Get your sleep back

Veedma is a telehealth clinic for women in perimenopause and menopause: the years before, around and after the last period. We find the cause of your symptoms before treating them. Poor sleep, a short fuse, lost words, weight that settles at the waist, low desire and painful sex can come from estrogen, progesterone or testosterone moving, and just as easily from an underactive thyroid, low iron or rising insulin. A blood draw timed to your cycle, read next to your symptoms and history by our medical team, tells them apart.

When hormones are the cause, a licensed provider prescribes bioidentical estradiol through the skin, micronized progesterone, vaginal estradiol or low-⁠dose testosterone, dosed to your levels and re-⁠checked. When the cause is elsewhere, we treat that first: levothyroxine or liothyronine for an underactive thyroid, iron when your stores are low, bupropion in place of an antidepressant that has flattened desire. Our protocols follow The Menopause Society, the International Menopause Society (2026 recommendations) and the Endocrine Society.

Menopause is a single date: 12 months after your last period, on average around age 51 in the US. Perimenopause is the stretch before it, usually 4 to 8 years, when the ovaries slow down unevenly: progesterone fades first, estrogen swings high and low from month to month, and periods change length before they stop (Harlow et al., STRAW+10, JCEM, 2012; Santoro et al., JCEM, 2017). Most of the symptoms women bring to Veedma start in perimenopause, while periods still arrive: broken sleep, a short fuse, anxiety, brain fog, heavier or closer periods, joint aches, hot flashes. After the last period, estrogen settles low and the later symptoms take over: vaginal dryness, bladder changes, bone loss.

The distinction matters for treatment. In perimenopause the hormone that has moved most is often progesterone, and estrogen may still be high, so the plan can start with progesterone alone or a low estradiol dose read against your cycle. After menopause, estradiol with progesterone is the usual pair. Veedma treats both stages; the blood draw, timed to your cycle if you still have one, shows which stage you are in.

About 41 million US women are aged 45 to 64, and 82% of women 45 and older report menopause symptoms, roughly 34 million women (FDA, November 2025; Doamekpor et al., Journal of Women's Health, 2023). Yet in 2023 only 1.5% of women aged 45 to 49, 3.4% at 50 to 54 and 3.5% at 55 to 59 were on hormone therapy (Faubion et al., Mayo Clinic Proceedings, 2026), down from about 27% of postmenopausal women in 1999 to under 5% by 2020 (Yang and Toriola, JAMA Health Forum, 2024).

The drop followed the 2002 Women's Health Initiative headlines and the boxed warning the FDA added to estrogen products in 2003. In November 2025 the FDA removed that warning, concluding the risks had been overstated for women under 60 or within 10 years of menopause. Training has not caught up: only 31.3% of OB-⁠GYN residency programs have a menopause curriculum (Allen et al., Menopause, 2023), and in one survey 6.8% of residents felt prepared to manage menopause (Kling et al., Mayo Clinic Proceedings, 2019). Veedma exists for that gap: providers who specialize in women's hormone health, blood work first, and treatment decided on your symptoms rather than your age.

A women's hormone blood test at Veedma is $79 for the Essential panel, drawn at Quest Diagnostics on the day of your cycle we specify. It covers 71 biomarkers: estradiol, FSH, total testosterone by LC-⁠MS/MS, free testosterone by LC-⁠MS/MS with equilibrium dialysis, a thyroid panel (TSH, free T4, free T3), an iron panel (ferritin, iron, TIBC, transferrin saturation), a lipid panel, a comprehensive metabolic panel (blood sugar, liver and kidney function, and electrolytes), hs-⁠CRP for inflammation, and a complete blood count.

The Complete panel is $359 and covers 100 biomarkers: everything in the Essential panel plus LH, DHEA-⁠S, prolactin, thyroid antibodies, vitamin D, B12, folate, magnesium, zinc, insulin, a 3-⁠month blood sugar average, ApoB, homocysteine, omega-⁠3 levels and more. Both prices include the blood draw, a clinical review with the decision and next steps in your messages, and your consultation; nothing more is charged unless your provider prescribes treatment. Both panels are FSA/HSA eligible. Full marker lists are on the Lab panels page.

