Strut Health Company Overview & Business Model: An Independent Clinical Review

What Is Strut Health and How Does It Work?

Strut Health is a direct-to-consumer telehealth company that connects patients with licensed prescribers through an asynchronous online intake process. Patients complete a structured health questionnaire, upload photos where relevant (for hair loss, for example), and a physician or physician assistant reviews the submission and issues a prescription if appropriate. There is no live video call required, though synchronous consultations may be offered for complex cases.

The pharmacy model relies on compounding. Most of what Strut dispenses is not an FDA-approved finished drug product. Instead, licensed 503A compounding pharmacies prepare formulations to order. This distinction matters clinically and legally, and patients should understand it before enrolling.

The Asynchronous Model: Efficiency vs. Oversight

Asynchronous telehealth reduces cost and increases access. A 2022 systematic review in the Journal of Telemedicine and Telecare found that asynchronous models produced comparable patient satisfaction scores to synchronous visits for dermatologic and sexual health conditions, though evidence on long-term clinical outcomes remains limited (1).

The trade-off is reduced real-time clinical interaction. A prescriber reviewing a questionnaire cannot perform a physical exam, palpate the scalp, or directly observe the pattern of hair loss. For androgenetic alopecia, this limitation is generally acceptable because diagnosis relies primarily on pattern recognition. For ED with potential cardiovascular co-morbidities, the absence of a direct exam carries more weight, and patients should be aware that PDE5 inhibitors carry contraindications that a questionnaire alone may not fully surface.

Compounding Pharmacy Network

Strut routes prescriptions to 503A compounding pharmacies. Under FDA guidance, 503A pharmacies prepare drugs for individual patients based on a valid prescription and are not required to undergo the same pre-market approval process as commercial drug manufacturers (2). This means Strut's combination topical finasteride-minoxidil formulas, for example, have not individually gone through FDA efficacy trials. The clinical evidence underlying the individual active ingredients, however, is strong and reviewed in detail below.

Is Strut Health Legitimate?

Strut Health operates within the legal framework governing telehealth prescribing and pharmaceutical compounding in the United States. The company is not a scam or rogue operation. Legitimacy has layers, and patients deserve a clear-eyed assessment.

Prescriber Licensure

Strut's prescribers hold active state licenses and are subject to the same Medical Practice Acts as brick-and-mortar physicians. The platform states that all consultations are reviewed by a licensed provider before a prescription is issued. Independent verification of individual prescriber credentials is possible through state medical board websites.

Compounding Pharmacy Accreditation

The compounding pharmacies Strut uses carry PCAB (Pharmacy Compounding Accreditation Board) accreditation, which signals adherence to quality standards beyond minimum state board requirements. PCAB accreditation is voluntary and not a federal requirement, but its presence indicates a pharmacy has passed third-party sterility, potency, and labeling audits.

Regulatory Gray Areas

Where Strut, like all compounding-focused telehealth platforms, operates in regulatory gray territory is in off-label combination formulations. The FDA has stated clearly that compounded drugs are not FDA-approved, and the agency has issued warning letters to some compounders promoting specific unapproved combinations (3). Patients should ask their Strut prescriber whether the specific formulation they are receiving has published efficacy data, and this article answers that question for the most common categories below.

What Does Strut Health Prescribe?

Strut's catalog covers four main areas: androgenetic alopecia (AGA) in men, erectile dysfunction, peptide therapies, and a women's health line. The clinical evidence supporting each area varies considerably.

Men's Hair Loss: Finasteride, Minoxidil, and Combination Topicals

This is Strut's highest-volume category and the area where its compounding model offers the clearest clinical rationale.

Oral finasteride is a 5-alpha reductase inhibitor approved by the FDA in 1997 at 1 mg daily for male AGA. In a 2-year randomized controlled trial (N=1,553), finasteride 1 mg/day produced a statistically significant increase in hair count versus placebo (P<0.001) and was rated as improved or greatly improved by 66% of men at 24 months compared with 7% on placebo (4).

Topical minoxidil (2% and 5% solutions) is FDA-approved for men. A Cochrane review of 26 trials confirmed that topical minoxidil 5% is more effective than 2% for scalp hair regrowth, with the 5% formulation showing greater hair counts at 48 weeks (5).

