"How much will this cost me?"
It's often the second question women ask (after “How long will I be on HRT?) when their doctor suggests menopause treatment—and the one that gets the vaguest answers. The truth? Menopause treatment costs range wildly, from $10 to over $600 per month, depending on what you need, where you live, and whether you know how to navigate the system.
Here's what makes the cost question so complicated: Your insurance copay might be $150 while your neighbor with different insurance pays $10 for the exact same medication. Someone without insurance might actually pay less than both of you using discount coupons. And that's before factoring in manufacturer copay cards that can reduce your cost to $0.
In this guide, we're breaking down the real costs of every menopause treatment option—from hormone replacement therapy to non-hormonal medications, supplements, and alternative therapies. More importantly, we'll show you how to access the lowest prices, regardless of your insurance situation.
What you'll learn:
- Real-world costs for HRT (pills, patches, creams, and more)
- How much Veozah and other non-hormonal medications actually cost
- Hidden costs most doctors don't mention (labs, follow-ups, compounding)
- Prescription vs. over-the-counter: when spending more actually saves you money
- Insurance coverage patterns and what's typically covered
- How to cut your costs by 50-80% using strategies most women don't know about
Savings examples:
Hormone Replacement Therapy (HRT) Costs
HRT is the gold standard for menopause treatment, but the price varies dramatically based on the type and delivery method you choose.
Estrogen-Only HRT
Who needs it: Women who've had a hysterectomy (no uterus)
Estrogen Pills
- Generic estradiol: $10-30/month with insurance, $20-50/month without
- Brand name (Estrace): $50-100/month with insurance, $200-300/month without
- Premarin (conjugated estrogen): $30-80/month with insurance, $150-250/month without
Estrogen Patches
- Generic estradiol patches: $25-60/month with insurance, $80-150/month without
- Vivelle-Dot (brand): $60-120/month with insurance, $250-400/month without
- Climara: Similar pricing to Vivelle-Dot
HRT Patch advantages:
- Bypass the liver (safer for some women)
- Steady hormone levels (no peaks and valleys)
- Once or twice-weekly application (vs. daily pills)
- Often better for women with migraine history
Money-saving tip: Patches have manufacturer copay programs that can reduce your cost to $0-25/month. Check current patch prices and savings programs.
Estrogen Gels and Creams
- EstroGel: $50-100/month with insurance, $200-350/month without
- Divigel: $40-90/month with insurance, $180-300/month without
- Evamist spray: $60-120/month with insurance, $250-400/month without
When they're worth it:
- You have skin reactions to patches
- You prefer flexible dosing
- Your insurance covers them well
Combination HRT (Estrogen + Progesterone)
Who needs it: Women who still have a uterus (progesterone protects against endometrial cancer)
Combination Pills
- Generic combinations: $15-40/month with insurance, $30-80/month without
- Activella: $30-70/month with insurance, $150-250/month without
- Prempro: $40-90/month with insurance, $200-350/month without
- Femhrt: $35-75/month with insurance, $160-280/month without
Combination Patches
- Climara Pro: $60-120/month with insurance, $280-450/month without
- CombiPatch: $50-100/month with insurance, $250-400/month without
Separate Progesterone
Some women take estrogen + separate progesterone:
- Micronized progesterone (Prometrium): $20-50/month with insurance, $40-100/month without
- Generic progesterone: $10-30/month with insurance, $15-50/month without
Total monthly cost for separate approach: $30-130/month depending on insurance and whether you choose generic
Cost comparison:
- Combination product: One copay, slightly higher price
- Separate products: Two copays, but more dosing flexibility
- The math: If each copay is $10-20, separate products might actually cost MORE despite lower individual prices
Vaginal Estrogen (Local Treatment)
Who needs it: Women with vaginal dryness, painful sex, or urinary symptoms (can be used with OR without systemic HRT)
- Vagifem tablets: $80-150/month with insurance, $250-350/month without
- Yuvafem (generic Vagifem): $30-80/month with insurance, $100-180/month without
- Estrace vaginal cream: $50-120/month with insurance, $150-250/month without
- Generic estradiol cream: $30-70/month with insurance, $80-150/month without
Important coverage note: Some insurance plans cover vaginal estrogen even when they don't cover systemic HRT. Check your specific plan.