Yes. Progesterone is usually the first hormone to slip: cycles get a few days shorter, PMS gets worse, sleep gets lighter and the fuse gets shorter while periods still arrive on time. In the SWAN cohort, cycles kept their length until about 5 years before the final period while the share of cycles with normal progesterone fell from 88% to 23% in the last year (Santoro et al., JCEM, 2017). In a survey of 946 women still cycling regularly, 57% reported irritability, 60% forgetfulness and 42% waking in the night for over an hour, and most did not expect any of it before 50 (Coslov et al., Menopause, 2021).

In these years estrogen is often still normal or high while progesterone is missing, so adding estrogen on its own can make the swings worse (International Menopause Society White Paper, 2026). Because levels move month to month, we time your blood draw to a specific cycle day and read it against your symptoms, so your provider treats the hormone that has moved.

A blood draw is the only way to tell. Tiredness, weight gain, low mood, lost words and thinning hair are the same whether the driver is estrogen, an underactive thyroid, low iron or rising insulin, and the look-⁠alikes are common: 1 in 8 women develops a thyroid disorder (American Thyroid Association), 1 in 3 women has iron deficiency (JAMA Network Open, 2024) and 1 in 3 women has prediabetes (CDC). A symptom questionnaire cannot separate them, and estrogen will not fix a thyroid or iron problem.

Every Veedma panel reads hormones, thyroid, iron and blood sugar. When the driver is not hormonal, your provider explains the finding in your messages, and the same provider treats it: levothyroxine when two readings confirm an underactive thyroid, iron when your stores are low, insulin resistance addressed directly. When a finding needs a specialist, you are referred with your results in hand.

You can be prescribed hormone therapy without blood work, and many gynecologists do. After 45, menopause is diagnosed from age, symptoms and periods, because a single hormone level swings from week to week (NICE guideline NG23). Veedma tests anyway, for four reasons that are separate from that diagnosis.

1. Look-⁠alikes. An underactive thyroid, low iron and rising blood sugar cause the same tiredness, low mood, lost words, weight gain and thinning hair, and hormones will not fix them: 1 in 8 women develops a thyroid disorder (American Thyroid Association), 1 in 3 women has iron deficiency (JAMA Network Open, 2024) and 1 in 3 women has prediabetes (CDC). Every Veedma panel includes a full thyroid panel, an iron panel with ferritin, and blood sugar.
2. How your body will handle treatment. How well hormone therapy works depends on the organs that process it. The liver breaks down sex hormones, so liver function is checked before anything is prescribed, along with kidneys, cholesterol and a complete blood count, and your provider plans treatment around the results.
3. Your hormones, read together. Estradiol on its own says little in these years: it can read 10 pg/mL one month and 300 the next. FSH is the pituitary's signal to the ovaries, and it climbs as the ovaries slow down, starting about 6 years before the final period (Randolph et al., JCEM, 2011). A higher FSH next to your estradiol points to perimenopause, which a single estradiol number cannot show. One FSH reading can vary too, so our medical team reads the pair with your cycle day and your symptoms.
4. A baseline for your dose. Later results are compared with your first numbers, and testosterone is measured before it is ever prescribed, as the 2019 global consensus recommends (Davis et al., JCEM, 2019).

The blood draw is one visit to a Quest Diagnostics location. The Essential panel is $79 and includes your consultation.

Four bioidentical hormones, as your labs and symptoms call for them: micronized progesterone as a capsule at bedtime; estradiol as a daily skin cream or a twice-⁠weekly patch, never a pill; vaginal estradiol as a small insert or cream, with a vaginal DHEA cream as the alternative when painful sex is the main complaint; and low-⁠dose testosterone cream at about a tenth of a male dose, for low desire once estradiol and progesterone are in place.

