Message based Async Care
An async visit is a convenient way to receive care on your schedule. Instead of a live appointment, you complete a secure online intake. A licensed clinician reviews your intake and, if appropriate, provides a prescription and follow-up guidance. No video visit required.
Prescription Service Fee
Prescriptions provided through asynchronous (online) visits include a flat prescription service fee of $35 per medication.
This fee covers:
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Review of your intake and health history
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Clinical decision-making and prescribing
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Safety screening for contraindications and interactions
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Coordination with the pharmacy
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Medical documentation
Medication costs are billed separately by the pharmacy and are not included in this fee.
The prescription service fee applies equally to all medications.
How Pricing Works
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Prescription service fee: $35 per medication/Async Service
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Pharmacy cost: Billed directly by the pharmacy
All fees are disclosed prior to checkout. There are no hidden charges.
Important Notes
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Prescription service fees are non-refundable once a prescription is issued
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Fees apply whether a medication is filled or not
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We do not mark up medication prices
What’s included
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Secure online intake (no video visit)
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Clinical review completed by a licensed provider
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Prescription to your local pharmacy or compounding pharmacy (if appropriate)
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Dose selection and adjustment within protocol
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Secure messaging for medication-related questions
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Annual async renewal required
What’s not included
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Medication cost (paid directly to pharmacy)
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In-person visits or labs (only if clinically indicated)
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All medication pricing information is estimated and subject to change. Insurance coverage and patient cost-sharing vary widely. Final pricing is determined by your insurance plan and pharmacy at the time of dispensing.
Hair Loss Treatment for Men and Women (Oral Minoxidil). Rx provided is for one year of meds.
Oral Minoxidil Rx for Women: 1.25mg daily
Oral Minoxidil Rx for Men: 2.5mg daily
Simple, discreet medical care for hair loss. Complete a short online intake and, if appropriate, receive a 1-year prescription — no subscriptions, no video visit required. Cost of medication note included.
Typical range with insurance:
👉 ~$0–$30 per month (often modest copay when covered).
👉Cost Plus Pharmacy (cash-pay, no insurance accepted, mail order): $6.10/month
Eye Cream
Caffeine 1%/Niacubanude 2%/Vitamin C 2%/Estriol 0.5% #15g. Rx is provided with one refill.
This compounded topical cream combines several skin-supportive ingredients to help improve the look and feel of aging skin, including overall tone, texture, and hydration. It is intended for cosmetic skin support and is commonly used as part of an anti-aging skincare routine.
What Each Ingredient Does
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Caffeine (1%): Helps support the appearance of puffiness and promotes a more refreshed look by supporting microcirculation in the skin.
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Niacinamide (2%): Supports the skin barrier, helps improve the appearance of uneven tone, and may reduce the look of redness from dryness or irritation.
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Vitamin C (2%): An antioxidant that supports brighter-looking skin and helps protect against environmental stressors.
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Estriol (0.5%): A mild estrogen that may support skin thickness and elasticity as natural hormone levels change over time.
What to Expect
This product is intended to support:
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Smoother-looking skin texture
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Improved hydration and softness
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More even-looking tone and brightness
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Support for the appearance of fine lines over time
Results vary and are typically gradual with consistent use.
How Long This Prescription Will Last
This medication is dispensed in a 15-gram container.
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With once-daily use, one container typically lasts approximately 4–6 weeks, depending on the amount applied.
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Using more than directed may shorten how long the medication lasts.
Actual duration may vary slightly based on individual use.
👉 Compound Pharmacy Cost $ 70
Facial Cream
Estriol 0.3%/Vitamin C 1%/Hyaluronic Acid 0.5% Cream 30g Rx with one refill.
This compounded facial cream is designed to support skin hydration, texture, and overall appearance using a combination of gentle, skin-supportive ingredients.
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Estriol (0.3%) is a mild estrogen that may help support skin thickness and elasticity as estrogen levels decline over time.
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Vitamin C (1%) is an antioxidant that supports skin tone and helps protect against environmental stressors.
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Hyaluronic Acid (0.5%) helps attract and retain moisture, improving skin hydration and softness.
👉 Compound Pharmacy Cost $75.00
How Long This Medication Should Last
This prescription is dispensed as a 30-gram pump.
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1 pump nightly: one container should last approximately 4 months
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2 pumps nightly: one container should last approximately 2 months
Actual duration may vary slightly depending on use and dispensing, but most patients fall within this range.
About compounded medications
This product is custom-compounded by a licensed compounding pharmacy and is not an FDA-approved commercially manufactured medication. Compounded medications are prepared based on individual prescriptions and clinical judgment.
Arousal Cream For Women
Alprostadil 300mcg/0.1ml in pharmabase #3ml with one refill. (30 days supply)
Topical Alprostadil Cream (Female Use)
Topical alprostadil is a non-hormonal, on-demand medication designed to support genital blood flow and sensitivity in women. It is applied externally in a small amount shortly before sexual activity.
