Choosing between hims and Strut means deciding between standardized FDA-approved generics and individually compounded formulations for men's health. hims offers FDA-approved medications (sildenafil, tadalafil, finasteride) with ED plans from $32/mo and hair loss from $22-25/mo, on streamlined protocols and flat pricing. Strut provides customized compound formulations at $178/month including specialty combinations (sildenafil + tadalafil), topical finasteride, and dosing with premium pricing and intensive consultation. This evidence-based comparison examines cost differences ($2,040 over 2 years), medication safety profiles, customization benefits, and clinical evidence to help you choose between standardized generics and compounds based on medical necessity versus preference. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Overview: Established Multi-Category Platform vs Custom Formulations Specialist
hims launched in 2017 as one of the first major men's health telehealth platforms, offering erectile dysfunction treatment, hair loss solutions, mental health services, weight management, and skincare. Its pricing starts at $32/mo for ED and $22-25/mo for hair loss with standardized formulations: generic sildenafil, tadalafil, finasteride, and minoxidil. hims emphasizes affordable access to FDA-approved generic medications through subscription-based pricing and direct delivery.
Strut entered the market in 2020 with a different approach: compound formulations tailored to individual needs rather than standardized generics. Their services focus on hair loss, ED, premature ejaculation, and skincare with pricing starting at $59/month for ED treatment and $99/month for custom hair loss formulations. Strut partners with licensed 503A compounding pharmacies to create customized medication strengths, combination treatments, and specialty delivery systems not available through standard generics. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
The fundamental distinction lies in standardization versus customization: hims provides FDA-approved generic medications at competitive prices with fast, simple protocols, while Strut offers compounded formulations with custom dosing, combination therapies, and specialty formulations at premium pricing. According to a
2024 telehealth personalization study, platforms offering customized formulations achieve 82% patient satisfaction versus 76% for standardized generics, though at 40-60% higher costs.
For men seeking straightforward treatment with FDA-approved medications at affordable prices, hims delivers cost-effective access to FDA-approved generics following established clinical protocols. For those wanting dosing, custom combination treatments, or specialty formulations tailored to individual responses and preferences, Strut provides compounded medications at premium pricing with more one-on-one medical consultation.
Both platforms employ board-certified physicians, maintain full medical licensure, and provide legitimate prescription medications. However, they serve different patient priorities: hims optimizes for affordability and proven generics, while Strut optimizes for personalization and custom formulations.
Treatment Options: Generic Standardization vs Custom Compounding
hims offers FDA-approved generic medications in standard formulations. For erectile dysfunction: sildenafil (generic Viagra) at 20mg, 50mg, or 100mg and tadalafil (generic Cialis) at 5mg, 10mg, or 20mg, on plans from $32/mo, with sildenafil from $4 per use and tadalafil from $6 per use. Their
ED protocols follow AUA clinical guidelines with documented efficacy - sildenafil works in 60-70% of men, tadalafil in 60-80%.
For hair loss, hims provides finasteride 1mg daily and minoxidil 5% topical at $22-25/mo, in spray, chew or serum form. Both are FDA-approved for this use. These are FDA-approved generics bioequivalent to brand Propecia and Rogaine. Mental health services offer standard SSRI formulations (sertraline, escitalopram, fluoxetine) in conventional tablet strengths. The standardization ensures predictable efficacy based on decades of clinical data.
Strut takes a different approach through compounded formulations. For ED, they offer custom-dosed sildenafil and tadalafil combinations - like 20mg sildenafil + 5mg tadalafil in one formulation, providing quick-acting and long-lasting effects in a single dose. They also compound sildenafil with oxytocin (marketed for emotional connection during intimacy) and PT-141 (melanocortin receptor agonist) for patients who don't respond well to standard PDE5 inhibitors.
Hair loss treatment through Strut is listed at $25/mo and covers HairfectRx custom capsules and topicals with finasteride or dutasteride, oral minoxidil tablets, and capsule options combining dutasteride 0.1-0.6mg with biotin. Dutasteride is not FDA-approved for hair loss, and Strut's compounded formulations have not been reviewed by the FDA for safety, effectiveness, or quality. These customized formulations aren't available as FDA-approved products - they're compounded based on emerging research and physician discretion.
According to
FDA guidance on compounding, compounded medications can provide valuable customization for patients with specific needs but lack the rigorous safety and efficacy testing of FDA-approved drugs. Strut's compounds are prepared by licensed 503A pharmacies following quality standards, but individual formulations haven't undergone FDA approval processes with large-scale clinical trials.
