You've tried the magnesium. You've tried the cooling sheets. You finally caved and called your OB-GYN — the soonest appointment is in four months. Your primary care doctor said she doesn't really "do HRT" and you should see a gynecologist. You looked at Midi. You looked at Alloy. The subscription pricing made your eyes glaze and you closed the tab. Meanwhile it's 3 AM again and you're awake.

That's the moment most women land on CodyMD. Not because the visit happens online — because four months of waiting while you suffer doesn't make sense. The CodyMD promise is straightforward: a 1-Hour Prescription for a personalized HRT plan. Here's how it actually works.

The 3-Step Process: 1-Hour Prescriptions

1. Chat with Cody, our AI doctor, 24/7/365. You open the chat and Cody opens with something like, "Hey — I'm Cody. What's going on?" From there it's a conversation, not a form. Cody asks one question at a time, paced and warm. Your name, date of birth, sex at birth (this matters for perimenopause), state, what you're feeling. Then the specifics that actually drive an HRT decision: how your periods are changing, your symptom cluster (hot flashes, night sweats, sleep, mood, brain fog, vaginal dryness, sex hurting), what you've tried, current medications, personal and family history of breast or ovarian cancer, BRCA status, any history of blood clots, any recent stroke or heart attack, and your most recent mammogram. When the intake is done, Cody summarizes the case in a clean clinical sentence and sends it to the reviewing doctor.

2. A US-licensed doctor reviews and prescribes within 1 hour. A named, board-certified physician — for example, "Dr. Iris Maruska, your reviewing physician" — reads your case and writes back in the same chat thread. The message is substantive: what they prescribed (typically an estradiol patch or gel plus micronized progesterone if you have a uterus), the dosing schedule and why, what to expect in week one versus week four, when to message back if something isn't right, red flags that warrant urgent care. Sign-off comes from the doctor by name, on behalf of the Cody Team. Not a chatbot. A clinician making decisions about your specific case.

3. Pick up at your pharmacy. Cody captured your pharmacy choice during the intake. The Rx is e-sent directly there and usually ready within an hour of the doctor's review. You walk in, pick up the patch and the progesterone, and you start that night.

The visit is $49 flat. No insurance required. HSA and FSA eligible.

Plus: 14 Days of Unlimited Follow-Up Messaging

This is the part most online services skip. After your visit, you have 14 days of unlimited messaging with Cody and the care team. HRT is the condition where this matters the most. Titration is real. Side effect questions come up. "Is this breakthrough bleeding normal?" "How long until the night sweats actually stop?" "My patch is falling off — what do I do?" You reply in the same chat thread.

If something needs a clinical answer, Cody escalates back to your reviewing doctor. If there's a hiccup at the pharmacy — a prior auth on the estradiol gel, an out-of-stock micronized progesterone, a slow fill on a Friday afternoon — the care team will call the pharmacy on your behalf.

You're not handed a prescription and waved off at the door. You have a clinician in your pocket for two weeks while you settle in.

What Cody Actually Asks (and Why)

The intake isn't a sterile form because HRT decisions actually need a clinician's frame of mind in the gather phase. Cody is built to mirror that.

A few things Cody specifically asks every patient seeking HRT:

• Symptoms. The full perimenopause cluster, prompted one at a time so you don't underreport.

• Periods. Last period date. Pattern over the last 12 months. Heaviness, length, bleeding between cycles. This determines whether you're in peri or postmenopause and shapes the progesterone dosing rhythm.

• Cancer history. Personal history of breast or ovarian cancer, family history in first-degree relatives, BRCA testing if you've done it. Patients with disqualifying history are referred — that's not a failure of the service, it's the service working.

• Clot history. Personal or family history of DVT, PE, stroke, or heart attack. Smoking. These shift the prescription toward transdermal estradiol (lower clot risk than oral) or rule out systemic HRT entirely.

• Mammogram status. A current mammogram within the last 1–2 years is standard practice before starting systemic HRT — the same standard your gynecologist would follow. If yours is overdue, Cody will flag it. The doctor may prescribe and ask you to schedule one, or hold the Rx until you have one. It depends on your risk profile.

• Other meds. Anything that interacts with hormones — anticonvulsants, certain antidepressants, supplements you might not think to mention.

By the end, Cody summarizes back what you said in a clinical sentence — something like "44-year-old in active perimenopause with vasomotor and sleep symptoms, normal periods within last 60 days, mammogram current 8 months ago, no personal or family history of breast or ovarian cancer, no clot history, currently on sertraline 50 mg." You can confirm or correct it before it goes to the doctor.

What the Doctor's Message Actually Looks Like

The doctor's reply is the part that pulls the whole visit together. It's a specific plan: estradiol 0.05 mg/24h transdermal patch changed twice weekly, micronized progesterone 100 mg orally at bedtime, what to expect in the first two weeks (gradual reduction in night sweats, possible breast tenderness early on, some mood lift by week three), when to come back for titration, red flags. Signed by the doctor by name.

The kind of explanation you'd want from an OB-GYN who had unlimited time and unlimited menopause-medicine training — except you got it in under an hour, from your couch.

Portland Delivery, If You're Local

If you're in the Portland metro area, you can also have your medications delivered. Just ask Cody about Portland delivery during your visit and the team will set it up alongside the standard pharmacy pickup.

What CodyMD Prescribes (and Doesn't)

FDA-approved bioidentical estradiol — patch, gel, or oral — and oral micronized progesterone for women with a uterus. Sometimes vaginal estradiol for genitourinary symptoms. The choice of route is matched to your symptom profile, your clot risk, and what fits your life. Full breakdown in the bioidentical HRT explainer.

CodyMD does not prescribe compounded pellets, custom-mixed creams, or hormones based on saliva testing. Not because they're never used somewhere — but because for nearly every patient, FDA-approved bioidenticals are safer, more predictable, and just as effective.

When CodyMD Is the Right Fit — and When It Isn't

Online perimenopause treatment works well for women in active perimenopause or early menopause with the classic symptom cluster (the full picture is in our perimenopause symptoms guide) and no disqualifying history.

It's not the right starting point if you have a personal history of breast or ovarian cancer, an active clotting disorder, recent unexplained vaginal bleeding, recent stroke or heart attack, or surgical menopause that's been complicated. In those cases your CodyMD doctor will tell you so and recommend an in-person specialist.

What Life Looks Like Once the Plan Is In Place

Two weeks in, the patch is doing its work. Night sweats are easing. You're sleeping in stretches instead of fragments. Your mood is steadier. By week six, hot flashes are mostly memories. By month three, you can recognize yourself again. That's the destination — not endless cycling through supplements, but a steady, doctor-built plan that just works.

In 1 hour, for $49. With 14 days of support on the back end. From your couch.