This medication works by temporarily increasing local blood flow, which may help improve physical arousal and sensation. It does not affect hormone levels and does not increase sexual desire.
How It’s Used
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Applied using a small fingertip amount to the external genital area
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Used 5–30 minutes before sexual activity
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Intended for occasional, as-needed use
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Should not be used more than once in 24 hours unless directed
Who This May Be Helpful For
Topical alprostadil may be an option for women experiencing:
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Reduced genital sensitivity or arousal
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Difficulty achieving orgasm related to decreased blood flow
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Sexual changes associated with menopause or postpartum changes
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Physical arousal difficulties despite normal desire
This medication is not a treatment for low libido, relationship concerns, or psychological causes of sexual dysfunction.
Important Safety Information
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This medication is non-hormonal
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Possible side effects include temporary warmth, redness, tingling, or mild burning at the application site
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Dizziness or headache may occur in some individuals
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Small amounts may be transferred to a partner through skin contact
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Not recommended during pregnancy; additional counseling may be required during breastfeeding
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Should not be used on broken skin or with active genital infections
What to Expect
Results vary. Some patients notice effects with the first use, while others may require several attempts to assess benefit. If irritation or concerning symptoms occur, use should be discontinued and the clinic contacted.
Storage & Refill Policy
This medication must be refrigerated and is only stable for 30 days. One refill is included so patients may obtain a second 30-day supply if the medication is effective. Refills should be filled only after the initial supply is completed or discarded.
👉 Compound Pharmacy Cost: $80.00 for 15ml
About compounded medications
This product is custom-compounded by a licensed compounding pharmacy and is not an FDA-approved commercially manufactured medication. Compounded medications are prepared based on individual prescriptions and clinical judgment.
Local Vaginal Estrogen Therapy
Estradiol Vaginal Cream (0.01%) 30g tube Rx with 3 refills.
Evidence-based treatment for genitourinary syndrome of menopause (GSM) which includes vaginal dryness, burning/irritation, painful sex, recurrent UTI's, urinary urgency/frequency, vulvar dyscomfort related to perimenopause/ menopause. Simple online intake with clinician review and annual prescription if appropriate.
👉Insurance Range: vary but range 10-100/month with most plans on the lower range.
👉Cost Plus Pharmacy (cash-pay, no insurance accepted, mail order) $13.21/month.
Local Vaginal Estrogen Therapy
Estriolol/DHEA 0.5mg/5mg/ml Vaginal Cream 30grams. Rx is provided with 3 refills.
Why estriol + DHEA?
How Estriol and DHEA Work Together
Estriol
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Estriol is the weakest naturally occurring estrogen
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It primarily acts locally on vaginal tissue
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It supports tissue thickness, elasticity, and moisture
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It is generally associated with less systemic estrogen activity compared to estradiol
DHEA (Dehydroepiandrosterone)
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DHEA is a hormone precursor naturally produced by the body
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When applied vaginally, it can be locally converted within vaginal tissue into small amounts of estrogen and androgens
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This supports tissue health, sensation, and comfort without acting as systemic hormone therapy
Together, estriol and DHEA provide local hormonal support at the tissue level, rather than delivering a stronger systemic estrogen signal.
Why Some Patients Choose Estriol/DHEA Instead of Estradiol Alone
Estradiol vaginal therapy is very effective and remains a standard treatment for GSM. However, some patients prefer estriol/DHEA because:
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Estriol is less potent than estradiol and may feel gentler for long-term local use
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The combination supports vaginal tissue through multiple pathways, not estrogen alone
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Some patients experience better comfort or sensation with DHEA-containing products
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It may be preferred by patients who are sensitive to estradiol or want a lower-potency option
This option is not necessarily “better” than estradiol, but it can be a better fit for certain patients.
Important Expectations
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Estriol/DHEA vaginal cream is local therapy, not systemic hormone replacement
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It is not intended to treat hot flashes, night sweats, or other whole-body menopausal symptoms
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Improvement is typically gradual, occurring over several weeks
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Results vary, and some patients may respond better to estradiol alone
How Long Does One Tube Last?
Loading Phase
Dose: 0.5–1 mL nightly
Duration: 2–4 weeks
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0.5 mL nightly
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30 g ÷ 0.5 mL = ~60 doses
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Lasts ~8–9 weeks if used nightly
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1 mL nightly
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30 g ÷ 1 mL = ~30 doses
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Lasts ~4–5 weeks if used nightly
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At maintenance dosing:
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0.5 mL, 2–3×/week → tube can last 3–4 months
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1 mL, 2–3×/week → tube can last 6–8 weeks
👉 Compound Pharmacy Cost $115
About compounded medications
This product is custom-compounded by a licensed compounding pharmacy and is not an FDA-approved commercially manufactured medication. Compounded medications are prepared based on individual prescriptions and clinical judgment.
