Prescription hormone replacement therapy

One cream. Both hormones. Whole-body balance.

Alumei™ is a physician-prescribed vaginal cream combining bioidentical estradiol and micronized progesterone in a single daily application — designed for steady absorption, minimal mess, and support for sleep, mood, energy, hot flashes, and vaginal comfort.

100% online. No office visit required. A licensed physician reviews every intake.

  • Physician reviewed
  • Compounded in a licensed U.S. pharmacy
  • Bioidentical hormones
  • Free, discreet shipping
  • HSA/FSA eligible
Alumei HRT Cream bottle
Licensed U.S. physicians 503A compounding pharmacy Pharmaceutical-grade ingredients HIPAA-secure platform
What is Alumei

Two hormones your body already knows, in one nightly step

Alumei™ is a compounded hormone replacement therapy (HRT) cream for women navigating perimenopause and menopause. Each gram contains estradiol 6 mg — the body's primary, most active estrogen — and progesterone 200 mg, its calming, protective counterpart.

Both are bioidentical: molecularly identical to the hormones your body produces naturally. Instead of juggling a patch for estrogen and a pill for progesterone, Alumei delivers both in one simple nightly application, compounded to your prescription.

Two strengths · 3-month supply
  • Low dose30 gm bottle — one pump applied vaginally once daily
  • Higher dose45 gm bottle — two pumps applied vaginally once daily

You select a starting dose at checkout; a licensed physician reviews your health history and confirms it, recommends a different strength, or determines hormone therapy isn't right for you. Because Alumei is a metered-pump cream, your dose can be fine-tuned as your needs change.

Inside the formula

Every ingredient, explained

E2 · 6 mg/gm

Bioidentical estradiol

The most potent of the body's estrogens — and the one that declines most sharply through menopause. Restoring estradiol supports:

  • Hot flashes & night sweats — the classic vasomotor symptoms
  • Vaginal & urinary health — elasticity, lubrication, comfort during intimacy
  • Bone density — estrogen is central to bone strength
  • Mood & cognition — many women report clearer thinking
  • Skin & sleep — collagen support, fewer 3 a.m. wake-ups
P4 · 200 mg/gm

Micronized progesterone

Estrogen's essential partner — protective, calming, and dosed to reflect the body's own physiology.

  • Endometrial protection — balances estrogen's effect on the uterine lining
  • Sleep support — its metabolites act on GABA, the brain's calming pathway
  • Calm & mood — often called the "quieting" hormone
  • Symptom stability — smooths perimenopause's hormonal turbulence

"Micronized" means the particles are ultra-fine for better absorption. The higher dose vs. estradiol is intentional — it mirrors the body's natural ratio.

Base · Ellage®

Ellage® anhydrous base

The first water-free base developed specifically for vaginal medication — and what sets Alumei apart from ordinary creams.

  • Self-emulsifying delivery — forms a micro-emulsion on contact with natural moisture, releasing hormones directly to the tissue
  • Mucoadhesive = less leakage — holds hormones in contact with tissue; in vitro testing shows significant potential to minimize leakage
  • Gentle — published in vitro studies show it's nonirritating and doesn't affect vaginal pH
  • Works even with dryness — self-emulsifies with only trace moisture

Formulated without wheat, gluten, milk, egg, soy, fish/crustacean, peanut, or tree nuts.

Why delivery method matters

The same hormone behaves differently depending on how it enters your body

Vaginal delivery absorbs hormones through the mucosa directly into circulation — bypassing the digestive system and first-pass liver metabolism. That means steadier levels, lower effective doses, and direct local benefit to vaginal tissue on top of whole-body support.

Alumei™ vaginal cream Oral pills Patch
First-pass liver metabolism Bypassed Yes — hormone partially broken down; oral estrogen's liver processing raises clotting-factor production Bypassed
Estrogen + progesterone together ✓ One product Usually separate pills ✗ Patch + separate pill
Hormone levels Steady absorption Peaks and troughs between doses Steady, but varies with skin & adhesion
Dose flexibility Finely adjustable Fixed tablet strengths Fixed patch strengths
Local vaginal benefit ✓ Direct
Skin irritation / adhesive None N/A Possible; can loosen with sweat or showers

Route-of-administration differences reflect general findings in published hormone-therapy literature. Individual results vary. Your clinician will help determine the best route for you.

The science

Apply. Emulsify. Absorb.