Beyond hormones, when the panel or the visit points there: levothyroxine for an underactive thyroid, with liothyronine (T3) added when symptoms persist on levothyroxine alone; bupropion in place of an antidepressant that has flattened desire and orgasm; and sildenafil cream for arousal and sensation. No pellets and no estrogen pills. All are prescribed by a licensed provider after your consultation and made for you by an NABP-⁠accredited partner pharmacy in the USA.

No. Pellets are implanted under the skin and release estradiol or testosterone for months at a dose that cannot be adjusted or stopped once it is in. In a study of 539 women, those on pellets had side effects such as abnormal bleeding, mood changes and weight gain 4 times as often as women on FDA-⁠approved hormone therapy (57.6% versus 14.8%; Jiang et al., Menopause, 2021), and pellet users commonly reach estradiol and testosterone levels far above the normal range, which the International Menopause Society flagged again at its 2026 World Congress. Veedma prescribes estradiol through the skin as a daily cream or a twice-⁠weekly patch, so the dose can be raised, lowered or stopped at any visit, and low-⁠dose testosterone as a daily cream for the same reason.

Bioidentical means the hormone is chemically identical to the one your body makes: estradiol, progesterone, testosterone. That is how ACOG defines it (Clinical Consensus No. 6, 2023), and FDA-⁠approved estradiol and micronized progesterone are bioidentical; body-⁠identical is the term NICE uses in the UK for the same molecules. Veedma prescribes only bioidentical hormones, the form The Menopause Society and the International Menopause Society favor over synthetic progestins and conjugated estrogens. Compounded means a licensed pharmacy makes the medicine for you at the dose your provider prescribes, instead of a factory making it in fixed strengths. Veedma's partner pharmacies are NABP-⁠accredited and compound in the USA. Your provider sets the dose from your labs and re-⁠checks it with blood work. What the societies warn against is pellets and doses set from saliva tests, and Veedma uses neither.

The molecule can be the same; the route is what changes the risk. An estrogen pill passes through the liver first and raises clotting factors. Estradiol through the skin, as a cream or patch, reaches the blood directly and does not. In a Danish study of about 40,000 clot, stroke and heart attack cases, oral estrogen raised clot risk 1.6 times and stroke risk 1.3 times, while transdermal estradiol raised neither (Berggreen et al., BMJ, 2026). The International Menopause Society's 2026 recommendations grade transdermal estrogen as not increasing clot risk even in women with extra risk factors.

That is why Veedma prescribes estradiol through the skin by default and does not offer estrogen pills, while several online clinics lead with the pill because it is the cheapest form. The 2025 FDA label change removed the heart disease, breast cancer and dementia warnings from estrogen products; the route choice is the layer of safety on top of that.

If you have a uterus and take estrogen, you need a progestogen to protect the uterine lining. Which one matters. The breast cancer risk in the 2002 Women's Health Initiative headlines came from a synthetic progestin, medroxyprogesterone, combined with oral estrogen (incidence 1.28 times placebo over 20 years of follow-⁠up); estrogen on its own in the same trials was linked to 22% fewer breast cancers and 40% lower breast cancer mortality (Chlebowski et al., JAMA, 2020). The International Menopause Society grades the breast risk as primarily associated with synthetic progestogens, with micronized progesterone carrying a lower one (2026 recommendations, grade A).

Veedma prescribes only micronized progesterone, the same molecule your ovaries made, as a capsule at bedtime: it protects the uterus, and deeper sleep is usually the first change women notice.

Usually not. Progesterone's job in hormone therapy is to protect the lining of the uterus from estrogen; without a uterus there is no lining to protect, so estradiol on its own is the standard regimen (The Menopause Society, 2022 position statement). In the Women's Health Initiative, women without a uterus who took estrogen alone had 22% fewer breast cancers over 20 years of follow-⁠up than women on placebo (Chlebowski et al., JAMA, 2020). Your provider may still suggest progesterone at bedtime for sleep, or if you have a history of endometriosis, because tissue outside the uterus can respond to estrogen. If your ovaries were removed as well, you are in surgical menopause and can start hormone therapy right away, at any age under 60.

