Online Menopause HRT Comparison
Joi vs Winona HRT compares two online menopause-care services with different approaches to blood testing, prescription testosterone, pricing and medication fulfillment. The better option depends on the treatment and monitoring you need not which provider offers the longest product list.
Joi is the more relevant choice if prescription testosterone or recurring laboratory monitoring is important to you. Joi requires an initial lab panel and currently lists testosterone cream and injections, subject to clinician approval and state restrictions. [1]
Winona is the simpler choice if you mainly want estrogen, progesterone or vaginal estrogen without mandatory hormone testing. Winona states that it does not require routine bloodwork and does not prescribe testosterone. [4] [5]
More testing does not automatically mean better menopause care. Independent clinical guidance says routine hormone testing is usually unnecessary before starting hormone therapy for typical menopause symptoms. [8]
This article compares publicly displayed U.S. prices, laboratory requirements, medication policies, refund terms and independent medical guidance. We did not enroll, obtain a prescription, complete lab testing or independently test either service.
This comparison also does not measure customer-service response times, shipping reliability or individual medical outcomes.
Joi vs Winona: What Is the Main Difference?
Joi starts with required lab testing and separates care fees from medication costs. Winona starts with a symptom-and-history review and generally includes virtual physician access in the medication price.
| Comparison point | Joi | Winona |
|---|---|---|
| Starting process | Lab panel followed by a clinician review. [1] | Online medical intake and physician review; routine hormone testing is not required. [4] |
| Initial lab price | $149 for 56 biomarkers, $399 for 71 biomarkers or $699 for 110 biomarkers before temporary discounts. [1] | No required initial hormone-panel purchase for standard onboarding. [4] |
| Ongoing care cost | $50 per month, billed quarterly. Joi says follow-up labs, clinician visits and care-team check-ins are included. Medication is separate. [1] | Winona says virtual doctor visits, follow-ups, messaging and standard shipping are included in the medication price. [6] |
| Prescription testosterone | Joi lists injections at $59 per month and cream at $69 per month, subject to clinical approval and state access. [1] | Winona states that it does not prescribe testosterone. It may prescribe DHEA, which is not the same treatment. [5] |
| Displayed medication prices | Estrogen from $49 to $89 per month, progesterone from $54 to $69 and testosterone from $59 to $69, plus the care fee. [1] | Combined estrogen/progesterone cream from $89 per month, estrogen patch from $149, estrogen tablets from $54 and progesterone capsules from $39. [3] |
| Refund flexibility | Prescription products, diagnostic labs and paid hormone-therapy fees are described as final and non-refundable. [10] | An order may be canceled for a full refund during the 24-hour waiting period. Once pharmacy preparation starts, the medication cannot be refunded. [7] |
| Editorial fit | Better aligned with prescription testosterone and structured monitoring. | Better aligned with simpler estrogen or progesterone care. |
Does Joi Require Blood Tests While Winona Does Not?
Yes. Joi requires an initial laboratory panel, while Winona says routine hormone testing is not required before standard HRT prescribing. [1] [4]
How Joi starts care
- Select and purchase a laboratory panel.
- Complete the blood draw through an available laboratory option.
- Review the results with a licensed clinician.
- Receive a treatment recommendation, if medically appropriate.
Joi says patients typically repeat labs and have a clinician follow-up around six weeks after starting treatment, followed by check-ins approximately every three months until dosing is stable. [1]
How Winona starts care
- Complete an online health and symptom questionnaire.
- A physician reviews your symptoms and medical history.
- The physician decides whether treatment is appropriate.
- Medication is prepared if a prescription is approved.
Winona says it adjusts treatment using symptoms and follow-up responses rather than requiring a routine hormone panel before prescribing. [4]
Routine hormone testing is not generally recommended before starting treatment for typical menopause symptoms because hormone levels fluctuate during the menopause transition. [8]
Broader testing can still be useful when a clinician expects thyroid, metabolic, blood-count, kidney or liver results to change treatment or trigger another medical evaluation. The number of biomarkers alone does not prove better care.
Which Provider Offers Testosterone Therapy for Women?
Joi offers a pathway to prescription testosterone; Winona does not. However, testosterone treatment for women has important clinical and regulatory limitations.