Apply

A measured pump of cream, applied vaginally at bedtime as prescribed. No applicator to fill, no guessing.

Emulsify

On contact with natural moisture, the Ellage® base forms a micro-emulsion that releases estradiol and progesterone to the vaginal mucosa.

Absorb & adhere

The mucoadhesive system holds the hormones against the tissue, extending contact time while they absorb into circulation — without the leakage of water-based creams.

The Ellage® base has been the subject of ten published in vitro and ex vivo studies by PCCA Science examining drug release, self-emulsification, mucoadhesion, leakage potential, irritation profile, and effect on vaginal pH.

How it works

From questionnaire to your door — 100% online

Complete your online intake

Tell us about your symptoms, health history, and goals, and select your preferred starting dose. About 5–10 minutes, from your phone.

Physician review

A licensed physician reviews your intake and selected dose. They may confirm it, recommend a higher or lower strength, or reach out through your secure portal. If approved, your prescription goes to our partner compounding pharmacy.

Discreet, fast shipping

Compounded to your prescription and shipped free in plain packaging. Each delivery is a 3-month supply, and refills work the same way — no pharmacy lines.

Pricing & membership

Simple, transparent pricing. Everything included.

Low dose · 30 gm

One pump daily

Applied vaginally once daily. A gentle starting point many women begin with.

First 6 months$179/mo
Month 7 onward$99.50/mo
Start with low dose
Higher dose · 45 gm (larger bottle)

Two pumps daily

Applied vaginally once daily. For women with more significant symptoms.

First 6 months$199/mo
Month 7 onward$119.50/mo
Start with higher dose

Every membership includes

  • Your customized bioidentical hormone cream, delivered every 90 days
  • A full 3-month supply per shipment, with a 10+ day overfill buffer
  • Ongoing medical oversight — dose adjustments before month 3, dose increases available after month 3
  • Unlimited access to clinical experts and chat support
  • Free replacement if your prescription is lost or damaged in transit
  • All pharmacy, admin, and shipping costs bundled — no surprise fees
  • A personalized hormone plan — not a one-size-fits-all formula
  • Cancel anytime — no contracts, no cancellation fees

Billed monthly. You choose your preferred dose at checkout; a licensed physician confirms or adjusts it based on your health history. If hormone therapy isn't appropriate for you, you won't be charged for medication. No insurance needed. HSA/FSA eligible.

Who it's for

Made for the symptoms of perimenopause and menopause

  • Hot flashes & night sweats
  • Sleep disruption
  • Mood changes, anxiety, irritability
  • Brain fog
  • Vaginal dryness or discomfort
  • Low libido
  • Fatigue
  • Irregular cycles

Alumei is not appropriate for everyone. Women with certain conditions — including a history of breast or uterine cancer, blood clots, stroke, liver disease, or unexplained vaginal bleeding — may not be candidates for hormone therapy. That's exactly why every intake is reviewed by a physician before anything is prescribed.

Questions, answered

Frequently asked questions

About Alumei

What exactly is in Alumei™?

Each gram contains 6 mg of bioidentical estradiol and 200 mg of bioidentical micronized progesterone, compounded in the Ellage® anhydrous vaginal base. It contains no wheat, gluten, dairy, egg, soy, fish, peanut, or tree nut ingredients.

What does "bioidentical" mean?

Bioidentical hormones are molecularly identical to the estradiol and progesterone your body produces on its own. Your body recognizes and metabolizes them the same way it handles its own hormones.

What is a compounded medication?

Compounded medications are prepared by a licensed pharmacy to a physician's specific prescription — in this case combining two hormones in one customized cream. Compounding allows your dose to be tailored and adjusted in ways mass-produced products can't match. Compounded drugs are prepared under state and federal pharmacy regulations but are not individually FDA-approved products.

Why one combined cream instead of separate estrogen and progesterone products?

Simplicity and consistency. One product, one nightly routine, one refill — with both hormones delivered in a physiologic ratio. Fragmented regimens (patch + pill + cream) are harder to stay consistent with, and consistency is what drives results.

Why is the progesterone dose so much higher than the estradiol dose?

That's normal and intentional. Progesterone is naturally present in the body at far higher levels than estradiol, and it requires a larger dose to achieve its protective and symptom-relieving effects. The ratio in Alumei reflects the body's own physiology.

Using Alumei

How do I use it?