Eye Cream
Estriol 0.1%/Vitamin C 1%/Hyaluronic Acid 0.5% Cream 15g Rx with one refill.
Estriol Eye Cream
Caffeine 1% · Niacinamide 2% · Vitamin C 2% · Estriol 0.1%
A compounded topical eye cream designed to support the delicate under-eye area by improving hydration, texture, and the appearance of fine lines.
This formulation combines low-dose estriol with proven non-hormonal actives to address common under-eye concerns while remaining gentle enough for daily use.
What this cream may help with
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Fine lines and crepey texture around the eyes
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Dryness and thinning skin
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Puffiness and tired-appearing eyes
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Dull or uneven tone in the under-eye area
Results vary and are not guaranteed.
Key ingredients & why they’re included
Estriol 0.1%
A weaker, naturally occurring estrogen that supports skin hydration and elasticity. In low topical concentrations, estriol may help improve skin thickness and resilience in estrogen-responsive tissue.
Caffeine 1%
Helps reduce the appearance of puffiness by supporting microcirculation and minimizing fluid retention under the eyes.
Niacinamide (Vitamin B3) 2%
Supports the skin barrier, improves texture, and helps reduce the appearance of fine lines and uneven tone.
Vitamin C 2%
An antioxidant that supports collagen production and brightens the appearance of the skin.
How to use
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Apply a small, pea-sized amount total (both eyes combined) to clean, dry skin
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Gently tap around the orbital bone using your ring finger
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Avoid direct contact with eyes, eyelids, or lash line
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Use once daily, preferably in the evening
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If you have sensitive skin, start every other night for the first 1–2 weeks
Important safety information
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For external use only
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Do not apply to broken or irritated skin
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Stop use and contact the clinic if irritation, rash, or worsening pigmentation occurs
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Use daily sunscreen, as vitamin C may increase sun sensitivity
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Do not use if pregnant, trying to conceive, or breastfeeding
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Patients with a history of estrogen-sensitive conditions or blood clots may require additional evaluation before prescribing
About compounded medications
This product is custom-compounded by a licensed compounding pharmacy and is not an FDA-approved commercially manufactured medication. Compounded medications are prepared based on individual prescriptions and clinical judgment.
👉 Compound Pharmacy Cost $80.00
How long will this prescription last?
This prescription contains 15 grams of compounded estriol eye cream.
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With once-daily use (a pea-sized amount for both eyes combined),
most patients can expect this to last approximately 8–12 weeks.
Actual duration may vary based on how much is applied and individual use patterns. Using more than directed will cause the product to run out sooner and may increase irritation or side effects.
Arousal Cream For Women
Sildenafil 10mg/ml #15ml
Prescription includes one refill.
Topical sildenafil is a non-hormonal, locally applied medication designed to support genital blood flow when used prior to sexual activity. It is formulated for external use only and is applied in a small amount to the genital area.
Unlike oral sildenafil, this formulation is intended to work locally, with minimal systemic absorption when used as directed.
How It Works
Sildenafil is a vasodilator, meaning it helps increase blood flow by relaxing blood vessels. When applied topically, it may enhance physical arousal and sensitivity related to improved local circulation.
This medication does not increase sexual desire and does not treat psychological or relationship-based concerns.
How It’s Used
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Applied externally using a small fingertip amount
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Used approximately 5–30 minutes before sexual activity
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Intended for as-needed use
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Should not be used more than once in 24 hours unless directed
Each prescription is dispensed as a 15 mL tube.
Who This May Be Helpful For
Topical sildenafil may be an option for individuals experiencing:
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Reduced genital blood flow
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Physical arousal difficulties
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Decreased sensitivity during sexual activity
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Sexual changes associated with menopause, postpartum changes, or vascular factors
This medication is not intended to treat low libido or conditions requiring systemic therapy.
Important Safety Information
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This medication is non-hormonal
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Possible side effects include local warmth, redness, tingling, mild burning, headache, dizziness, or lightheadedness
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Small amounts may be transferred to a partner through skin contact
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Not recommended during pregnancy; additional counseling may be required during breastfeeding
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Should not be applied to broken skin or areas with active infection
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Individuals with significant cardiovascular conditions may require additional evaluation
What to Expect
Response varies between individuals. Some patients notice effects with the first use, while others may need several attempts to determine benefit. If irritation or concerning symptoms occur, use should be discontinued and the clinic contacted.
How Long This Prescription Will Last
This medication is dispensed as a 15 mL tube.
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When used as directed (a small fingertip amount as needed), one tube typically lasts several weeks to a few months, depending on frequency of use.
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Because this medication is used only before sexual activity, the duration varies from person to person.
👉 Compound Pharmacy Cost: $58.00 for 15ml
Async Care is not appropriate for emergencies or complex medical conditions. Prescriptions are provided only when clinically appropriate after provider review. Not all conditions qualify for async treatment.