FDA-approved testosterone products are approved for certain medical conditions in men, not specifically for women. Testosterone prescribed to women may therefore involve off-label use of a commercial product or a compounded prescription. [9]
Off-label prescribing means a licensed clinician uses an approved medication in a way that is not specifically included in its FDA-approved labeling.
When is testosterone evidence-based?
International consensus guidance identifies one clearly evidence-based indication: hypoactive sexual desire disorder, or HSDD, in postmenopausal women after a proper clinical assessment. [11]
HSDD means persistent low sexual desire that causes personal distress and is not better explained by another medical, medication, psychological or relationship factor. A low testosterone result alone does not diagnose HSDD.
Available evidence does not establish testosterone as a general treatment for weight loss, fatigue, cognitive performance, muscle building or overall wellness. [11]
Why Joi’s injection listing needs caution
Joi lists testosterone injections, but a listed product is not a medical recommendation. International guidance advises against injections or other formulations that produce testosterone levels above the normal premenopausal female range. [11]
Before choosing testosterone, ask:
- What symptom or diagnosis is being treated?
- Why is this formulation preferred?
- Is the product compounded?
- What blood-level range will be targeted?
- When will repeat bloodwork be performed?
- When will treatment stop if it does not help?
Is Winona’s DHEA the same as testosterone?
No. DHEA is a hormone precursor, not prescription testosterone. Winona states that it may prescribe DHEA on a case-by-case basis. [5]
Independent consensus guidance does not recommend systemic DHEA as an HSDD treatment for postmenopausal women with normal adrenal function. [11]
Is Joi testosterone available in every state?
No. Joi currently lists Alabama, Arkansas, Connecticut, Delaware, Georgia, Hawaii, Louisiana, Minnesota, Missouri, Mississippi, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island and South Carolina as states where it cannot ship testosterone. [1]
State rules can change. Verify eligibility before purchasing a lab panel specifically to seek testosterone therapy.
Joi vs Winona Cost: What Could You Pay?
Winona may cost less initially for a straightforward estrogen/progesterone plan. Joi requires a lab purchase and quarterly care payment before medication is added.
| Illustrative scenario | Calculation | Estimated cost |
|---|---|---|
| Joi lab and first three months of care | $149 lab + $150 care | $299 before medication |
| Joi with testosterone cream | $149 + $150 + ($69 × 3) | $506 |
| Winona combined estrogen/progesterone cream | $89 × 3 | $267 |
| Winona estrogen patch plus progesterone capsules | ($149 + $39) × 3 | $564 |
Estimates exclude possible taxes, dose changes, extra medications, injection supplies, additional testing, outside-pharmacy charges or expedited shipping. Promotional discounts are also excluded.
What does each price include?
Joi
- Initial laboratory panel charged separately.
- $50 monthly care fee billed quarterly.
- Follow-up labs and clinician visits included.
- Medication charged separately.
- Medication generally ships and bills quarterly.
Company-stated pricing model. [1]
Winona
- No required initial hormone panel.
- No separate virtual-visit copay.
- Follow-ups and messaging included.
- Standard shipping included.
- Total cost depends on the prescribed medication.
Company-stated pricing model. [6]
How Do Refunds and Compounded Medications Compare?
Joi’s lab and paid treatment charges are largely non-refundable. Winona gives customers a 24-hour cancellation window before pharmacy preparation begins. Both services may use compounded medication.
| Issue | Joi | Winona |
|---|---|---|
| Refund policy | Prescription products, diagnostic labs and paid hormone-therapy fees are described as final and non-refundable. [10] | Orders can be canceled for a refund during the 24-hour waiting period. Once pharmacy preparation begins, customized medication cannot be refunded. [7] |
| Compounded medication | Joi states that some treatments may include compounded products that are not FDA-approved. [1] | Winona sells customized treatments prepared through compounding pharmacies, as well as selected commercially manufactured products. |
| What to verify | Ask whether the exact prescription is compounded, which pharmacy fills it and whether it can be transferred. | Ask whether the exact product is compounded or FDA-approved and whether an outside pharmacy creates an additional fee. |
Compounded drugs are not FDA-approved. The FDA does not verify their safety, effectiveness or quality before marketing. The FDA says compounded products should be used when a patient’s medical needs cannot be met by an FDA-approved drug. [12]
Which Service Is the Better Fit?