Money-saving strategies:
- Generic versions work just as well
- One tube of cream lasts 2-3 months with maintenance dosing
- Compare vaginal estrogen prices across discount sites
Testosterone for Women
Who needs it: Women with low libido, fatigue, or difficulty building muscle (often overlooked but important)
The problem: No FDA-approved testosterone products for women in the US
Your options:
- Low-dose men's products: $30-80/month
- Compounded testosterone cream/gel: $50-150/month
- Testosterone pellets: $300-600 per insertion (lasts 3-6 months)
Pellet cost breakdown:
- $300-600 every 3-6 months = $50-200/month average
- Usually NOT covered by insurance
- Requires minor in-office procedure
Total HRT Cost Summary
Minimum cost (all generic, good insurance): $10-30/month
Average cost (some generic, average insurance): $50-150/month
Maximum cost (brand names, no insurance, no coupons): $400-800/month
The big variable: Insurance coverage and whether you know about discount programs.
Non-Hormonal Prescription Medications
Can't or don't want to take hormones? These FDA-approved alternatives help with specific symptoms.
Veozah (Fezolinetant) - For Hot Flashes
Retail price: $550-650/month
With insurance (typical copay): $50-150/month
With manufacturer copay card: $0-25/month (most patients pay $0)
For uninsured: Patient assistance may provide free medication
The catch: Requires liver function monitoring
- Blood tests every 3 months for first 9 months
- Each test: $30-75 (varies by lab and insurance)
- Annual monitoring cost: $120-300 first year
Is it worth it?
YES, if you:
- Can't take estrogen (breast cancer history, clotting risk)
- Want non-hormonal option
- Have commercial insurance (most pay $0 with copay card)
Savings example: Jennifer, 56: "I was paying $125/month copay for Veozah until my doctor's office told me about the manufacturer card. Now I pay $0. The blood tests add maybe $30 every 3 months, but my hot flashes are 80% better."
Learn more about Veozah in our article: Veozah for Menopause: A Comprehensive Guide for Women Navigating Perimenopause and Menopause
Find current Veozah pricing and manufacturer savings
Paxil/Brisdelle (Low-Dose Paroxetine)
FDA-approved for: Hot flashes
Generic cost: $10-20/month with insurance, $15-40/month without
Brand (Brisdelle) cost: $40-80/month with insurance, $200-400/month without
Why it's cheaper: Been around for decades as an antidepressant, now has low-dose version for menopause
Drawbacks to consider:
- SSRI side effects (nausea, sexual dysfunction possible)
- Can't stop suddenly (requires tapering)
- Takes 2-4 weeks to work
Best for: Women on a tight budget who can't take hormones
Gabapentin (Off-Label for Hot Flashes)
Cost: $10-30/month with insurance, $15-50/month without
Effectiveness: Reduces hot flashes by 30-50% (less than hormones but helps many women)
Why doctors prescribe it:
- Very inexpensive
- Also helps with sleep
- Good safety profile
- Generic widely available
Drawbacks:
- Drowsiness (take at bedtime)
- Some women need higher doses (costs increase)
Over-the-Counter Supplements
No prescription needed, but costs add up—and effectiveness is hit-or-miss.
Black Cohosh Supplements
Cost range: $10-30/month
Effective dose: 40-80mg daily of standardized extract
Brand comparisons:
- Remifemin (standardized): $18-25/month
- Nature's Way: $12-18/month
- Generic store brands: $8-15/month
The verdict: Some women swear by it, studies show modest effect. Try for 2-3 months to see if it works for you.
Estroven Complete
Cost: $20-35/month retail
Where to save: Amazon Subscribe & Save (15% off), Costco bulk
Contains: Black cohosh, soy isoflavones, green tea
Is it worth $25/month? Maybe, if:
- You're in early perimenopause with mild symptoms
- You want to avoid prescription medications
- You've tried it and it works for you
Reality check: For $25-35/month, you could get prescription-strength solutions that work better for most women.
Red Clover Supplements
Cost: $12-25/month
Evidence: Mixed—some studies show benefit, others don't
Maca Root
Cost: $15-30/month
Popular for: Energy and libido
Evidence: Limited but traditionally used
Total OTC Supplement Costs
If you're trying multiple supplements (many women do):
- Black cohosh: $15/month
- Estroven or similar: $25/month
- Evening primrose oil: $12/month
- Vitamin D: $8/month
- Total: $60/month or more
Consider: For $60/month, you could get prescription HRT with proven effectiveness. Talk to your doctor about whether supplements or prescriptions make more sense for your situation and budget.