Yes, and it often makes the plan simpler. A levonorgestrel IUD releases a progestogen into the uterus, so it protects the lining the way progesterone does in hormone therapy; the NICE menopause guideline lists it as the progestogen option alongside estradiol (NICE guideline NG23). That means your provider can add estradiol through the skin without a separate progesterone capsule, while the IUD also handles contraception during perimenopause, when pregnancy is still possible. Women who want progesterone's effect on sleep can take it as well. A copper IUD contains no hormone and does not protect the lining, so with estradiol you would take progesterone as usual.

Yes, for low sexual desire, where labs and symptoms support it. Measured by mass spectrometry, testosterone is about a quarter lower in the late 30s than in the early 20s (Skiba et al., JCEM, 2019) and keeps sliding through the 40s and 50s; natural menopause itself does not drop it (Wang et al., EBioMedicine, 2025). The evidence supports testosterone for low desire, arousal and sexual satisfaction, and the 2019 global consensus endorsed by the Endocrine Society names that as the only indication. Trials have not shown benefit for muscle, mood or memory: the 2026 PAMELA trial found no effect on muscle power or strength, and the FDA's September 2026 workshop reached the same reading. Clinics that sell testosterone to women for energy or muscle are ahead of the evidence.

We use a daily cream at about a tenth of a male dose, added after estradiol and progesterone are in place, and re-⁠check your level at month 3 and every 6 months so it stays in the female range.

For most healthy women who start before 60, or within 10 years of their last period, the benefits outweigh the risks for treating symptoms. That is the position of The Menopause Society and the International Menopause Society, and in November 2025 the FDA removed its boxed warning about heart disease, breast cancer and dementia from estrogen products. The 2002 headlines came from women averaging 63 years old on older formulations. What we prescribe is the same molecules your ovaries made, through the skin, with micronized progesterone. Estradiol through the skin showed no added clot or stroke risk in a 2026 Danish study of 40,000 cases, while oral estrogen raised clot risk 1.6 times (Berggreen et al., BMJ, 2026). In the Women's Health Initiative trials, estrogen on its own was linked to 22% fewer breast cancers over 20 years of follow-⁠up (Chlebowski et al., JAMA, 2020); the added risk in older studies came from synthetic progestins, and micronized progesterone carries a lower one. A 2026 Danish study of 876,805 women found no increase in mortality over 14 years (Mikkelsen et al., BMJ, 2026). Started in the early 50s, hormone therapy was associated with less dementia over the next 13 years; started later, it was not (Squires et al., Alzheimer's & Dementia, 2026, UK Biobank, 183,450 women; an association, not a guarantee).

Before prescribing, your provider reviews your personal and family history, including breast cancer and clots, your blood pressure, a mammogram within the last year, your liver, kidneys and blood count from the panel, and any bleeding that has not been explained. A history of breast cancer, a previous clot or stroke, or unexplained bleeding means hormone therapy is not started online: you keep your results and your consultation, and we say who to see next.

There is no fixed stop date. The Menopause Society's 2022 position statement says hormone therapy does not need to be stopped at 60 or 65 or after any set number of years; the decision is made with your provider at a yearly review, weighing your symptoms, your health and your preference. Hot flashes last a median of 7.4 years, and for some women more than a decade (Avis et al., JAMA Internal Medicine, 2015), so a 5-⁠year limit leaves many women to ride them out. Bone protection lasts only as long as estrogen is taken. Vaginal estradiol has no stop date at all. At Veedma the dose follows your symptoms and your blood work, re-⁠checked at month 3 and every 6 months, and the question of whether to continue is yours and your provider's, not a calendar's.