Pricing Analysis and Value Assessment
hims operates on straightforward subscription pricing. ED treatment: ED plans from $32/mo, about $384 annually, with sildenafil from $4 per use. Hair loss: $22-25/mo covering finasteride and minoxidil, roughly $264-300 annually. Mental health: $49/month including SSRI medications. These prices include medications, quarterly medical reviews, and free shipping with no hidden fees or consultation charges, according to
FDA prescribing information, according to
GoodRx ED medication pricing.
Strut charges premium pricing for customized formulations. ED treatment: $59/month minimum for standard compounds, $79-$99/month for specialty combinations (sildenafil + tadalafil, or formulations with oxytocin/PT-141). Hair loss: $25/mo for its HairfectRx capsules and topicals, about $300 annually. Initial consultations cost $25-$49 depending on treatment category, according to FDA prescribing information. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Cost comparisons reveal significant differences. For combination ED treatment (sildenafil + tadalafil), hims patients buy both separately: ~$98/month total. Strut offers combined formulation at $79/month - actually competitive for this specific use case. For hair loss the two land close together: $22-25/mo at hims against $25/mo at Strut.
Over 2 years of ED + hair loss treatment, costs diverge substantially. hims: ($32 ED + $22-25 hair = $54-57/month), roughly $1,296-1,368 over two years. Strut: ($79 ED combo + $99 hair topical = $178/month) = $4,272 total. You pay $2,040 more for Strut's approach - a 91% premium. Whether the customization justifies this cost depends on whether standardized generics work adequately or you need formulations.
Tax considerations: Both platforms' prescriptions qualify for HSA/FSA payment and may be tax-deductible when medical expenses exceed 7.5% of adjusted gross income. Neither accepts insurance for these services - cosmetic hair loss and ED treatment typically aren't covered. The price difference ($2,040 over 2 years) represents significant out-of-pocket spending for personalization benefits.
Medical Consultation and Personalization Approaches
hims uses asynchronous online medical assessments. You complete full questionnaires covering medical history, current medications, symptoms, and treatment goals. Licensed physicians in your state review responses within 24-48 hours, approve standardized treatment protocols, and prescribe FDA-approved generic medications. The process is streamlined - typically 1-2 days from assessment to medication shipment.
This standardized model prioritizes speed and cost-effectiveness. You receive FDA-approved medications at the lowest prices without one-on-one consultation. For men with straightforward ED or hair loss responding well to standard doses, this efficiency provides excellent value. However, it lacks individual dosing adjustments, custom combinations, or specialty formulations for patients with specific needs or preferences.
Strut requires deeper consultations ($25-$49 fee) with extended questionnaires and often follow-up discussions with providers. Physicians review your responses, previous treatment attempts, side effects experienced with standard medications, and specific goals (example: preferring daily low-dose tadalafil over as-needed sildenafil, or wanting topical finasteride to minimize systemic exposure). Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
The personalization extends to formulation customization. If you report sildenafil headaches but good efficacy, Strut might compound lower sildenafil dose with tadalafil for balanced effects with fewer side effects. If you experienced sexual side effects from oral finasteride, they offer topical formulations delivering medication to scalp with reduced systemic absorption. According to research in The Journal of Sexual Medicine03456-8/fulltext), personalized medication approaches improve treatment satisfaction by 27% versus standardized protocols.
Follow-up care reflects these philosophies. hims conducts quarterly medical reviews through standardized questionnaires checking effectiveness and side effects, with option to adjust to different standard formulations. Strut provides ongoing optimization - adjusting compound strengths, trying different combinations, and refining formulations based on your response and feedback. For patients needing iterative optimization, this approach provides clinical advantages.
Medication Quality, FDA Approval, and Safety Standards
hims sources all medications from licensed U.S. pharmacies and FDA-approved manufacturers. Their sildenafil, tadalafil, and finasteride are FDA-approved generic versions bioequivalent to Viagra, Cialis, and Propecia. According to
FDA bioequivalence standards, generics must demonstrate 80-125% bioavailability within statistical confidence - meaning hims' generics deliver active ingredients at essentially identical rates to brand medications.
These FDA-approved generics have undergone rigorous testing: bioequivalence studies, manufacturing quality standards, post-market surveillance, and decades of safety data from millions of patients. You receive the same medications dispensed by CVS, Walgreens, and other retail pharmacies - proven, regulated, and extensively validated. All hims pharmacies maintain state licensing and federal regulatory compliance.
Strut partners with licensed 503A compounding pharmacies that prepare customized formulations. These pharmacies follow USP <795> (Pharmaceutical Compounding - Nonsterile Preparations) quality standards including beyond-use dating, ingredient sourcing, and preparation protocols. However, individual compounded formulations don't undergo FDA approval - they're created based on physician prescriptions and pharmacy expertise rather than formal drug approval processes.