Exactly as your prescriber directs — one pump (low dose) or two pumps (higher dose) applied vaginally once daily, typically at bedtime. Alumei comes in a metered-pump bottle, so every dose is measured for you.

Will it leak or feel messy?

This is the problem the Ellage® base was engineered to solve. Unlike traditional water-based creams, Ellage is mucoadhesive — in vitro testing shows it has significant potential to minimize leakage. Most women apply at bedtime and forget it's there.

How long until I notice a difference?

Every woman is different. Some symptoms, like vaginal dryness and sleep, often respond within the first few weeks; others, like mood, energy, and skin changes, typically build over two to three months of consistent use. Your care team will check in and can adjust your dose with your prescriber if needed.

I have vaginal dryness — will the cream still work?

Yes. The Ellage base was specifically shown to self-emulsify even in the presence of very small amounts of moisture, so it performs even for women with significant dryness.

What if I miss a dose?

Apply your next dose at the regular time — don't double up. Consistency matters more than perfection.

Safety

Is hormone replacement therapy safe?

For most healthy women within roughly 10 years of menopause onset, current guidance from major medical organizations supports HRT as an appropriate, effective treatment for menopausal symptoms — with benefits that generally outweigh risks when properly prescribed and monitored. Hormone therapy is not risk-free, however, and it isn't right for everyone. That's why a licensed physician reviews your complete health history before prescribing, and why ongoing follow-up is part of how we work.

Who should not use Alumei?

Hormone therapy may not be appropriate for women with a history of breast cancer, estrogen-dependent cancers, blood clots (DVT/PE), stroke, heart attack, liver disease, or undiagnosed vaginal bleeding, among other conditions. Your intake form screens for these, and the reviewing physician makes the final determination.

What are possible side effects?

As with any hormone therapy, some women experience breast tenderness, spotting, bloating, headache, or mood changes — especially in the first weeks as your body adjusts. Most early side effects settle with time or a dose adjustment. Any unusual or persistent symptoms should be reported to your prescriber promptly.

Is Alumei FDA-approved?

The active ingredients — estradiol and micronized progesterone — are the same hormones found in FDA-approved therapies, and our pharmacy sources pharmaceutical-grade ingredients. As a compounded medication prepared to your individual prescription, Alumei itself is not an FDA-approved product; compounded drugs are regulated under state boards of pharmacy and federal compounding law rather than the FDA new-drug approval process.

Does Alumei affect vaginal pH?

In vitro testing shows the Ellage® base itself should not affect vaginal pH.

Getting started & membership

Do I need to see a doctor in person?

No. The entire process — intake, physician review, prescribing, and refills — happens online. If the reviewing physician needs more information, they'll contact you through the secure portal.

How do I know which dose to pick?

Choose the option that best matches your symptoms — many women start with the low dose, while those with more significant symptoms may select the higher dose. Either way, you're not choosing alone: a licensed physician reviews your health history and will confirm your selection, recommend a different strength, or reach out with questions before anything is prescribed. Your dose can also be adjusted after you start.

Do I need a prescription?

Yes. Alumei is a prescription medication. You select your preferred dose at checkout, but nothing ships until a licensed physician reviews your intake and issues a prescription. The physician may approve your selected dose, recommend a different strength, or determine that hormone therapy isn't appropriate for you.

How is it shipped?

Fast and free, in plain packaging with no indication of the contents. Each shipment is a full 3-month supply (with a 10+ day overfill buffer) and arrives every 90 days. If your prescription is ever lost or damaged in transit, we replace it free.

How much does it cost? Does insurance cover it?

Alumei membership is billed monthly: $179/mo for the low dose (30 gm) or $199/mo for the higher dose (45 gm) during your first 6 months. After that, your rate automatically drops — to $99.50/mo (low dose) or $119.50/mo (higher dose). Your membership includes the medication, physician oversight, dose adjustments, unlimited chat support, and shipping — no hidden fees. No insurance is needed.

Can I cancel or pause?

Yes — you're never locked in. Cancel anytime with no fees or contracts.

What if my dose isn't right?

This is where a compounded pump cream shines. Your prescriber can adjust your dose before month 3 if you're not responding as expected, and dose increases are available starting after month 3 — all without switching products or restarting therapy. Just message our clinical team through your portal.

Feel like yourself again

Start your online visit today. A licensed physician reviews every intake — and if Alumei is right for you, it ships free and discreetly to your door.

Start your online visit
Start your online visit