopausal patients)
Bloating or fluid retention
Drowsiness from progesterone (usually a feature, taken at bedtime)

Most resolve within 4-8 weeks as your body adjusts.

Less common 1-10%

Headache, especially when starting
Nausea (can switch from oral to topical to fix)
Mood changes
Skin reaction (topical cream)

Provider can switch dose, format, or timing, usually fixes these.

Rare but serious <1%

Blood clots (DVT/PE), risk lower with transdermal than oral
Stroke (very rare in healthy women under 60)
Gallbladder issues
Endometrial changes (why we always pair estradiol with progesterone)

Contraindicated

Active or history of breast cancer
Active or history of blood clots / DVT / PE
Active liver disease
Unexplained vaginal bleeding
Pregnancy

Call your provider right away if you experience leg swelling, chest pain, sudden severe headache, vision changes, or new breast lumps. The "window of opportunity", within 10 years of menopause or before age 60, is when HRT shows the strongest benefit-to-risk profile.

Common questions

HRT, answered.

The most common questions our medical team hears about hormone replacement therapy, answered with the current evidence, not the 2002 headlines.

01What is HRT?

Hormone replacement therapy restores the estradiol and progesterone your body produces less of during perimenopause and after menopause. It addresses hot flashes, sleep disruption, mood changes, vaginal dryness, brain fog, and bone density loss.

02When should I start HRT?

The evidence-based "window of opportunity" is within 10 years of your last period or before age 60, when HRT shows the strongest cardiovascular, cognitive, and bone-density benefits with the lowest risk profile. Many providers now consider perimenopausal HRT (in your 40s, before periods stop) appropriate as well.

03Do I need both estradiol and progesterone?

If you have an intact uterus: yes. Unopposed estrogen raises endometrial cancer risk; progesterone protects the endometrium. If you've had a hysterectomy, estradiol alone is typically sufficient. Your provider determines this during intake.

04Bioidentical vs synthetic, what's the difference?

Bioidentical hormones (17β-estradiol and micronized progesterone) are molecularly identical to what your body produces. Older synthetic regimens (older synthetic regimens) are different molecules with different metabolic profiles and slightly different risk profiles. OPTML prescribes bioidentical, which is the modern standard.

05Is HRT safe for me?

For healthy women starting within 10 years of menopause, modern bioidentical HRT is associated with reduced cardiovascular and all-cause mortality. Concerns from a widely-discussed early-2000s women's health study largely applied to older synthetic hormone regimens started in women a decade or more past menopause. The current evidence base is dramatically more nuanced and favorable.

06How quickly will I feel something?

In the menopause literature, symptom changes are often discussed within the first weeks, with bone and other long-term effects accruing over time. Individual results vary; your physician will discuss what to expect for your case.

07Who shouldn't use HRT?

Patients with active estrogen-dependent cancer, unexplained vaginal bleeding, active liver disease, or recent stroke/MI should not start systemic HRT. Your provider screens for these.

Mechanism reference · scroll to see the shift

Watch the cluster shift from declining to restored.

Hot flashes & night sweatsResolved

Sleep depth & continuityDeeper

Brain clarity / word-findingRestored

Mood stability & calmSteady

Joint comfortSupported

Genitourinary comfortRestored

Mechanism reference based on published research on bioidentical estradiol + micronized progesterone therapy (ACOG Practice Bulletin 141; the clinical literature CPG, 2015). Compounded preparations are not FDA-approved or evaluated by the FDA for safety, effectiveness, or quality. Not a prediction of personal outcomes. Individual response varies.

End the night sweats, brain fog, sleep loss. Bioidentical HRT.