Starting late is a different decision from continuing. The Menopause Society and the International Menopause Society place the favorable window at under 60 or within 10 years of the last period; women who start after that have higher absolute risks of heart attack, stroke, blood clots and dementia, so starting is usually not advised (The Menopause Society, 2022). A woman who started inside the window can continue past 60 with a yearly review. Two things stay open at any age: vaginal estradiol for dryness, painful sex and bladder infections, which barely enters the bloodstream, and treatment of thyroid, iron or blood sugar problems found on the panel. If you are past the window and still have hot flashes, your provider will say what is reasonable and what is not.

Yes, and it is one of the most common early ones, often worst in the week or two before a period. Progesterone and estrogen both act on the brain's mood circuits, so the fuse gets shorter as progesterone slips and estrogen starts to swing. In a survey of women still cycling regularly, irritability was the most reported mood symptom at 57% (Coslov et al., Menopause, 2021). Many women are offered an antidepressant at this point. If the rage tracks your cycle, hormones are the more likely driver: bedtime progesterone or steadier estradiol often changes it within a cycle or two, and in a 2026 study of 260 women on hormone therapy, severe mood symptoms fell from 62% to 25% within about 4 months (Fairweather et al., Menopause, 2026).

You can start hormone therapy while taking an antidepressant; the two are commonly combined, and nothing is stopped abruptly. What Veedma looks at is whether the antidepressant is doing the job you need. Depression is about 40% more likely in perimenopause as hormones fall (Badawy et al., Journal of Affective Disorders, 2024), so if the low mood began with your cycle changes, hormone therapy may be treating the cause; in a 2026 study of 260 women on hormone therapy, severe mood symptoms fell from 62% to 25% in about 4 months (Fairweather et al., Menopause, 2026). If your antidepressant has flattened desire or made orgasm hard to reach, which is common with SSRIs such as sertraline, escitalopram and fluoxetine, your provider can discuss switching to bupropion, which works through dopamine and norepinephrine and is far less likely to do that. Any change to an antidepressant is tapered and coordinated with the clinician who prescribed it.

Hormone therapy is not a weight-⁠loss drug, and it addresses several drivers of midlife weight change: broken sleep, loss of muscle, and the shift of fat to the abdomen that comes with falling estrogen (in SWAN, the rate of fat gain doubled across the transition; Greendale et al., JCI Insight, 2019). Your panel also checks thyroid and blood sugar, two frequent contributors we treat directly, and the Complete panel adds insulin, which almost no routine check-⁠up measures.

Estrogen is what keeps collagen in skin, and collagen falls once estrogen does, which is why creams that used to work stop working. In a 2023 meta-⁠analysis of 15 studies and 1,589 women, hormone therapy raised skin collagen and thickness and, modestly, elasticity; dryness did not change, and a 4-⁠year randomized trial found no effect on facial wrinkles (Pivazyan et al., Journal of Menopausal Medicine, 2023; Owen et al., KEEPS, Fertility and Sterility, 2016). We do not prescribe hormones for skin alone; it is one of the things that comes back when the hormone that moved is treated.

1. Order your lab panel. Choose the Essential or Complete panel and book a morning blood draw at any of 2,000+ Quest Diagnostics locations. Still cycling? We tell you which day to go. Already have recent labs? Upload them instead for a free review.
2. Get your results and clinical review. While your lab results are being processed, you submit your medical history. Our medical team then reviews your results and history and explains the decision and next steps in your messages.
3. Meet your provider. If the clinical review confirms treatment is appropriate, you select a membership (card saved, nothing charged) and book a video visit. A licensed provider who specializes in women's hormone health goes through your labs, symptoms and history with you and, if treatment is right for you, writes the prescription.
4. Start treatment. When the prescription is sent, your membership activates and your medication ships from our NABP-⁠accredited partner pharmacy.
5. Follow-⁠up. Symptoms are reviewed at week 6, blood work follows at month 3 and then every 6 months, and your provider adjusts the dose on your symptoms and your numbers.

Only once a provider prescribes treatment. The lab panel price covers the blood draw, the clinical review and your consultation. If the clinical review confirms treatment is appropriate, you select a membership and save a card before booking the visit. Nothing is charged at that step, and the visit costs nothing.

