How Much Do Estrogen Products For Menopause Cost?

Menopause and postmenopausal symptoms — such as hot flashes, night sweats, and brain fog — can impact your quality of life. These symptoms are caused by hormonal changes, such as declining estrogen levels.

Estrogen therapy, a type of hormone replacement therapy (HRT), is an effective treatment for menopause symptoms. Estradiol is the most common form of estrogen for HRT to treat menopause. This medication comes in many forms, including creams, suppositories, and patches. This treatment is also an important part of estrogen-based gender-affirming hormone therapy. 

How much does estrogen cost?

The cost of prescription estrogen replacement will depend on which form you take and your insurance coverage, if you have a prescription plan. Here are the costs of different kinds of estrogen treatments, along with potential ways to save.

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Creams

Estrogen creams can provide relief for vaginal dryness and pain during sex. There are two main types of estrogen cream — Estrace (estradiol) and Premarin (conjugated estrogens):

• Estrace is available in generic and brand-name versions. With GoodRx, the average cash price of 1 tube of generic Estrace cream is $127.90. But with a free GoodRx coupon, the price may be as low as $24.00 at certain pharmacies. This cream is used as needed, then typically 1 to 3 times per week after your symptoms improve. The number of doses in a tube is specific to the needs of each person.

• Premarin is only available as a brand-name medication. The average cash price for 1 tube is $24.35. For eligible consumers, a manufacturer’s savings card can drop the price to as low as $35 per prescription for up to 2 prescription fills per year. This cream is used as needed. The number of doses in a tube is specific to the needs of each person.

Gels

Estradiol gel treats menopause-induced night sweats and hot flashes. It comes in both generic and brand-name options:

• Divigel is sold in packets for application on the thigh once a day and comes in both generic and brand-name versions. The average cash price for a carton of 30 packets (a 1-month supply) of the generic version is $164.93, but your cost could be as low as $42.08 with a free GoodRx coupon and as low as $33.38 with a GoodRx Gold membership.

• Elestrin is only available as a brand-name medication. It’s applied to the upper arm once a day and comes in a package with 2 bottles that each contain 30 doses of medication (a 2-month supply per package). The average cash price for that supply is $322.37. The PAN Foundation — an organization that helps underinsured people with life-threatening, chronic, and rare diseases get the medications and treatments they need — has a patient assistance program that includes Elestrin for people who meet certain eligibility requirements.

• EstroGel is only available as a brand-name medication. It is applied to the entire arm once a day. The average cash price is $253.51 for 1 bottle that contains 30 doses of medication (a 1-month supply). You may be eligible to save up to $35 on your copays for up to 12 prescription fills per year with the EstroGel savings card. The PAN Foundation offers a patient assistance program for EstroGel.

Injections

Estrogen injections are another option for treating menopause symptoms. Options include:

• Delestrogen (estradiol valerate), a once-a-month injection, comes in both generic and brand-name versions. The average cash price for the generic version of the 20 mg/mL dose is $146.37 for a 5-mL vial. But it may cost you as low as $52.07 at certain pharmacies with help from GoodRx.

• Depo-Estradiol (estradiol cypionate) only has a brand-name version and comes in a 5 mg/mL dose. Many people only need to inject this medication once monthly. The average cash price for 1 vial is $269.93. But, it may cost as little as $249.48 with GoodRx. Eligible people who don’t have commercial insurance may qualify for the Pfizer RxPathways patient assistance program. Eligibility requirements for this program changed on January 1, 2024. Depo-Estradiol is still included, but eligibility is limited to people who are uninsured or have government health insurance, such as Medicare, Medicaid, or Tricare — among other qualifications. People with commercial insurance are no longer eligible for the Pfizer RxPathways patient assistance program.

Oral medications

If you prefer tablets, there are generic and brand-name options:

• Estrace (estradiol), the most common oral estrogen medication, is available as a generic only. Brand-name Estrace tablets are no longer available. The average cash price for a 90-day supply of 1 mg generic Estrace tablets is $30.97. But with GoodRx, it may cost you as little as $17.00.

• Premarin (conjugated estrogens), listed above as a cream, is also available as brand-name oral tablets in doses ranging from 0.3 mg to 1.25 mg. There is no generic option. The average cash price for a 30-day supply of the 0.0625 mg dosage is $273.22. You should know that Pfizer offers a savings card for Premarin tablets to help consumers with commercial health insurance pay as little as $30 per prescription fill, with a maximum savings of $55 per prescription. Eligible people who don’t have commercial insurance may qualify for the Pfizer RxPathways patient assistance program. The PAN Foundation’s patient assistance program also includes Premarin.

