For most healthy women starting within 10 years of menopause, modern bioidentical HRT is associated with reduced cardiovascular and all-cause mortality. The Women's Health Initiative concerns largely apply to older synthetic regimens started in older women, not to bioidentical estradiol and progesterone.

OPTML retail: progesterone $79/mo, estradiol tablet $99/mo, estradiol cream $229/mo. The most common protocol is the HRT bundle (estradiol + progesterone together) at $199/mo all-inclusive.

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

OPTML for Women

★★★★★4.9 / 200,000+ patients across our provider network

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

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

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

Start your free assessment Treatment options

Starting at $199/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 returns

Most patients report sleeping through the night for the first time in years within 2-4 weeks. Progesterone’s GABA-active metabolite handles sleep onset; estradiol stabilizes sleep architecture.

Hot flashes resolve

80-90% of patients see vasomotor symptoms fully resolve within 4-8 weeks at appropriate doses. Drenched-pillow nights become uncommon, then rare, then forgotten.

The mood floor comes back

The flatness, the anxiety, the irritability you didn’t recognize as hormonal, lifts. Progesterone’s allopregnanolone effect is the closest thing to a clean GABA-modulator outside of pharmaceutical sleep aids.

Mental clarity restored

The brain fog isn’t aging. It’s estradiol withdrawal. Patients in the "window of opportunity" (within 10 years of menopause) see the strongest cognitive recovery.

Bones protected

Estradiol is one of the most effective interventions for preventing postmenopausal bone loss when started in the window. Real DEXA improvements at 6-12 months.

Vaginal & genitourinary

Topical estradiol cream resolves dryness, discomfort, and recurrent UTIs, often within weeks, with minimal systemic absorption.

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): $199/mo · Estradiol alone: from $99/mo · Progesterone: $79/mo

Ready to start

Start your free consultation.

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.

Start your free assessment → 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

How OPTML's HRT works

5-min intake

Symptom profile (Greene Climacteric scale), cycle status, history, contraindication screen.

Optimized Health (Female) labs

$229 panel: estradiol, progesterone, FSH, LH, TSH, DHEA-S, A1c, full metabolic. Or upload existing labs from the past 6 months.

Provider review

A licensed U.S. physician builds the protocol, molecule, format, dose, schedule, and reviews any contraindications.

Ship + check in

Compounded medication ships in 2-3 days. Provider re-checks symptoms and labs 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.

What to expect

Your typical 12-week HRT journey

Based on aggregate clinical data and Cochrane reviews of HRT for menopausal symptoms.

Week 1-2

Days 1-14

Sleep starts to deepen

Most patients on micronized progesterone notice better sleep within the first week. Estradiol begins steady-state by end of week two.

Week 4

−50% hot flashes

Vasomotor symptoms ease

Average 50% reduction in moderate-to-severe hot flashes by week 4. Night sweats drop. Mood lifts. Brain fog clears measurably.

Week 8

Steady-state

Energy and libido return

By week 8 most patients feel "back to themselves." Skin firmness, joint comfort, and sexual function improve. Provider checks in for dose review.

Month 3

−74% hot flashes

Full therapeutic effect

Average 74% reduction in hot flashes by 12 weeks. Sleep quality, mood, cognition, and bone-marker improvements measurable on labs.

Source: MacLennan AH et al. Cochrane Review of HRT for vasomotor symptoms. Endocrine Society 2022 menopause clinical practice guideline. Symptom-relief data are aggregated from multiple trials.

Start your free assessment →

Transparent pricing

LegitScript verifiedLicensed US providersHIPAA-protected503A pharmacy

Progesterone

$79/month— cancel anytime

Micronized, oral, bedtime.

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

See progesterone details

Estradiol Tablet

$99/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.

Source: 2022 NAMS Position Statement on Hormone Therapy; ELITE trial; KEEPS trial; Endocrine Society Clinical Practice Guidelines.

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 (Premarin, medroxyprogesterone) are different molecules with different metabolic profiles and slightly different risk profiles. OPTML prescribes bioidentical, which is the modern standard.

05Is HRT safe? What about the WHI study?

For healthy women starting within 10 years of menopause, modern bioidentical HRT is associated with reduced cardiovascular and all-cause mortality. The 2002 Women's Health Initiative concerns largely applied to older synthetic regimens (Premarin + Provera) 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?

Sleep and mood improvements often within 2-4 weeks. Hot flashes typically resolve at 4-8 weeks. Bone density and cardiovascular benefits are long-term and accrue over years.

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.

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