The membership starts only if the provider prescribes treatment at the end of the visit. When the prescription is sent, your membership activates and your card is charged, then bills every 3 months. If the provider decides treatment is not right for you, or you decide against it during the visit, nothing is charged and no membership starts. You keep your lab results and the recommendations in your messages.

Lab panels are a separate payment and are non-⁠refundable once the blood draw is collected, because they cover lab work and clinical analysis already performed.

Your first lab panel is paid once: $79 for the Essential panel, 71 biomarkers, or $359 for the Complete panel, 100 biomarkers, each with a clinical review and your consultation. Membership is $135 a month, billed $405 every 3 months, and it starts only when a provider prescribes treatment.

Membership includes the Essential panel, 71 biomarkers, at month 3 and every 6 months after, each with a clinical review; provider visits, lab reviews and treatment adjustments; unlimited messaging with your care team; member pricing on medication; and free delivery. You can add the Complete panel, 100 biomarkers, at any time.

Medication is added at member pricing, per month: estradiol cream from $20, the patch from $45, micronized progesterone from $11, vaginal estradiol from $13, testosterone cream from $20, levothyroxine from $5, bupropion from $35, sildenafil cream from $24. A higher dose or a different form can cost more. A typical month with estradiol cream and progesterone starts at $166, all in. Membership and labs are both FSA/HSA eligible.

Yes. If you have results from Function Health, Superpower, InsideTracker, Hone, Everlywell, Quest Diagnostics, Labcorp or any other CLIA-⁠certified lab drawn in the past 180 days, upload them for a free clinical review. Our medical team explains the decision and next steps in your messages within 24 hours on business days. No credit card, no obligation. From there the path is the same as for women who order our panel: if the clinical review confirms treatment is appropriate, you select a membership, book the video visit at no charge and pay only if the provider prescribes treatment.

To reach a treatment decision, the upload has to include estradiol, FSH, TSH, ferritin, a complete blood count and liver and kidney function, drawn on a known cycle day if you are still cycling; for testosterone the method has to be LC-⁠MS/MS, since immunoassay results in the female range are not reliable enough to dose on. If something is missing, your care team explains exactly which markers to add in your messages.

Hormone therapy at Veedma is prescribed on symptoms and stage, with labs as the safety baseline and the way to rule out look-⁠alikes, because hormone levels swing from month to month in these years and no single number defines a deficiency. Typical candidates are women 40 and older with sleep, mood, cycle, hot flash, joint, vaginal or sexual symptoms, starting before 60 or within 10 years of the last period.

Some findings mean hormone therapy is not started online: a history of breast cancer, a previous clot or stroke, unexplained bleeding, or an uncontrolled blood pressure reading. Your provider also needs a mammogram within the last year. In those cases your provider explains the finding and who should evaluate it in your messages, and you keep the consultation. When the panel shows the driver is thyroid, iron or insulin rather than hormones, that is treated first.

On every Veedma panel, total testosterone is measured by LC-⁠MS/MS and free testosterone by LC-⁠MS/MS with equilibrium dialysis, the reference methods clinical research uses. The draw is in person at a CLIA-⁠certified Quest Diagnostics location. A woman's testosterone sits low on the scale, and that is where the common clinical immunoassay fails. When five widely used automated immunoassays were checked against mass spectrometry, the average error in women's samples was 23%, and 2 of the 5 could not reliably measure anything below 35 to 100 ng/dL, where most women sit (La'ulu et al., Clinical Biochemistry, 2018). Another common clinical immunoassay barely tracked the true value below 100 ng/dL (Shi et al., Journal of Chromatography B, 2021). The 2019 global consensus on testosterone therapy for women, endorsed by the Endocrine Society and the International Menopause Society, grades direct assays as "highly unreliable in the female range" and names mass spectrometry as the accurate method (Davis et al., JCEM, 2019). Our dose decisions come from published research, so your result has to be measured the way the research measured it. The same reason rules out finger-⁠prick home kits: capillary tubes read testosterone 14% lower than a venous draw (Vasavan et al., Journal of Applied Laboratory Medicine, 2025).