Check if OTC supplements are FSA/HSA eligible (they can be with a prescription!)
Hidden Costs of Menopause Treatment
Beyond medication, these costs catch women by surprise:
Initial Medical Visits
Primary care doctor:
- Office visit copay: $20-50
- Or full visit cost without insurance: $100-250
Menopause specialist/OB-GYN:
- Specialist copay: $40-75
- Or full visit cost: $200-400
Integrative/functional medicine doctor:
- Usually don't take insurance: $300-600 for initial visit
- Follow-ups: $150-300
Lab Testing
Basic hormone panel:
- With insurance: $20-100 copay
- Without insurance: $200-500
Comprehensive testing:
- FSH, estradiol, progesterone, testosterone, thyroid
- With insurance: $50-150
- Without insurance: $400-800
Annual Follow-Up Costs
Once on HRT, expect:
- Doctor visits: 1-2 per year = $40-150/year in copays
- Lab work: Annual or biannual = $40-200/year
- Mammograms: Annual (usually covered) = $0-50
- Total ongoing costs: $80-400/year beyond medication
Compounding Pharmacy Costs
Some women need custom formulations:
- Bioidentical hormone formulas: $50-200/month
- Custom testosterone doses: $75-150/month
- Unique combinations: $100-300/month
Important: Usually NOT covered by insurance, but some women find it worth the cost for precise dosing.
Insurance Coverage: What to Expect
What's Usually Covered
Most insurance plans cover:
✅ Generic HRT pills (Tier 1 or 2)
✅ Generic patches (Tier 2 or 3)
✅ Generic progesterone
✅ Vaginal estrogen (often separate from systemic HRT coverage)
✅ Annual gynecological visits
✅ Mammograms
What requires prior authorization:
- Brand-name medications when generic exists
- Veozah (newer medication)
- Testosterone for women
- Compounded medications (usually not covered)
Medicare Coverage
Medicare Part D covers:
- Most generic HRT medications
- Some brand-name options
- Vaginal estrogen products
Typical copays:
- Generic: $0-10/month (Tier 1)
- Preferred brand: $30-50/month (Tier 3)
- Non-preferred: $80-150/month (Tier 4)
Important limitation: Can't use manufacturer copay cards with Medicare (federal law prohibits it)
Alternatives for Medicare patients:
- Medicare Extra Help program (reduces copays to $0-4.50)
- Patient assistance programs for uninsured
- Generic options almost always
No Insurance? Here's Your Strategy
- Use discount cards: GoodRx, SingleCare, RxSaver often beat insurance prices
- Shop around: Prices vary 50-300% between pharmacies in the same town
- Choose generics: Always 70-90% cheaper than brand names
- Check Costco: Don't need membership for pharmacy, often lowest prices
- Try Mark Cuban Cost Plus Drugs: Transparent pricing, growing selection
- Ask about 90-day supplies: Usually 10-20% cheaper per month
Compare all discount pharmacy options here.
Telemedicine: All-Inclusive Pricing
Sometimes paying a subscription is simpler (and cheaper) than navigating insurance.
Fountain HRT
- Cost: $199/month (everything included)
- Includes: Virtual visits, lab work, medications, shipping
- Best for: Women who want no surprises, concierge care
- Math: If you're paying $60/month for meds + $50 copays + $100 labs, you might break even
Joi Women's Wellness
- Cost: $50/month for medication access
- Includes: Testosterone (hard to get elsewhere)
- Best for: Women needing testosterone who can't get it prescribed locally
Evernow
- Cost: $35-49/month + pharmacy costs
- Includes: Unlimited messaging, virtual visits
- Best for: Ongoing support with flexible medication options
When Telemedicine Makes Financial Sense
Choose telemedicine if:
- Your local doctor won't prescribe HRT
- You're paying high specialist copays ($75+)
- You need medications insurance doesn't cover well
- You value convenience and want everything included
Stick with traditional care if:
- You have excellent insurance coverage
- Your copays are low ($10-30)
- You already have an HRT-friendly doctor
- You prefer in-person care
Cost Comparison
Let's look at what different women could actually pay:
How to Reduce Your Costs by 50-80%
Strategy 1: Use Manufacturer Copay Cards
How they work:
- You present card with insurance at pharmacy
- Card covers your copay amount
- Most patients pay $0-25/month
Best programs:
- Veozah: Most patients pay $0
- Various patch brands: Copay assistance available
- Check individual medication websites
Who can use them:
- ✅ Commercial insurance holders
- ❌ Medicare/Medicaid patients (federal law)
- ❌ Uninsured (different programs available)
Strategy 2: Always Compare Insurance vs. Coupons
Your pharmacist can run it both ways:
- With your insurance
- With a discount coupon
Sometimes the coupon is cheaper!