Patches

Estrogen patches typically come in once-a-week and twice-a-week options. There are dozens of estrogen patch brands on the market, and they all contain different amounts of estradiol. A few pricing examples include:

• Generic estradiol patches come in several doses. They are packaged in cartons of 4 once-weekly patches or 8 twice-weekly patches. With GoodRx, a monthly carton of any dose or frequency can cost around $30 or less.

• Climara comes in both brand-name and generic versions. It’s a once-a-week patch with various dose options. The average cash price for a month’s supply of generic 0.05 mg Climara patches is $63.24. But with GoodRx, you may pay as little as $30.62 a month at certain pharmacies. The PAN Foundation’s patient assistance program includes Climara.

• Vivelle-Dot is a twice-weekly patch available in brand-name and generic versions. It comes in several different doses, as well. The average cash price for 8 of the generic 0.05 mg patches is $89.69. But this may cost as little as $31.63 with a GoodRx coupon.

Vaginal suppositories

Vaginal estradiol suppositories are placed inside the vagina and can help with vaginal symptoms of menopause. Some can help with vaginal dryness and irritation, while others can help with pain during sex. They aren’t approved to help with hot flashes or night sweats. Typically, you place 1 insert into the vagina once a day for 2 weeks. After that, you place 1 insert into the vagina twice a week, such as on Tuesdays and Fridays. Options include:

• Imvexxy is a brand-name vaginal capsule (also called an insert). The average cash price for a 10 mcg maintenance 8-pack is $267.49. The lowest-cost option is available by home delivery through Imvexxy’s pharmacy partner. A manufacturer copay card can drop the cost to as low as $35 for consumers with commercial insurance. This copay card can be used at most retail pharmacies.

• Vagifem is a vaginal tablet that’s available in generic and brand-name options. The 10 mcg generic 8-pack’s average cash price is $134.38. The same quantity for the name brand costs $179.03 with GoodRx.

Vaginal rings

Estrogen rings are inserted in the upper part of the vagina for 90 days at a time. Here are two options, which are only available in brand-name versions:

• Estring (estradiol) provides a low dose of estrogen (about 0.0075 mg per day). It can help with vaginal menopause symptoms. The average price for 1 ring is $649.85. With the manufacturer savings card, consumers with commercial insurance can pay as little as $45 per ring for up to 4 prescription fills.

• Femring (estradiol acetate) releases higher doses of estrogen (0.05 mg or 0.1 mg per day). It can help with both vaginal and bodywide symptoms, such as hot flashes. The average cash price is $1005.41 for a 0.05 mg ring and $1057.09 for a 0.1 mg ring. With the manufacturer copay savings card, consumers with commercial insurance can pay as little as $25 per ring for up to 5 prescription fills annually.

Does insurance cover estrogen therapy?

Many insurance plans cover estrogen therapy. Most Medicare, Medicaid, and commercial insurance prescription plans cover estradiol in some form. So does Tricare.

It’s important to note that having insurance coverage for estrogen products doesn’t always make them affordable. Brand-name products are often in the tiers with the highest copays. Even with insurance, brand-name estrogen products can have steep out-of-pocket costs. Generic estrogen options can save you money.

Can you buy estrogen over the counter?

Yes. There are estrogen products available over the counter (OTC). But these are different from what’s available with a prescription. Some OTC topical creams (those applied to the skin) may contain estrogen. But they can vary in the amount and type of estrogen they contain. These aren’t generally recommended by medical experts and shouldn’t be used as a substitute for prescription estrogen products.

It’s a good idea to discuss which estrogen product might be right for you with your medical team. Be sure to tell your prescribers if cost is a concern, so they can prescribe more affordable options. In some cases, they may suggest you try an OTC non-hormonal vaginal lubricant first.

How long should you take estrogen?

Estrogen is recommended at the lowest dose that works and for the shortest time needed to improve symptoms. When your symptoms of menopause start to ease, your medical care team may start reducing your dose. This generally happens after about 5 years of use, or around age 59.

Consult your care team about how long you should take estrogen.

What is the most affordable estrogen, and what is the most expensive?

The most affordable type of estrogen is generic estradiol tablets, which can be $20 or less per month with a GoodRx coupon. On the high end, a 90-day vaginal ring can cost more than $800.

Where can you find help paying for estrogen medication?

Using GoodRx can help you pay less for many estrogen products. Sometimes extra savings are available. For example, the exclusive GoodRx manufacturer discount for Imvexxy suppositories can bring the cost of a maintenance 10 mcg 8-pack for twice-a-week use down from more than $200 to about $85.

For brand-name estrogen products, manufacturers offer copay cards to help people with commercial insurance pay less out of pocket. Some medications also have patient assistance programs that can provide your estrogen at no cost if you meet certain eligibility requirements.

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Written by:

Veneta Lusk

Veneta Lusk is a personal finance and healthcare writer with 15 years of experience. She holds a bachelor of arts in journalism from the University of North Carolina at Chapel Hill.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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