Most online menopause clinics prescribe from a questionnaire. Hers, Alloy, Winona and Evernow say some version of "no blood work needed": a 5-⁠minute intake, a provider who approves the order in the background, estrogen for everyone at one starting dose, often as a pill, and a follow-⁠up when the prescription needs renewing. Midi runs insurance-⁠billed video visits and does not recommend hormone testing. Hone tests 50+ markers and sells testosterone to women for energy and muscle, which the evidence does not support. Veedma is built on five differences:

1. Blood work first, every time. 71 biomarkers drawn on the right day of your cycle, read next to your symptoms and history by a licensed provider. In the early 40s estrogen is often still high while progesterone is missing, and estrogen alone can worsen the swings (IMS White Paper, 2026); a questionnaire cannot see that.
2. Look-⁠alikes caught before hormones are blamed. Thyroid, iron and blood sugar are on every panel, and when one of them is the driver, it is treated first.
3. Through the skin, with micronized progesterone, no pellets. The route and the progestogen the 2026 evidence favors (Berggreen et al., BMJ, 2026; IMS 2026).
4. Dose set from your symptoms and your numbers, and re-⁠checked. Symptoms reviewed at week 6, blood work at month 3 and every 6 months after, and the dose follows you, not the renewal calendar.
5. A video visit and a price you can see. A provider who specializes in women's hormone health, unlimited messaging between visits, membership at $135 a month, and medication at member pricing with from-⁠prices on the page.

Sleep and night sweats usually change first, within the first weeks, as bedtime progesterone takes hold and estradiol comes on board. Hot flashes and mood build to their fullest relief by week 8 to 12: in a 2026 study of 260 women, severe mood symptoms fell from 62% to 25% within about 4 months (Fairweather et al., Menopause, 2026). Focus, sex drive and vaginal comfort follow over months 2 to 3 once levels are steady; vaginal dryness and painful sex ease over 2 to 12 weeks on vaginal estradiol. Energy, body shape and bone respond from month 3 onward and keep building (The Menopause Society position statements, 2020 and 2022). These timings are what most women report; how fast you get there depends on where you start, the form and the dose. We review your symptoms at week 6 and re-⁠check levels at month 3, adjusting the dose if something is not improving on schedule.

Yes. Veedma is LegitScript-⁠certified, the standard that pharmacies, telehealth providers and the major search and ad platforms use to confirm an online healthcare service operates legally and safely; you can verify our certification on LegitScript's website. Every prescription is written by a provider licensed to prescribe in your state, after a video visit that reviews your symptoms, labs and medical history, and is filled by our NABP-⁠accredited partner pharmacy in the USA. Safety labs are repeated on a schedule, not only when you ask, and treatment follows The Menopause Society, International Menopause Society and Endocrine Society guidelines.

Yes. Your health information is protected under HIPAA and the California Confidentiality of Medical Information Act (CMIA). It is treated as protected health information from the moment you share it, including labs you upload before any treatment relationship, handled only as those laws permit, and we do not sell your personal information. See our Privacy policy for the full detail.

Veedma is a direct-⁠pay clinic and does not bill insurance. Compounded bioidentical hormones are generally not covered by insurance, and a flat membership is often less than the copays for separate visits, labs and medication combined. Both the membership and the lab panels are FSA/HSA eligible: they qualify as medical expenses, so you can pay with pre-⁠tax dollars from a Flexible Spending Account or Health Savings Account.

Veedma serves patients in most U.S. states. We currently do not operate in Alabama, Alaska, the District of Columbia, Hawaii, Mississippi, New Jersey, New York, Oklahoma, Rhode Island, Utah or Wisconsin. Your state is confirmed at checkout, since coverage changes as we onboard additional licensed providers.