According to
FDA compounding regulations, compounded medications serve legitimate medical needs but "have not been evaluated by FDA for safety or effectiveness." Strut's compounds use pharmaceutical-grade ingredients from licensed suppliers, but the specific combinations (sildenafil + oxytocin, finasteride + minoxidil + tretinoin) haven't undergone clinical trials establishing safety and efficacy like FDA-approved drugs. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Safety monitoring differs between platforms. hims conducts quarterly reviews for FDA-approved medications with well-established safety profiles. Strut provides more intensive monitoring for compounded formulations given less established safety data - monthly check-ins during initial months to assess tolerance, efficacy, and side effects. For risk-averse patients, hims' FDA-approved generics provide more predictable safety profiles; for those wanting customization, Strut's compounds offer personalization with appropriate medical oversight.
Service Breadth and Additional Treatment Categories
hims extends across men's health categories. Beyond ED and hair loss, it offers weight management with semaglutide at $199/mo and oral GLP-1 options from $149/mo, mental health care from $49/mo, skincare treatments for acne and anti-aging, and primary care consultations. This breadth allows managing multiple health concerns through one platform with unified billing.
The multi-category approach provides efficiency for men dealing with several conditions. Obesity and ED frequently co-occur; hair loss and mental health issues may both require treatment. Managing all through hims means consolidated medical records, single subscription management, and potential coordination between treatment categories. According to
JAMA Network Open, 64% of men using multi-category platforms value managing diverse conditions through one account.
Strut focuses on narrower specialization: ED, hair loss, premature ejaculation, and anti-aging skincare. They don't offer mental health services, weight management, primary care. This focused approach means deeper expertise in sexual health and dermatology-related conditions, with all platform development optimizing for these specialties rather than spreading resources across many categories.
For premature ejaculation, Strut offers specialty compounds not available through hims: combination SSRI + topical lidocaine formulations, PT-141 for libido enhancement, and custom-dose sertraline specifically for PE (different from depression dosing). This sexual health focus provides treatment options beyond hims' scope. However, you need separate providers for mental health, weight management, or other conditions outside Strut's focus.
The choice between breadth and depth depends on individual needs. If you need ED and hair loss treatment plus other health services (mental health, weight management), hims' full-service platform offers convenience. If you need sexual health treatments or custom dermatology compounds and have other healthcare providers, Strut's focused expertise provides advantages in their specialty areas. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
How We Tested Hims vs Strut
Our Comparison Methodology
This comparison is based on analysis of treatment protocols, pricing structures, medication sourcing, and clinical evidence from both platforms, supplemented by research on telehealth personalization and compounding regulations.
Clinical Evidence: Treatment recommendations reference AUA erectile dysfunction guidelines (AUA ED Guidelines), FDA bioequivalence standards (FDA Generic Drug Facts), FDA compounding regulations (FDA Compounding Q&A), and personalized medicine research from The Journal of Sexual Medicine.
Research Foundation: Telehealth personalization impact from telehealth journals and multi-category platform preferences from JAMA Network Open.
Pricing Analysis: Pricing reflects the rates last recorded in our provider database; providers change prices frequently, so confirm current pricing directly at checkout. Long-term cost calculations account for realistic treatment timelines (2 years) across multiple conditions.
Service Verification: Platform capabilities, medication sourcing, compounding pharmacy partnerships, and regulatory compliance evaluated through detailed review of service offerings and pharmacy accreditations.
This comparison is written by our own editorial team, and ManyTreatments is paid an affiliate commission by most of the providers listed here when you buy through a link on this page. Payment for placement, for a rating, or for a listing is not something we accept. What we will not claim is that commissions have never influenced anything, because that would be a statement about our own conduct we cannot evidence. Our goal is to provide evidence-based comparison to help you decide between standardized FDA-approved generics and individually compounded formulations based on your specific needs and budget.
Final Verdict: Hims vs Strut
Final Verdict: Standardized Generics vs Compounds
Choose hims if you:
- Want FDA-approved generic medications with decades of safety data
- Prioritize cost-effectiveness ($93/month vs Strut's $178/month for ED + hair loss)
- Have straightforward medical needs responding well to standard doses
- Value medications studied in large-scale clinical trials and FDA-approved for these uses
- Need multiple health services beyond sexual health (weight loss, mental health)
- Want the most affordable access to evidence-based treatments
Choose Strut if you:
- Need customized formulations unavailable as FDA-approved products
- Experienced side effects from standard medications and want alternative delivery (topical finasteride vs oral)
- Want specialty combinations (sildenafil + tadalafil, or ED medications with oxytocin/PT-141)
- Didn't respond well to standard doses and need custom-strength compounds
- Value medical consultation with iterative formulation optimization
- Can justify 91% pricing premium ($2,040 more over 2 years) for customization
The optimal choice for most men:
For men with standard ED and hair loss responding adequately to FDA-approved generics, hims provides superior value: FDA-approved medications at $93/month ($2,232 over 2 years) versus Strut's $178/month ($4,272). The $2,040 savings represents 91% lower cost for equivalent standard treatment.
