Sleep again. Think clearly. Feel like yourself.
Bioidentical estrogen, progesterone, and topical estradiol — personalized at your online visit and prescribed by a US-licensed physician.
- Current-guideline HRT regimen — bioidentical estrogen and progesterone
- Bioidentical hormones — same hormones your ovaries used to make
- Build your bundle at checkout — one provider, one shipment, one fee
From less than $7 a day
$199 per component·all-inclusive: provider, medication, shipping
2 minutes · No commitment until a provider approves
40+ years
FDA-approved estradiol
7 in 10
Women have perimenopause symptoms
24 hours
Physician review
Licensed providers in your state
503A/B pharmacies, USP-grade compounding
No charge until a provider approves
- Cancel, pause, or switch protocols anytime — no annual commitment.
- All-inclusive pricing — provider, medication, and shipping in one monthly number. No surprise bills.
- Ongoing provider access — message your prescriber anytime through the patient portal.
Hot flashes, sleep disruption, or mood shifts in perimenopause or menopause
Vaginal dryness, irritation, or recurrent UTIs
Confused by conflicting HRT advice and want a current-guideline protocol
Current-guideline HRT regimen — bioidentical estrogen and progesterone
Bioidentical hormones — same hormones your ovaries used to make
Build your bundle at checkout — one provider, one shipment, one fee
You're not alone.
Perimenopause and menopause symptoms aren't 'in your head.' Hot flashes, night sweats, sleep disruption, mood shifts, brain fog — they're caused by declining estrogen and progesterone. Bioidentical HRT replaces what your body is no longer producing.
And you deserve to feel like yourself.
You don't have to white-knuckle your way through it. You don't have to wait until it gets worse. The medicine exists — and so does your right to use it.
How the estrogen + progesterone pairing works
Bioidentical estrogen and progesterone, picked at your online visit. The clinical logic behind each component:
Steady estrogen
Whichever form fits you (patch, gel, or tablet), the goal is steady estradiol levels — not the peak-and-crash that comes with under-titrated dosing.
Transdermal skips the liver
Patch and gel deliver estradiol through the skin, skipping the liver — which is why NAMS leans transdermal when clotting risk is a concern. Oral tablet remains an option for patients better suited to it.
Hot flashes + sleep
Estradiol is what calms hot flashes. Progesterone protects the uterine lining; bedtime oral capsule has the strongest deep-sleep evidence.
What menopause societies prefer
Bioidentical estrogen + progesterone is the regimen NAMS and ISSWSH lean toward; the specific delivery forms are picked at intake based on your case.
Hormone levels at the menopause transition
Estradiol stays steady through the early 40s, then drops sharply at menopause. Progesterone falls earlier — perimenopause changes start in the late 30s/early 40s.
Source: Burger et al. Hormonal changes in the menopause transition. Recent Progress in Hormone Research, 2002.
What the research says
NAMS / ISSWSH-aligned HRT evidence base.
The 2022 hormone therapy position statement of The North American Menopause Society
NAMS Position Statement, 2022
Hormone therapy is the most effective treatment for vasomotor symptoms; transdermal delivery is preferred where clotting risk is a concern.
Transdermal vs oral estrogen and venous thromboembolism risk
Canonico et al., 2007
Transdermal estrogen does not increase VTE risk in postmenopausal women, unlike oral estrogen.
Effects of micronized progesterone on sleep in postmenopausal women
Schussler et al., 2008
Oral micronized progesterone improved deep sleep architecture in postmenopausal women.
What women have been doing — and where modern HRT fits
| Bioidentical HRT | OTC supplements | Nothing | |
|---|---|---|---|
| FDA-approved active ingredients | ✓ Yes (estradiol, progesterone) | No | — |
| Addresses the root cause (low hormones) | ✓ Yes | Partially (varies by product) | — |
| Backed by major medical society guidelines | ✓ NAMS, Endocrine Society, BMS | Limited | — |
| Time to relief | ✓ 2–12 weeks | Variable (often months, often no effect) | — |
What happens after you click
- Step 1
Today
2-minute online visit. No charge unless a physician approves.
- Step 2
Within 24 hours
A US-licensed physician reviews your intake and approves a protocol that fits — or tells you it isn't right for you.
- Step 3
5–7 days
Your prescription arrives in discreet packaging from a licensed US pharmacy.
What's in this protocol
Estradiol
Patch (0.025-0.1mg/day, 1-2x weekly), topical gel (daily), or oral tablet (0.5-2mg daily) — picked at your online visit
Bioidentical estrogen — the same hormone your ovaries used to make. Your provider picks the form that fits you best at your online visit: transdermal patch (preferred for steady levels with lower clotting risk), topical gel (for patients whose skin doesn't tolerate the patch), or oral tablet. The estrogen is the same — only the form changes.
Progesterone
Oral capsule (100-200mg at bedtime) or Biest 50:50 with Progesterone cream — picked at your online visit
Bioidentical progesterone — required pairing with systemic estrogen (it protects the uterine lining). Most patients take it as an oral capsule at bedtime, where it's also been shown to deepen sleep. Some patients pick a Biest 50:50 combination cream instead, depending on the answers in their online visit.
Topical Estrogen
Vaginal cream 0.01% (~1g, 2-3x weekly) or Biest 50:50 Cream — picked at your online visit
Topical estrogen for the dryness, irritation, and urinary symptoms that often show up in peri- and post-menopause. Your provider picks between localized vaginal cream (for genitourinary symptoms specifically; minimal absorption into the bloodstream) or a Biest 50:50 cream (for patients on a topical-cream regimen). Both deliver bioidentical estrogen.
Flexible payment options available at checkout · Cancel anytime · HSA/FSA reimbursable (Letter of Medical Necessity available from your provider on request)
Inside your kit
- 1
Bioidentical estradiol
Patch, gel, or tablet. Monthly supply.
- 2
Bioidentical progesterone
Oral capsule at bedtime or topical cream. Monthly supply.
- 3
Dosing card
Provider-personalized schedule + when to check in.
Reviewed and prescribed by a US-licensed physician
Every Pepvio prescription is reviewed by a US-licensed physician. Real intake review, real prescription decision, real follow-up. We're not a supplement company. Your physician decides if HRT is right for you based on your intake — and if it isn't, you aren't charged.
Take care of yourself.
Your symptoms are real. The treatment is real. You've waited long enough. A US-licensed physician reviews your intake — usually within 24 hours. You're not charged until they approve a protocol that fits.
See if I qualifyPepvio protocols require a valid prescription from a licensed healthcare provider. All medications are compounded by licensed pharmacies. Pepvio does not provide medical advice; all medical decisions are made by licensed providers in our network. Individual results may vary.