HRT (hormone replacement therapy) is a hot topic these days in the women’s wellness space, especially for those of us over the age of 35. I tried Winona last year and shared my experience in this blog post. 

As a personal trainer and women’s weight loss coach, I like to stay on top of things that directly affect women, like HRT. I was recently introduced to Inner Balance, another HRT company for women in perimenopause and beyond. Inner Balance’s approach to HRT is different than Winona's. Both companies appear to have compelling and scientifically proven approaches to treatment, but they are a bit in contrast to each other.

Since I was already aware of Winona’s approach to HRT, I decided to dive into Inner Balance’s approach to see what’s different, what’s the same, and which one best serves the needs of women over the age of 35. 

First, Let’s Chat About Winona

I tried Winona about a year ago when I was experiencing some hormonal changes that caused me to gain 10lbs despite not making any changes in my diet and exercise routine. I was doing everything “right,” but couldn’t seem to drop even a pound. I’ve always had hormone-related issues. In fact, I was diagnosed with PCOS back in 2015, but when I hit 35, my issues seemed to really ramp up.

Without getting into the whole background story, I did all kinds of things to get to the root of my problem, with trying HRT being one of them. I chose to go through Winona because I had been familiar with them for a few years, knew that they were helping thousands of women (I was a member of their Facebook group, which contains countless testimonials), and I didn’t have health insurance, so Winona provided an affordable out-of-pocket solution.

Winona is slightly controversial in their approach to prescribing bioidentical hormones to women - they do not require lab work, and they prescribe based on symptoms. In fact, when I came to Winona, I had just gotten a full panel of blood work, gut health testing, and hormone testing (DUTCH test) done and wanted to run them by a Winona Dr. before moving forward with treatment. Dr. Green from Winona has been happy to review my labs, but basically dismissed them, saying it’s incredibly hard to draw any kind of concrete conclusions from hormone testing because our hormone levels fluctuate daily (and even hour by hour). 

Winona prescribes medications based on your symptoms. Then, if needed, they will tweak your prescription to better suit your needs. They utilize compounded medications that they can customize to your specific needs, but they start off with a “best guess” prescription and see how you respond. Adjustments to your treatment are made based on your symptoms and are done via your Winona portal, where you have access to their care team 24/7. 

The treatment options that Winona offers include; 

• Estrogen body cream with progesterone
• Estrogen patch
• Vaginal estrogen cream
• DHEA
• Progesterone body cream
• Estrogen body cream
• Estrogen tablets
• Progesterone capsules
• Estriol cream with Tretinoin
• Blossom (arousal cream)
• Minoxidil hair serum

Winona’s bread and butter product is their Estrogen body cream with progesterone and DHEA. In fact, these were the exact medications prescribed to me for my symptoms. The HRT creams are meant to be applied to any area of your skin that has no hair (except for on the breasts). Most women, myself included, apply it to their wrists/forearms. 

Winona prescribes you 3 months of medications, instructing you to take them consistently in order to start to see and feel results. From there, adjustments are made based on your feedback and symptoms. Support can be found in your dashboard by reaching out to your assigned Winona Dr., the care team, or by engaging in the Facebook group. 

The average cost for HRT through Winona is $89/month for the cream and $27 for a 3-month supply of DHEA. There are no additional fees associated with ongoing treatment or care (including any medication dosage adjustments), unless you decide to add any additional products. Winona does not offer a money-back guarantee.

Now, Let’s Look Into Inner Balance

Inner Balance is serving the same demographic as Winona, but doing it a bit differently. When it comes to Inner Balance, they have one hero product, Oestra. Oestra is a vaginal progesterone and estradiol (estrogen) vaginal HRT cream that’s designed to target and correct the hormone imbalances associated with women over 35.

Specifically, Inner Balance treats women experiencing:

• General perimenopaus or menopause
• Endometriosis 
• PCOS
• Postpartum

Essentially, Oestra can potentially help treat any hormone-related female issue. Inner Balance operates very similarly to Winona when it comes to prescribing their HRT based on symptoms, not on lab tests. If, by the way,  you are looking for a provider that requires lab testing before prescribing HRT, Midi Health is a good option. I compared Midi Health to Winona in a recent blog post. Again, this approach can be controversial, but it is also opening the door for more women to receive treatment. We all know how it feels to have labs come back as “normal” when we feel anything but.