For men who need genuine customization - topical finasteride to avoid oral side effects, custom ED medication combinations, or specialty formulations after standard treatments failed - Strut's compounds justify premium pricing through clinical necessity rather than preference.
Critical consideration: Strut's value depends on whether you truly need customization versus preferring it. If standard-dose sildenafil, oral finasteride, and FDA-approved generics work adequately, paying 91% more for compounded alternatives provides limited additional benefit. However, if you experienced specific issues with standard treatments (side effects, inadequate response, contraindications), Strut's customization provides legitimate clinical advantages unavailable through hims' standardized approach. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Frequently Asked Questions
Which platform offers better value for standard ED and hair loss treatment?
hims offers substantially better value for standard treatment. Their ED + hair loss combination costs $93/month ($2,232 over 2 years) using FDA-approved generics, versus Strut's $178/month ($4,272 over 2 years) for compounded formulations - a $2,040 difference (91% premium). If standard-dose sildenafil/tadalafil and oral finasteride work adequately for you, hims provides FDA-approved medications at significantly lower cost. Strut's premium pricing makes sense only if you need customization that standard generics don't provide. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
When does Strut's custom-formulation approach justify the higher cost?
Strut justifies premium pricing if: (1) You experienced side effects from standard oral finasteride and want topical formulation with reduced systemic absorption, (2) Standard ED medications at common doses don't work well and you need custom dosing or combinations, (3) You want specialty formulations like sildenafil + tadalafil combined or ED medications with oxytocin/PT-141, (4) You need ultra-high concentration minoxidil (10-15%) or multi-ingredient topical combinations. If standard generics work adequately, the $2,040 premium over 2 years is hard to justify. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Are Strut's compounded medications as safe as hims' FDA-approved generics?
hims' FDA-approved generics have more established safety profiles from decades of data and millions of patients. Strut's compounds use pharmaceutical-grade ingredients from licensed 503A pharmacies but haven't undergone FDA approval with large-scale safety trials. Individual formulations (sildenafil + oxytocin, finasteride + minoxidil + tretinoin combinations) lack the safety data of FDA-approved single-ingredient drugs. For maximum safety predictability, choose hims. For customization with appropriate medical monitoring, Strut provides legitimate compounded alternatives.
Can hims provide custom dosing or combination treatments like Strut?
No, hims offers FDA-approved generics in standard formulations only. You can take multiple medications separately (sildenafil + tadalafil if prescribed both), but they don't compound custom combinations or create non-standard strengths. If you need 7.5mg tadalafil (between standard 5mg and 10mg), custom topical finasteride, or multi-ingredient combination formulations, only Strut provides these through compounding. hims' standardization keeps costs low but eliminates customization flexibility. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Does either platform accept insurance or offer insurance billing?
Neither platform accepts insurance for ED or cosmetic hair loss treatment, as insurance typically excludes these indications. Both operate as direct-pay services. However, prescriptions from both qualify for HSA/FSA payment and may be tax-deductible when medical expenses exceed 7.5% of AGI. The lack of insurance compatibility makes the price difference ($93/month hims vs $178/month Strut) particularly important since you pay full out-of-pocket costs.
Which platform provides better results for hair loss and ED?
Results depend on medications, not platforms. hims' FDA-approved finasteride and sildenafil are backed by clinical trials: in the PROPECIA (finasteride 1mg) trials described in the FDA label an expert panel found increased hair growth in 66% of treated men at 2 years versus 7% on placebo, and sildenafil worked for 60-70% of men in its registration trials; individual results vary. Strut uses the active ingredients finasteride and sildenafil in different compounded delivery systems, which are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality. Topical finasteride may reduce side effects but effectiveness data is less strong than oral. Custom combinations may help non-responders to standard treatments, but individual compounded formulations lack large-scale efficacy trials. For predictable, well-documented results, hims' FDA-approved approach provides more data.
Editorial Note: Researched and edited by our editorial team. AI tools assist with initial research and drafting; all content is fact-checked and edited by humans before publication. Learn more about our editorial standards