Combination topical finasteride-minoxidil is where Strut differentiates itself from pharmacy retail. A 2021 randomized trial (N=458) published in JAMA Dermatology found that topical finasteride 0.25% plus minoxidil 3% produced greater hair density improvement than either agent alone at 24 weeks, with systemic DHT suppression significantly lower than oral finasteride (P<0.001) (6). This matters for men concerned about sexual side effects, since lower systemic DHT reduction may correspond to a lower side-effect burden, though long-term data on this point are limited.

Strut's topical combination formulas are compounded versions of this concept. They are not the exact product studied in the JAMA Dermatology trial, but they use the same active ingredients at comparable concentrations. Patients should ask for the certificate of analysis for potency and sterility from the dispensing pharmacy.

Erectile Dysfunction: Sildenafil, Tadalafil, and Combination Options

Strut prescribes both sildenafil (generic Viagra) and tadalafil (generic Cialis). Both are FDA-approved PDE5 inhibitors with decades of safety data.

Tadalafil 5 mg daily is FDA-approved for both ED and benign prostatic hyperplasia. A meta-analysis of 16 RCTs (N=3,284) found daily tadalafil 5 mg produced a mean International Index of Erectile Function (IIEF) score improvement of 6.5 points versus 1.3 for placebo (7).

Sildenafil carries a contraindication with nitrate medications and requires caution in men with hypotension or recent cardiovascular events. Strut's questionnaire screens for nitrate use, but patients should be transparent and complete in disclosing all medications, particularly poppers (amyl nitrate), which many men do not classify as "medications."

The FDA prohibits certain compounded sildenafil formulations under the Demonstrably Difficult to Compound list, so Strut's ED offerings are primarily standard oral tablets rather than novel compounded forms.

Peptide Therapies: Semaglutide, Sermorelin, and Others

Strut has expanded into GLP-1 receptor agonists (specifically compounded semaglutide) and growth hormone secretagogues like sermorelin. This is the area requiring the most caution.

Compounded semaglutide: The FDA placed semaglutide on its shortage list, which temporarily permitted 503A compounders to prepare semaglutide formulations. As of 2025, FDA has declared the shortage resolved and issued guidance that most 503A pharmacies must cease compounding semaglutide (8). Patients enrolled in Strut's semaglutide program should ask directly whether their dispensing pharmacy is still legally permitted to compound this drug. The efficacy data for branded semaglutide 2.4 mg (Wegovy) is strong: in STEP-1 (N=1,961), participants lost a mean 14.9% of body weight at 68 weeks versus 2.4% with placebo (9). Whether compounded semaglutide at varying concentrations and salt forms achieves the same outcomes is not established.

Sermorelin is a growth hormone-releasing hormone analog. It is FDA-approved as an injectable for pediatric growth hormone deficiency but is prescribed off-label by many anti-aging clinics for adult men. Evidence for sermorelin in healthy adults for body composition or recovery is limited to small, short-duration trials. The Endocrine Society's 2019 clinical practice guideline on growth hormone use in adults does not endorse GH secretagogues for anti-aging purposes outside of diagnosed adult GH deficiency (10).

Strut's peptide offerings reflect a broader industry trend toward prescribing compounds with thin evidence bases through telehealth channels. This does not make them illegal, but patients should calibrate expectations accordingly.

How Much Does Strut Health Cost?

Strut operates on a cash-pay model. There are no insurance claims, no copays, and no prior authorizations.

Pricing by Category

| Treatment | Approximate Monthly Cost | |---|---| | Oral finasteride 1 mg | $30, $50 | | Topical finasteride-minoxidil combo | $45, $75 | | Oral minoxidil | $25, $45 | | Tadalafil daily 5 mg | $35, $60 | | Sildenafil as-needed | $30, $55 | | Compounded semaglutide (where available) | $200, $400 | | Sermorelin injectable | $150, $350 |

These are estimates based on publicly available pricing at time of publication. Prices may change, and promotional first-month discounts are common.

The consultation fee is typically included in the first order or charged separately at approximately $15, $25. This is meaningfully lower than an office visit copay for most insured patients, and far lower than the out-of-pocket cost of a specialist visit for uninsured patients.

Cost vs. Branded Alternatives

Branded finasteride (Propecia) retailed at approximately $70, $100/month before generic entry. Generic finasteride from retail pharmacies now runs $10, $30/month through discount programs like GoodRx, which makes Strut's oral finasteride pricing competitive but not dramatically cheaper than retail generics. The value proposition increases with combination formulas, which are not commercially available.