The way it works at Inner Balance is you go through their intake questionnaire, and if you’re eligible (based on age, symptoms, etc.), they approve you instantly for Oestra. Oestra is a vaginal cream that you apply vaginally. Inner Balance makes a strong argument for vaginal delivery, stating that only 20-30% of oral and topical formulations actually absorb. According to Inner Balance, vaginal delivery is superior as it is a more effective way for hormones to be absorbed into the bloodstream. 

Oestra is a safe, natural, bio-identical hormone cream that can potentially treat a myriad of hormone-related symptoms, allowing women to feel more like themselves again, including reducing the signs of aging. 

When I went through the intake process for Inner Balance, I noticed that they have a section on the sales page that states Oestra is your all-in-one symptom management system. They are claiming that Oestra can replace doctor’s visits, lab testing, botox, weight loss injections, gut and vaginal probiotics, skincare, lubrication, hair loss supplements, and sleep/stress supplements. I didn’t use Oestra, but I am pretty confident that it can’t replace the effects of Botox or weight loss injections (I’m a bit skeptical about those claims). However, I am sure Oestra provides relief from many hormone-related symptoms.

One thing that stands out with Oestra is that they offer a 6-month money back guarantee and the promise that you’ll start to feel symptom releif within 30 days. Winona, on the other hand, recommended using their treatments regularly for at least 90 days to begin to experience results. 

Another standout between Inner Balance and Winona is that Winona is adamant that DHEA (prescribed in small, appropriate doses) is critical for balancing testosterone, and they therefore prescribe it alongside their HRT treatments regularly. Inner Balance is against the use of DHEA, stating that they prefer to allow a woman’s body to convert progesterone to testosterone in the right amounts. There are potential side effects associated with the use of DHEA (hair loss, acne, irritability, and weight gain). 

I directly asked my Winona Dr. about using DHEA (since I am a patient and have access), and this was his response:

“We prescribe DHEA, which gets turned into estrogen and testosterone in the body. It is a safe way to gently raise testosterone levels. I am careful to prescribe DHEA in dosages that greatly reduce the risk of testosterone side effects. For most women, the DHEA is enough to provide the benefits of testosterone without the risks and side effects that can occur with direct testosterone treatment.”

These are two very different philosophies and approaches. If you’re deciding between these two companies for HRT, I highly recommend doing as much research as possible, asking lots of questions, and being open to trying treatments consistently in order to experience benefits. I have read a lot of testimonials in the Winona community Facebook group from women who swear by DHEA.

Oestra costs $199/month for the first 6 months and then $99.50/month thereafter. This price includes your monthly Oestra cream, personalized treatment (they will adjust your compound based on needs), unlimited follow-ups with your Inner Balance Dr., and auto-replenishment (90-day supplies, billed monthly). 

Final Thoughts

First, I want to acknowledge that both Inner Balance and Winona are making giant strides in women’s health. Up until recently, HRT was majorly demonized in the health space and women were left to suffer in silence. Both of these companies are removing the stigma and judgment from using HRT and are making these medications so much more accessible.

While the goal of both Winona and Inner Balance is to help women feel their best, their approaches are slightly different. I honestly don’t believe that one is better than the other - there are pros, cons, and considerations to be made for both. My recommendation would be to go with the one that feels most aligned with your goals, budget, and preferences, and give it a consistent go. See how you feel, speak with your doctor, etc. 

For many women, the decision will come down to application. Some women are very comfortable with vaginal application, while others are not. The monthly cost may also play a role in your decision - Winona’s prices are very competitive at over $100 less per month than Inner Balance. I also think the DHEA controversy will play a role - you may either be for it or against it. If you’ve done your research and want to add DHEA, Winona is the way to go (but keep in mind that you don’t need to use DHEA if you go with Winona). 

Let me know which one you decide to go with. I’d love to hear your feedback and experience.