Menopause care, built for the long arc.
Menopause and perimenopause care is a multi-year relationship, not a transaction. The clinical rhythm is slower than GLP-1 and lighter than TRT: asynchronous review, quarterly check-ins, and dose adjustment driven by symptoms rather than by a lab gate. The retention problem is the whole business.
- Estradiol pill, patch, cream or vaginal gel, plus progesterone
- Non-hormonal pathways for patients who cannot take estrogen
- Asynchronous review with quarterly refill intake
- Combined HRT and TRT protocols where clinically appropriate
How a menopause program runs
Symptom-led rather than lab-led. The clinical work is titration and reassurance over quarters, which means the portal and the check-in cadence carry more weight than the checkout does.
Comprehensive symptom intake
Vasomotor symptoms, cycle history, medication and cardiovascular history, breast and clotting history, contraindications and consent.
Asynchronous provider review
A clinician licensed in the patient's state reviews the submitted intake and decides, without an appointment at any point.
Initial prescription
Estradiol in the delivery form the patient and provider choose, with progesterone where the patient has an intact uterus, or a non-hormonal alternative.
Month one review
An early refill intake catches side effects and lets the provider adjust levels before the patient decides the therapy is not working.
Quarterly review cycle
Async refill intake every quarter, adjusting dose and delivery form, with a synchronous option whenever the patient wants one.
Labs as merited
Ordered on clinical indication rather than as a blanket gate, so routine patients are not paying for panels their care does not require.
Any medication change restarts the clock
This is the operational rule that catches most operators out. A dose or delivery change is not a refill, and treating it as one produces both clinical and billing errors.
- A medication change triggers a refill intake four weeks later, not at the next quarterly date.
- Delivery form changes, pill to patch to cream, are protocol events with their own review.
- Progesterone is prescribed alongside estradiol where the patient has an intact uterus.
- Non-hormonal pathways cover patients with contraindications, so the funnel does not simply decline them.
- Combined estrogen and testosterone protocols are supported where clinically appropriate.
- Twelve-week billing cycles align the invoice with the review cadence rather than a monthly calendar.
Clinical and regulatory shape of the category
| Visit type | Asynchronous throughout. Intake is reviewed by a licensed clinician; there is no scheduled visit in the flow. |
|---|---|
| Labs | Ordered as clinically merited rather than as a universal gate on the first fill. |
| Refill cadence | Quarterly async refill intake, with a four-week review after any medication change. |
| Scheduling | Estradiol and progesterone are not controlled substances, so there is no DEA constraint on the category. |
| State availability | All 50 states and D.C. for the non-scheduled hormone pathways. |
| Retention shape | Multi-year. The portal, check-in cadence and provider messaging matter more than checkout conversion. |
Oversight is wired in, not bolted on
Prescriptions are involved, so clinical oversight is not a setting you switch on. It is wired into the workflow, and there is no configuration in which it is absent.
Provider review the platform enforces
Nothing is prescribed until a clinician holding a licence in that patient's state signs off. There is no path through the software that reaches a pharmacy without it.
State rules in the routing layer
Which questions get asked, which clinician picks up the case and which pharmacy fills it are all decided by where the patient is sitting. Texas and California can run as different programs without you maintaining two of anything.
An audit trail you can query
Every intake version, clinical decision, script and pharmacy handoff is written to the patient record and stays queryable. When someone asks what happened in March, you answer it in a minute.
Women's health operators ask us
No. Menopause care runs fully asynchronously on PharmaBro, which is what makes it operationally lighter than TRT. The patient submits an intake, a provider licensed in their state reviews it, and there is no call at any point.
Build a menopause brand patients stay with
Async rails, quarterly cadence, non-hormonal pathways, and a portal that carries the relationship for years.