Joi better matches people prioritizing prescription testosterone and structured lab monitoring. Winona better matches people prioritizing simpler estrogen or progesterone care without required bloodwork.
Joi may fit better if…
- You specifically want to discuss prescription testosterone.
- Joi can provide the requested treatment in your state.
- You want baseline and repeat laboratory monitoring.
- You accept separate lab, care and medication charges.
- Your clinician expects broader testing to change treatment.
Winona may fit better if…
- You mainly want estrogen, progesterone or vaginal estrogen.
- You prefer symptom-based onboarding without mandatory testing.
- You want virtual follow-up included in the medication price.
- You do not require prescription testosterone.
- You prefer a lower initial cash cost for a basic plan.
- You have unexplained or heavy vaginal bleeding.
- Pregnancy is possible.
- You have a history requiring detailed cancer-risk discussion.
- You have had a blood clot, stroke or significant liver disease.
- Your symptoms require a physical examination or imaging.
- You need coordinated specialist care.
These issues do not automatically rule out hormone therapy, but they may require more evaluation than a standard online intake provides.
What Should You Confirm Before Paying?
Confirm the exact medication, full payment, FDA status, pharmacy, monitoring plan and cancellation terms before checkout.
Medication
- What exact medication and dose are being considered?
- Is it FDA-approved, off-label or compounded?
- Why is this delivery method appropriate?
Cost
- How much will be charged today?
- What is the complete three-month cost?
- Are labs, visits, supplies and shipping included?
Monitoring
- When are follow-up labs required?
- How are side effects reviewed?
- What happens if treatment does not help?
Access and cancellation
- Is treatment available in your state?
- Can the prescription be transferred?
- What is the cancellation deadline?
Final Verdict: Joi or Winona?
Choose Joi if prescription testosterone or structured lab monitoring is central to your decision. Expect a more complicated payment structure because labs, ongoing care and medication can be separate charges.
Choose Winona if you mainly want estrogen or progesterone care with simpler onboarding. Winona may have a lower initial cash cost for a basic plan, but it does not prescribe testosterone.
Neither provider is automatically medically superior. The better option depends on the medication, whether testing will change treatment, your state, pharmacy flexibility and complete multi-month cost.
Frequently Asked Questions
Is Joi or Winona cheaper for HRT?
Winona may cost less initially for a basic estrogen/progesterone plan because routine hormone testing is not required and virtual follow-up is included in the medication price. Joi normally adds an initial lab purchase and a $50 monthly care fee before medication. [1] [3] [6]
Does Joi require bloodwork before HRT?
Yes. Joi requires an initial laboratory panel followed by a clinician review. Standard displayed panel prices currently begin at $149 before temporary promotions. [1]
Does Winona require hormone testing?
No routine hormone panel is required for standard Winona onboarding. Winona says its physicians generally assess treatment using symptoms, medical history and contraindications. [4]
Does Winona prescribe testosterone for women?
No. Winona states that it does not prescribe testosterone. It may prescribe DHEA, but DHEA is not the same medication and is not an evidence-equivalent replacement for testosterone therapy. [5] [11]
Is Joi testosterone available in my state?
Not in every state. Joi currently publishes a list of states where it cannot ship testosterone. Verify current eligibility before purchasing laboratory testing specifically for testosterone treatment. [1]
Are Joi and Winona medications FDA-approved?
It depends on the exact product. Some commercially manufactured medications may be FDA-approved, while compounded prescriptions are not. Ask about the exact prescription rather than applying one FDA status to every treatment offered by either company. [12]
Sources and Research References
- Joi Hormones (BHRT): labs, pricing, medications and state restrictions Joi + Blokes
- Women’s diagnostic laboratory panels Joi + Blokes
- Current treatment options and displayed prices Winona
- Hormone testing for HRT Winona Help Center
- Why Winona does not prescribe testosterone Winona Help Center
- Pricing, virtual visits, messaging, shipping and insurance information Winona Help Center
- Cancellation and refund policy Winona Help Center
- Hormone testing before hormone therapy American College of Obstetricians and Gynecologists
- Testosterone information U.S. Food and Drug Administration
- Refund and return policy Joi + Blokes
- Global Consensus Position Statement on Testosterone Therapy for Women The Journal of Clinical Endocrinology & Metabolism
- Compounding and the FDA: Questions and Answers U.S. Food and Drug Administration
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