Real example:
- Insurance copay for Premarin: $80
- GoodRx coupon at same pharmacy: $45
- Savings: $35/month = $420/year
Strategy 3: Shop Between Pharmacies
Prices vary wildly.
Same medication, same dose:
Use our HRT price checker tool: Compare prices at pharmacies near you
Strategy 4: Choose Generic When Possible
The FDA requires generics to be:
- Same active ingredient
- Same dosage
- Same effectiveness
- Same safety profile
The only differences:
- Inactive ingredients (fillers, colors)
- Appearance
- Price (70-90% cheaper)
When brand names matter:
- You've tried generic and had side effects
- You have severe allergies to fillers
- Your insurance covers brand but not generic (rare)
Strategy 5: Buy 90-Day Supplies
Most insurance plans:
- 30-day supply: $40 copay
- 90-day supply: $80 copay (2x cost, 3x medication)
- Savings: $40 per quarter = $160/year
Discount cards too:
- 30-day: $50
- 90-day: $120 (vs. $150 for three 30-day)
Strategy 6: Use FSA/HSA Accounts
All prescription menopause medications are FSA/HSA eligible
Using pre-tax dollars saves:
- 25% tax bracket: Save $25 on every $100 spent
- Paying $100/month? Save $25/month = $300/year
Even OTC supplements qualify if prescribed by your doctor
Learn which products are FSA/HSA eligible
Strategy 7: Patient Assistance Programs
For uninsured or underinsured:
- NeedyMeds.org - Database of assistance programs
- Partnership for Prescription Assistance
- Manufacturer PAPs (income-based)
Income limits (approximate):
- Single person: Under $30,000-60,000/year
- Two people: Under $40,000-80,000/year
- Varies by program
What you can get:
- Free medications for 3-12 months
- Must reapply annually
- Requires doctor signature
Is Menopause Treatment Worth the Cost?
Let's talk about value, not just price.
What You're Really Buying
Physical health protection:
- Bone density preservation (reduces fracture risk by 50%)
- Cardiovascular health (when started at the right time)
- Cognitive function support
- Skin, hair, and tissue health
Quality of life improvements:
- Sleep (priceless when you've been awake for 2 years)
- Mental clarity (your job performance matters)
- Mood stability (your relationships matter)
- Sexual function (intimacy matters)
- Energy levels (being able to exercise, work, live)
The Cost of NOT Treating
Short-term costs:
- Lost work productivity (brain fog, exhaustion)
- Relationship strain (mood swings, no libido)
- Poor sleep → other health issues
- Lower quality of life
Long-term costs:
- Osteoporosis treatment: $5,000-20,000/year
- Hip fracture: $40,000+ and life-changing
- Heart disease treatment: Tens of thousands annually
- Cognitive decline: Immeasurable
Breaking Down the Value
If HRT costs you $50/month:
- That's $1.67/day
- Less than a latte
- For relief from 10+ symptoms
- Plus long-term health protection
If Veozah costs you $0/month with copay card:
- Relief from debilitating hot flashes
- Ability to sleep through the night
- Keep your job performance up
- Return on investment: Incalculable
When to Spend More vs. When to Save
Worth Spending More On:
✅ A knowledgeable doctor
- Menopause specialist vs. PCP who's dismissive
- May cost more but gets you the right treatment faster
✅ The right delivery method
- Patches vs. pills if you have liver concerns
- Worth the extra $20-40/month for safety
✅ Testosterone if you need it
- Compounded costs more but may be life-changing
- Energy, libido, muscle mass matter
✅ Non-hormonal options if hormones aren't safe
- Veozah costs more than HRT
- But if you can't take estrogen, it's worth every penny
Where You Can Save:
✅ Generic vs. brand when appropriate
- Same ingredients, massive savings
- Try generic first
✅ Supplement spending
- Don't spend $100/month on unproven supplements
- When prescription options cost $20/month and work better
✅ Unnecessary testing
- Some functional medicine doctors order $1,000+ in labs
- Ask which tests are truly necessary
✅ Compounding when generic options exist
- Only go custom if you've tried standard options
Action Steps: Getting the Best Price
This Week:
-
Check your insurance formulary
- Call or check online
- Ask: "What's my copay for estradiol? For Veozah?"
