Frequently asked
The ones we get from patients before they sign up. If yours isn't here, our care team replies within a business day.
About Therisse
Therisse is a direct-to-consumer telehealth practice for women in perimenopause, menopause, and metabolic transition. We offer two programs: HRT (hormone replacement therapy) and Weight Management (a compounded semaglutide protocol).
We are not a marketplace, a referral service, or an algorithmic intake funnel. A U.S.-licensed physician from MD Integrations reviews your intake, decides whether you're a clinical fit, writes the prescription, and stays with you through treatment.
MD Integrations is a board-certified physician practice dedicated to Therisse patients. Every prescriber is board-certified and licensed in the state where you live.
No nurse practitioners reviewing checklists. No bots. The name on your chart is the person making the clinical call.
Yes. We're LegitScript-certified, which means our telehealth practice and pharmacy partner are audited and monitored against national standards for licensure, safety, and advertising.
Our medications are dispensed by Strive Compounding Pharmacy, a triple-accredited 503A pharmacy regulated by state pharmacy boards. We're transparent about who prescribes (MD Integrations), who dispenses (Strive), and who operates the platform (Ironoak Holdings LLC).
All 50 states and Washington, D.C. A few states require a brief video visit before an initial prescription; we'll flag that during intake if it applies to you.
If you move to a state where MD Integrations isn't licensed (this is rare and changes frequently), we'll work with you to transition care and refund any unused subscription period.
HRT
A personalized hormone replacement protocol — typically some combination of bioidentical estradiol, progesterone, and (where clinically indicated) testosterone — compounded for your specific dose by Strive Pharmacy.
Most patients use a transdermal estradiol cream or patch and oral micronized progesterone. The specific formulation, dose, and route are determined by your prescriber based on your symptoms, history, and goals.
It's complicated and we'll be honest. Compounded medications are not individually FDA-approved, but they are prepared by licensed compounding pharmacies under pharmacist supervision and state pharmacy board oversight. The active ingredients themselves (estradiol, progesterone) are FDA-approved drugs that have been used in millions of women for decades.
If you'd prefer a commercially manufactured, FDA-approved product (such as a brand-name patch), your physician can prescribe one — though we may not be able to fulfill it through Strive and you may need to use a retail pharmacy.
One charge every 90 days, on the day your next shipment goes out. Free shipping is included. There is no separate fee for messaging, dose adjustments, or refills within your subscription.
If you cancel mid-quarter, you keep the medication that's already shipped and you're not charged again. There are no cancellation fees, ever.
Not to start. The decision to begin HRT is made primarily on symptoms, history, and risk factors — current ACOG and NAMS guidance does not require baseline labs for the average symptomatic patient under 60.
Your physician may order labs later if there's a specific clinical reason (e.g., unexplained bleeding, persistent symptoms, monitoring testosterone). You'd pay the lab directly; we don't mark up lab work or bundle it into the subscription.
Then your physician won't prescribe it. The $49 visit fee is refunded within 48 hours, and there are no further charges.
Common reasons we don't approve someone include certain hormone-sensitive cancers, unmanaged cardiovascular conditions, or symptoms that warrant in-person workup we can't do over telehealth. We'll explain why and, where possible, suggest who you should see next.
Weight Management
Compounded semaglutide combined with B12 (cyanocobalamin) and glycine, administered as a once-weekly subcutaneous injection. Your physician titrates the dose monthly based on your response and tolerability.
We include a starter kit with syringes and instructions. A sharps disposal container is recommended (~$15, sold separately at any pharmacy).
Glycine is an amino acid we add as a stabilizer; it has no notable pharmacological effect at compounded concentrations. B12 is included because GLP-1 medications can mask or exacerbate B12 deficiency, particularly in women over 40, and many of our patients are already marginally low.
Neither B12 nor glycine alters the mechanism of semaglutide. The combination is a common 503A compounding choice for tolerability and shelf stability.
The active ingredient — semaglutide — is the same. Ozempic® and Wegovy® are FDA-approved, commercially manufactured products from Novo Nordisk. Our medication is compounded semaglutide, prepared by a licensed 503A pharmacy.
Therisse is not affiliated with or endorsed by Novo Nordisk. Ozempic® and Wegovy® are registered trademarks of Novo Nordisk A/S.
Probably, if you're a clinical fit and you stay on the protocol. In published trials of semaglutide for weight management, average weight loss over 68 weeks ranged from roughly 10% to 15% of body weight, depending on dose and adherence.
Outcomes vary based on starting weight, dose, side-effect tolerance, sleep, stress, and diet. Some women lose more, some lose less, some plateau and need a dose change. We don't promise an outcome — we promise an honest titration and a prescriber who returns your messages.
The most common side effects are nausea, constipation, reflux, and fatigue, particularly in the first few weeks and when titrating up. Most are mild and improve. We start low and increase slowly for this reason.
Less common but more serious risks include pancreatitis, gallbladder issues, and rare hypoglycemia. Your physician will screen for risk factors during intake and review every week of titration with you. If something feels wrong, message us — don't wait for your next check-in.
Billing & logistics
$49. That's the visit fee. We charge it after you complete intake, and we refund it within 48 hours if your physician determines you're not a clinical fit.
Nothing else is charged until your prescription is approved and your subscription starts.
No. We don't bill insurance for visits or medication, and we don't accept HSA/FSA for compounded products.
We chose this because insurance reimbursement on compounded HRT and weight management is unreliable and adds weeks of paperwork. Charging cash directly lets us keep visits short, prescribers focused, and pricing transparent.
From physician approval, Strive Pharmacy typically dispenses within 2 business days and your shipment arrives within 3–5 business days. Most patients receive their first delivery within a week of finishing intake.
You'll get tracking the moment it ships. All packaging is plain, unmarked, and discreet.
From your account, in two clicks. No phone tree, no retention specialist, no "are you sure" loop. We don't charge cancellation fees, ever.
If you cancel mid-period, you keep what's already been shipped and you're not charged again. If you change your mind, you can restart any time without redoing intake.
If your card fails, we'll retry once and then pause your subscription — we don't lock you out or send to collections. You can update payment from your account and we'll release your next shipment.
If you move to a state where your prescriber isn't licensed, we'll help transition care and refund any unused subscription period prorated to the day of the move.
Yes. All clinical communication — intake, messaging, video visits, chart notes — is HIPAA-compliant and stored in encrypted infrastructure that meets BAA standards.
We never sell or share your protected health information with advertisers, brokers, or third parties for marketing. Our full HIPAA Notice of Privacy Practices is linked in the footer.
Question not answered?
The intake covers most clinical questions — your physician answers the rest in writing.