Strut Health vs. Alternatives

The telehealth hair and sexual health space is crowded. The table below positions Strut against its three most frequently compared competitors across the dimensions that matter clinically.

| Dimension | Strut Health | Hims | Keeps | Roman | |---|---|---|---|---| | Consultation style | Async questionnaire | Async + optional video | Async questionnaire | Async + optional video | | Compounding model | Yes (503A) | Yes (limited) | No (retail only) | Limited | | Combination topicals | Yes | Yes | No | No | | Peptides / GLP-1 | Yes | Limited | No | No | | Women's health | Yes | Yes | No | Yes | | Insurance | No | No | No | No | | PCAB-accredited pharmacy | Stated yes | Varies | N/A | Varies | | Branded drug option | Limited | Yes | Yes | Yes |

Where Strut Has an Advantage

Strut's edge is in compounded combination formulations and peptide offerings. For men who want a topical finasteride-minoxidil combo without systemic finasteride exposure, Strut and Hims are the primary telehealth channels. Keeps and Roman do not offer compounded combination topicals.

Where Strut Has Limitations

Strut does not offer FDA-approved branded drugs as a primary option in most categories. Patients who specifically want Propecia (branded finasteride) or Rogaine (branded minoxidil) for brand-confidence reasons will not find them through Strut. The compounding model also means that if a specific pharmacy loses accreditation or the FDA changes compounding rules (as it did with semaglutide in 2025), Strut's product lineup can change abruptly.

When a Traditional Dermatologist May Be Preferable

For men with atypical hair loss patterns (patchy loss, rapid onset, diffuse thinning without family history), a teledermatology platform or in-person dermatologist visit is more appropriate than any direct-to-consumer hair loss service. The American Academy of Dermatology guidelines on alopecia recommend ruling out thyroid dysfunction, iron deficiency, and autoimmune conditions before initiating AGA treatment (11). A questionnaire-based platform will not order bloodwork unless the prescriber specifically requests it, and not all Strut consultations will include lab screening.

What Do Patient Reviews Say, and How Should You Weight Them?

Patient reviews of Strut Health on Trustpilot and Google average 4.2 to 4.5 stars across several hundred reviews, with high marks for shipping speed, packaging, and communication. Critical reviews cluster around two themes: unexpected price increases after promotional periods end, and difficulty canceling auto-ship subscriptions.

Neither praise nor criticism in consumer reviews constitutes clinical evidence. Hair regrowth timelines are long (meaningful response to finasteride and minoxidil typically requires 6 to 12 months of consistent use), so many short-duration reviews reflect product experience rather than clinical outcome.

A 2023 study in the Journal of the American Academy of Dermatology found that patient adherence to topical hair loss medications dropped below 50% at 12 months in men using retail products, primarily due to cost and inconvenience (12). Subscription-based delivery models like Strut's may improve adherence, though this specific platform has not been studied directly.

Clinical Bottom Line: Who Should Consider Strut Health?

Strut Health is a reasonable entry point for otherwise healthy men seeking evidence-supported treatments for androgenetic alopecia or ED who want a low-friction, lower-cost pathway to a prescription. The clinical evidence for the individual active ingredients in its hair and ED formulas is solid, even when the specific compounded formulations have not been independently trialed.

Men with cardiovascular comorbidities, multiple medications, atypical hair loss patterns, or interest in peptide therapies should either use Strut in conjunction with an existing primary care relationship or see a specialist directly. The asynchronous model works best when the diagnosis is straightforward and the safety screening needs are limited.

Patients considering Strut for compounded semaglutide should verify current FDA compounding status before enrolling, as the regulatory situation for GLP-1 compounding shifted materially in early 2025.

The Endocrine Society's position on telehealth for hormone therapy, stated in its 2023 clinical practice update, is that "telehealth can be appropriate for hormone therapy management when a complete medical history is obtained, contraindications are screened, and follow-up monitoring is ensured" (13). Strut's model meets the history and screening criteria for most of its hair and ED offerings, but follow-up monitoring is patient-initiated rather than scheduled, which places responsibility on the patient to report side effects or lack of response.

Ask your Strut prescriber to specify the monitoring interval and the criteria that would prompt a prescription adjustment. For finasteride users, a baseline PSA at age 40 or older is recommended by the American Urological Association before initiating a 5-alpha reductase inhibitor (14).