- Ask about prior authorization requirements
-
Research manufacturer copay cards
- Visit medication websites
- See if you qualify
- Download or register
-
Compare discount pharmacy prices
- Use our price comparison tool
- Check GoodRx, SingleCare, RxSaver
- Note the range—you'll be surprised
Before Your Appointment:
-
Come prepared with costs
- "I see generic estradiol is $15/month with my insurance"
- "Veozah shows a $0 copay with the manufacturer card"
- Helps guide treatment decisions
-
Ask about samples
- Drug reps leave samples
- Can try before committing
- Free 1-2 months' supply sometimes
After Getting Your Prescription:
-
Don't just hand it to your regular pharmacy
- Call around first
- Ask for pricing at 3-4 pharmacies
- Check with and without insurance/coupons
-
Ask pharmacist to run it both ways
- "Can you check this with my insurance AND with this GoodRx coupon?"
- Use whichever is cheaper
Final Thoughts: You Deserve Affordable Care
Here's what frustrates me most: The system is set up to confuse you. Prices aren't transparent. Insurance is complicated. Coupons and cards exist but nobody tells you about them.
The result? Women suffer needlessly or pay far more than necessary.
But now you know:
- HRT doesn't have to cost $400/month (usually $10-50)
- Veozah doesn't have to cost $600/month (most pay $0)
- Supplements aren't cheaper than prescriptions (often the opposite)
- Your insurance copay isn't always the best price
- Help exists if you're uninsured or underinsured
Bottom line: Don't let cost keep you from getting treatment. With the right information and strategies, menopause treatment is affordable for almost everyone.
Start here: Compare current medication prices and find savings programs
Your quality of life is worth it. Your health is worth it. And it doesn't have to break the bank.
Frequently Asked Questions
How much does HRT cost per month?
Generic HRT typically costs $10-50/month with insurance, or $30-100/month without insurance using discount coupons. Brand-name versions cost $50-200/month with insurance, or $200-600/month without.
Is menopause treatment covered by insurance?
Yes, most insurance plans cover generic HRT medications. Coverage varies for brand names, newer medications like Veozah (often requires prior authorization), and testosterone for women (inconsistent coverage).
How much does Veozah cost?
Veozah's retail price is $550-650/month. With the manufacturer copay card, most commercially insured patients pay $0. Medicare patients cannot use copay cards but may qualify for patient assistance programs.
Are menopause supplements cheaper than prescription medications?
Not always. Women often spend $50-100/month on multiple supplements with limited effectiveness, while prescription HRT can cost $10-50/month with proven results. OTC doesn't mean cheaper or better.
Can I use my FSA or HSA for menopause treatment?
Yes! All prescription menopause medications are FSA/HSA eligible. OTC supplements also qualify if your doctor writes a prescription for them. This allows you to use pre-tax dollars, saving 25-35% depending on your tax bracket.
What if I can't afford my menopause medication?
Options include: manufacturer copay cards (reduce to $0-25/month), patient assistance programs (free for qualifying low-income patients), discount pharmacy cards (GoodRx, SingleCare), generic options, and shopping between pharmacies. Don't suffer in silence—affordable options exist.
Symptom Relief
Managing menopause symptoms can feel overwhelming, especially when effective solutions seem hard to find. From unexpected skin changes to frustrating hot flashes, these shifts can impact daily life and overall well-being. Explore our Symptom Relief page to discover products that other women have found helpful in managing their symptoms of perimenopause and menopause.
If you’ve found a product that has made a difference for you, let us know through our contact form—we’d love to share it with others!
Explore More
Want to dive deeper into menopause and its symptoms? Visit our Resources page, where you’ll find a collection of studies, articles, and books from trusted experts. Whether you're looking for the latest research or practical insights, these resources can help you better understand your body and make informed decisions about your menopause journey.\
Related Reading:
This article is for informational and educational purposes only and does not constitute medical advice. The information provided should not be used as a substitute for professional medical consultation, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding hormone therapy, bone health, osteoporosis prevention, or any medical condition.
Last updated: November 21, 2025